Study On The Effect Of IMB Model Between Risk Perception And Medical Response In Patients With Coronary Heart Disease

ObjectiveTo investigate the current status of risk perception and medical response of coronary heart disease,to analyze the influencing factors and the relationship between the risk perception and medical response.On the basis of questionnaires’ results,combining the characteristics of coronary heart disease and related knowledge,develop appropriate IMB interventions,and evaluate the effects of IMB interventions on the risk perception,medical response and self-management behavior in patients with coronary heart disease.It might provide the basic references for nursing manager and clinical nurse of personalized psychological intervention and social support.Methods(1)From September to November 2016,A total of 317 coronary heart disease patients from 3 third-grade hospitals were asked to answer the questionnaires.The general data of patients with coronary heart disease were collected by self-made questionnaire,the risk perception questionnaire and medical response questionnaire were used to understand the current status and influencing factors between them.(2)Based on IMB Model theory,closely observed inclusion and exclusion criteria,88 patients from a third-grade hospital in the department of cardiology were selected,and randomly divided into treatment group(n=44)and control group(n=44).The patient in the control group were given with the routine care.In the intervention group,the patients were given the routine care and IMB Model intervention measures.Software package for statistical analysis 18.0 was used to analyze the date.The statistical methods ivolved the paired t test,c2test.and multivariate Logistic regression analysis.Expressed in P<0.05 or less difference was statistically significant.Results(1)The total score of risk perception with coronary heart disease patients was(39.79±7.94),the scores of three dimensions from the highest to the lowest were as following: economic risk(15.68±3.35),physical diagnosis and treatment risk(17.12±4.15),social psychological risk(6.99±2.39).Education background,sex,type of cost,account and working situation were the influencing factors of the risk perception,which can explain 38.9% of the total variance.(2)In the MCMQ,The score of face was(17.30±2.52),it was slightly lower than the national norm in patients with coronary heart disease(19.48±3.81).The scores of avoidance and yield were higher than national norm in patients with coronary heart disease(P<0.05).Personal monthlyincome and sex were the influencing factors of the face of medical response,which can explain 31.1% of the total variance.Disease course,working status,and education background were the influencing factors of the avoidance of medical response,which can explain 23.3% of the total variance.Type of cost,personal monthly income,working status and disease course were the influencing factors of the yield of medical response,which can explain 48.3%of the total variance.(3)Economic risk and the total score of risk perception were positive correlated to avoidance and yield(P<0.05),social psychological risk was positive correlated to yield.Economic risk and social psychological risk were the key factors that affects patient’s negative response.(4)Before the intervention,there were no significant differences of the demographic details,risk perception,self-made questionnaire and medical response between two groups(P > 0.05).(5)After 3 months’ intervention,in the intervention group the economic risk scores’(14.75±2.61)were slightly lower than those in the control group(15.83±1.76),the differences were statistically significant(P<0.05);scores of physical diagnosis and treatment risk(17.88±3.16)and social psychological risk(6.20±1.30)were compared with those in the control group,there were no statistically significant(P> 0.05).(6)After 3 months’ intervention,scores of the face in the intervention group were slightly higher than those in the control group,while scores of theavoidance and yield were slightly lower than those in the control group,the differences were statistically significant(P<0.05);the scores of self management behaviour were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusions(1)The coronary heart disease patients were at high risk perception level.Education background,sex,type of cost,account and working situation were the influencing factors of the risk perception.(2)Patients with coronary heart disease were more inclined to avoidance and yield to the stressful event of disease.(3)The intervention based on IMB can effectively reduce overall level of risk perception and improve the self-management behavior of the disease,prompt the patient to face the disease with a positive attitude.