Influencial Factors For In-hospitalized Patients With Acute Myocardial Infarction:Results From Risk Factors Self-management Program Survey

ObjectiveWe aimed to accurately describe the true cardiovascular risk factors of in-hospital patients with acute myocardial infarction(AMI)and the status of self-management,to evaluate the knowledge,attitude and behavior related to cardiovascular risk factors for AMI patients,and to find the relevant influencial factors for the self-management behavior program,to analyze the effect of risk factor interventions.All of them will provide a reference for the formulation of case management.MethodsDesign of the study is a cross-section survey.Recruited patients were from department of cardiovascular medicine on a large hospital in GuangZhou city,GuangDong province between December 2018 and December 2019.The material were the Acute Myocardial Infarction Risk Factors Questionnaire which was developed by group discussion and literature review,and Coronary artery disease Self-management Scale which developed by Ren Hongyan.The two anonymous questionnaires were posted to a random sample of recruted patients.Results were input and analysis by Statistical Product and Service Solutions 20.0(SPSS 20.0).Enumeration data were presented as frequency and proportion,Ranked data were presented as mean and standard deviation.We used descriptive statistics analysis of variable firstly,then we used one-way analysis and multi-factor analysis.One-way analysis used variance analysis,single sample t-test.Multi-factor analysis used multiple.linear regression or ordered logistic regression analysis.P variable which was less than 0.05 was statistically significant.Results1.We enrolled 354 patients with AMI(mean age was 58.69[standard deviation=7.01]years;88.14%were men,and 11.86%were women).2.Accuracy of cardiovascular risk factors were low.2.82%selected age which mean man is above 45years or woman is above 55 years.6.78%selected female menopause.31.64%selected high blood pressure.21.75%selected diabetes.20.62%selected dyslipidemia.19.77%selected smoking.20.34%selected excessive drinking.21.75%selected overweight or obesity.18.64%selected unhealthy eating habits.19.49%selected lack of physical exercise.12.71%selected sleep apnea syndrome.7.06%selected occupational type and shift.8.75%selected high mental stress.87.29%considered screening for high-risk groups of cardiovascular disease to be necessary,43.22%considered that it is very important to change bad living habits to prevent acute myocardial infarction,91.53%considered health education to be an important means of preventing coronary heart disease.31.07%chose nurse-based follow-up management model.3.The mean score of self-management is 43.79(standard deviation=12.25)scores.The mean score of daily life management dimension is 59.40(standard deviation=17.40)scores,the mean score of emotional management dimension is 51.57(standard deviation=19.32)scores,the mean score of disease knowledge management dimension is 32.98(standard deviation=14.28)scores.4.Multiple linear regression analysis revealed that sex,body mass index,kinds of oral drugs before admission,number of listed risk factors,number of exposed risk factors,blood pressure management,prognosis of acute myocardial infarction,and family assisstant were influecial factors.These factors entered the regression model,F=947.282,P<0.001,the multiple linear regression equation was statistically significant.5.Ordered logistic regression analysis showed that the OR value=21.999,and the intervention of risk factor knowledge was beneficial to improve the effect of risk factor control.Conclusion1.On this survey,the number of male was significantly more than that of women,the majority of patients belonged to elderly patients.2.According to assessment result of patients with AMI,risk factor knowledge rank was low level,coping attitude was relatively positive,management needs was high.3.Patients with AMI had lower self-management level,among which medical management behavior was the lowest.4.Sex,body mass index,number of oral drugs before admission,number of listed risk factors,number of exposed risk factors,blood pressure management,prognosis of acute myocardial infarction,family assistant are important predictors for self-management bahavior.The prognosis for AMI patient could be improved and the incidence of cardiac event in hospital could be reduced if the high risk factors can be properly handled.5.The intervention of risk factor related knowledge is beneficial to improve the effect of risk factor control.