Application Of Family Participatory Case Management In Cardiac Rehabilitation Of Patients With Acute Myocardial Infarction Undergoing PCI

ObjectivesTo explore the application effect of family participatory case management in cardiac rehabilitation of patients after intervention in acute myocardial infarction.To evaluate the effect of family participatory case management nursing model on cardiac rehabilitation compliance and quality of life of patients after acute myocardial infarction intervention.Object and MethodsThis research is a quasi-experiment study.According to inclusion and exclusion criteria,90 patients diagnosed with acute myocardial infarction(AMI)and performed emergency coronary intervention in a third grade class-A hospital in zhengzhou from march to June 2019 were selected as the study subjects.The first cardiovascular ward of the general hospital was listed as the control group,and the fifth cardiovascular ward was listed as the experimental group.The control group implemented the routine health education model,and the experimental group implemented the family participatory case management model on this basis.To evaluate the blood lipid,blood pressure and fasting blood glucose before,at the end of 1 month and at the end of 3 months.Generalized anxiety scale(GAD-7),patient health questionnaire depression scale(PHQ-9),cardiac rehabilitation compliance questionnaire,myocardial infarction multidimensional(MIDAS)assessment scale were used to evaluate the anxiety,depression,rehabilitation compliance and quality of life of the two groups of patients before,at the end of 1 month,and at the end of 3 months.IBM SPSS statistics 22.0 software was used for statistical analysis.The main statistical methods used were descriptive statistics,t test,?2 test,rank sum test,repeated measurement analysis of variance,and test level square ?=0.05.ResultsA total of 6 cases were lost to follow up during the whole intervention process,and 84 cases were finally completed in this study,including 42 cases in the experimental group and 42 case in the control group.The results are as follows:(1)There was no statistically significant difference in blood lipid,blood pressure,fasting blood glucose,anxiety score,depression score,lifestyle compliance and total score of life quality between the two groups before the intervention(P>0.05),and the data of the two groups were comparable.(2)At the end of 1 month of intervention,there were statistically significant differences in systolic blood pressure,anxiety score,treatment compliance,lifestyle compliance(excluding"alcohol consumption" and "body mass index")and quality of life among the groups(P<0.05).At the end of 3 months after intervention,there were statistically significant differences in total cholesterol,triglyceride,high-density lipoprotein,fasting blood glucose,systolic blood pressure,anxiety score,depression score,treatment compliance,lifestyle compliance(excluding "alcohol consumption"and "body mass index")and quality of life among the groups(P<0.05).(3)There were statistically significant differences in anxiety scores,depression scores and overall quality of life ratings between the two groups(P<0.05),and statistically significant differences in time effects(P<0.05).There were also interaction effects between intervention and time factors(P<0.05).(4)The intervention effect of quality of life in the experimental group was statistically significant before intervention,at the 1 month after intervention and 3 months after intervention(P<0.05).There were statistically significant differences in anxiety score,depression score,before intervention and 1 month after intervention,before intervention and 3 months after intervention(P<0.05).Conclusions(1)Family participatory case management model can effectively improve the levels of total cholesterol,triglyceride,high-density lipoprotein,fasting blood glucose and systolic blood pressure of patients with PCI in acute myocardial infarction.(2)Family participatory case management can reduce anxiety and depression,improve treatment compliance and lifestyle compliance,and improve quality of life.(3)This study verified the practicability and acceptability of intervention contents of family participatory case management model for PCI patients with acute myocardial infarction,and it is suitable for clinical and community promotion.