| BackgroundCoronary artery bypass grafting(CABG),is one of the most efficient treatment of coronary heart disease.Patients with CABG should take medicine,keep proper exercise,eat moderately and maintain a series of cardiac rehabilitation training.Patients are prone to have negative emotions such as anxiety and depression after surgery and are worried about their self-rehabilitations after discharge.Therefore,we should emergently focus on how to effectively evaluate the readiness,do well in the safe transition of patients during the transition period,improve patients’ self-care ability after discharge and reduce readmission rate and complication rate.Researches at home and abroad prove that discharge plan is an important nursing intervention to reach the smooth transition from hospital to community or home for patients.Discharge guidance based on information-motivation-behavior(IMB)model was used for patients with CABG before discharge in this research.The aim is to improve the discharge readiness,achieve the smooth transition of continued nursing in transition period,prevent or postpone coronary artery restenosis and thrombus outcomes and improve patients’ life quality and self-care ability at home.ObjectsWe aimed to establish and carry out a discharge guidance scheme based on IMB model.Impacts such as discharge readiness,quality of discharge guidance and satisfaction of nursing service of patients with coronary artery bypass grafting(CABG)was explored.Therefore,we hope to provide theoretical basis and practical guidance to improve the quality of clinical care and the conducting of continued nursing in transition period.MethodsBased on investigating the continued nursing’s needs of patients who received coronary artery bypass grafting(CABG),this study developed a discharge guidance plan(preliminary revision)based on the information-motivation-behavior(IMB)model by consulting relevant domestic and foreign literature and combining the opinions and suggestions of relevant experts.The discharge guidance plan(final version)based on the IMB model is formed after preliminary experiment and revision.Convenience sampling method was used to select 180 CABG patients who met the standards from a hospital in Zhengzhou.They were randomly divided into experimental group(89 cases)and control group(91 cases)by hospitalization sequence using random number table method.Patients in control group received cardiac surgery’s usual care and standard discharge guidance while patients in experimental group were given cardiac surgery’s usual care and discharge guidance based on IMB model.Collecting patients’ general information at the time of enrollment and evaluating discharge readiness,quality of discharge guidance and satisfaction of nursing service the time of discharge.Statistical analysis was performed by using the spss22.0 statistical software.The discharge readiness,total scores of discharge guidance quality,and scores in each dimension of the two groups of patients were expressed as mean ± standard deviation(?).The comparison between two groups was tested by using independent sample t.Descriptive analysis,t-test,and Chi-squre(χ2)test were used to test general information and nursing work satisfaction;the correlation between discharge readiness and discharge guidance quality was measured by speraman correlation analysis,with α = 0.05 as the test level.Results1.Finally,87 patients in the intervention group and 88 in the control group completed the study.There was no statistically significant difference in patients’ age,gender,education,marital status,monthly family income,medical insurance type,etc.in both groups(P > 0.05).2.In the intervention group,the total scores of discharge readiness was(98.44 ± 2.70).Personal status,adaptability,and expected help,the three dimensions’ scores were(24.51 ± 0.96),(40.89 ± 1.94),and(33.05 ± 1.49).While in the control group,the total scores of discharge readiness was(89.89 ± 2.66).Personal status,adaptability,and expected help,the three dimensions’ scores were(22.09 ± 1.08),(37.02 ± 1.89),and(30.77 ± 1.61).Total score of discharge readiness and score of personal status,adaptability,and expected help was higher than those in control group(P < 0.05).3.The intervention group’s total scores of discharge guidance quality was(148.34±5.50).Scores of information needing,information gaining,skill guidance and results were(42.72±2.30),(49.13±2.05),and(99.22±5.17).In control group,they were(137.64±6.99),(42.77±2.31),(44.77±2.24),and(92.86±6.24).The difference was statistically significant.(P < 0.05)4.Discharge readiness of patients received coronary artery bypass grafting(CABG)in both groups were positively correlated with discharge guidance quality,the r values of the intervention group and the control group were 0.519(P <0.05)and 0.481(P <0.05),respectively.5.The nursing service satisfaction rate of patients in control group was 89.6% while it was 98.1% in experimental group and the difference was statistically significant(P < 0.05).Conclusions1.Discharge guidance based on information-Motivation-Behavioral Skill Model(IMB model)was constructed for patients with CABG.2.Discharge guidance scheme based on IMB model can improve discharge guidance quality of patients with CABG.3.Discharge guidance scheme based on IMB model can improve discharge readiness and nursing service satisfaction of patients with CABG,and provide a reference to improve the quality of clinical nursing and carry out the continuous nursing. |
