A Study On The Influence Of Shared Decision-Making Perception On The Compliance Of Home And Exercise-based Cardiac Rehabilitation In Patients With Percutaneous Coronary Intervention

Objective:The purpose of this study was to understand the status and influencing factors of home cardiac rehabilitation in patients with Percutaneous Coronary Intervention(PCI).Analyze the status of shared decision making(SDM),the status of coronary heart disease knowledge and self-management behavior,and the impact on patient's home cardiac exercise rehabilitation compliance.To explore the correlation between SDM perception and knowledge of coronary heart disease and self-management behavior.It provides theoretical basis and methodological reference for the similar intervention studies such as improving the compliance of patients with PCI and improving the SDM perception of PCI patients in the home and exercise-based cardiac rehabilitation program.Method:This study used a convenient sampling method to select patients who were treated in a third-grade hospital in Changchun from October 2017 to April 2018.According to the inclusion and exclusion criteria of the study subjects,300 subjects were selected.Survey tools include: general information questionnaire,decision participation expectation scale,shared decision scale,coronary heart disease knowledge scale,coronary heart disease self-management behavior scale,home cardiac exercise rehabilitation compliance telephone follow-up scale.Data is entered and analyzed using Epidata 3.1 and SPSS 24.0.Descriptive statistics were applied to the general data of the subjects using the frequency and composition comparison;the chi-square test was used to analyze the influence of the general demographic data of the subjects on the patient's home cardiac exercise rehabilitation compliance;Univariate logisticregression analysis was used to analyze the effects of shared decision-awareness,knowledge of coronary heart disease and self-management behavior on patient cardiac rehabilitation.Multivariate unconditional logistic regression was used to analyze the main influencing factors of patient's home cardiac exercise rehabilitation compliance.Pearson correlation analysis and/or Spearman correlation analysis were used to explore the correlation between shared decision perception and coronary heart disease knowledge level and self-management behavior.Result:(1)The study subjects' home heart movement rehabilitation compliance questionnaire was divided into 18.54±4.96 points,the items were all divided into3.09±0.83,and 64.66% of the patients(183 persons)had high compliance with home cardiac exercise rehabilitation.(2)The actual score of the SDM questionnaire is 12~45,with an average score of 28.87±7.77,and the average score is 3.21±0.86.(3)The actual score of the questionnaire for coronary heart disease knowledge questionnaire is 20~52 points,the average score is 38.19±6.57,the average score is0.73±0.13,the actual score of self-management behavior questionnaire is 42~122,and the average score is 80.51.±12.90,the average score is 2.98 ± 0.48.(4)Univariate analysis showed that the compliance of home cardiac exercise rehabilitation was at the age of the patient(p<0.01),the number of coronary interventions(p<0.05),the number of stent implantations(p<0.05),and the SDM perception(p<0.01),coronary heart disease knowledge level(p<0.01),self-management behavior(p<0.01)was statistically significant.(5)Multivariate analysis showed: patient's age(p<0.01),SDM perception(p<0.05),risk factors in the CHD knowledge questionnaire(p<0.01),predisposing factors(p<0.01),treatment(P<0.01),secondary prevention(p<0.01),and life management(p<0.05)and emotional management(p<0.05)in the self-administered behavior questionnaire were the main influencing factors affecting the compliance of cardiac heart movement rehabilitation in PCI patients.(6)The correlation analysis showed that the SDM perception was positively correlated with the patient's total score of coronary heart disease knowledge(p<0.01),and had no significant correlation with the patient's total score of self-management behavior.Conclusion:(1)Subjects at home have poor cardiac compliance and are at a moderately lower level.(2)The SDM perception level of the study subjects was lower;the knowledge level of coronary heart disease was better;the self-management level was poor.(3)The main influencing factors affecting the home's heart exercise rehabilitation are: patient's age,SDM perception,concept in coronary heart disease knowledge questionnaire,risk factors,predisposing factors,treatment methods and secondary prevention dimensions,and self-management behavior questionnaire.The dimension of life management and emotional management.(4)The SDM perception of the study subjects was positively correlated with the total knowledge of coronary heart disease knowledge,and there was no significant correlation with the patient self-management behavior.