| ObjectiveThe purpose of this study is to investigate the current situation of secondary prevention of patients with coronary heart disease in the community via the Coronary Heart Disease Self-management Scale,EightItem Morisky Medication Adherence Scale,Zung's Anxiety AelfAssessment Scale,International Physical Activity Questionnaires,Sexual Knowledge Awareness and Sexual Health Education Needs of Patients with Coronary Heart Disease,to analyze above scales' relationships and influencing factors,and to explore the application of nursing intervention based on Interaction Model of Client Health Behavior(IMCHB)on secondary prevention of patients with coronary heart disease in community.It could provide a reference for the relevant research of community nursing staff.Methods1.Totally 373 patients with coronary heart disease in 5 community service centers in Hengyang City were selected as the object of the study and investigated with general data questionnaire,Coronary Heart Disease Self-management Scale,Eight-Item Morisky Medication Adherence Scale,Zung's Anxiety Self-assessment Scale,International Physical Activity Questionnaire,Sexual Knowledge Awareness and Sexual Health Education Needs of Patients with Coronary Heart Disease Scale from December 2018 to May 2019.In order to investigate the current situation of secondary prevention of patients with coronary heart disease in community,and to explore their influencing factors and relationships.2.Comparing the general data,self-management score,drug compliance score,anxiety score,energy consumption of physical activity,score of sexual knowledge and sexual education needs,patient satisfaction score,and clinical health status index of patients between the control group and intervention group.Control group patients were given the community general health education,intervention group patients were given the community general health education and nursing intervention based on IMCHB for patients with coronary heart disease from August 2019 to November 2019.3.Data was analyzed by the Statistical Package for the Social Sciences(SPSS)18.0,with the methods of statistical description t-test,linear correlation,chi-square test,and multiple linear model.Results1.The total scores of self-management of patients were(57.00±14.23),the score ranged from 21.00 to 98.00.Degree of education,time of illness,the number of chronic diseases,heart function rating and habitation manner were the influential factors for the CHD patients' selfmanagement.These factors explained 20.6% of the total variance.2.The total scores of drug compliance of patients were(5.41±1.82),the score ranged from 0.05 to 8.00.Degree of education,time of illness,personal monthly income and hospitalized times were the influential factors for the CHD patients' drug compliance.These factors explained 18.8% of the total variance.3.The total scores of anxiety of patients were(53.61±9.26),the score ranged from 33.75 to 78.75.Gender,degree of education,treatment,the number of chronic diseases,heart function rating and habitation manner were the influential factors for the CHD patients' anxiety.These factors explained 24.5% of the total variance.4.The energy assumption of physical activity of patients was(2422.34±2203.50).Age,occupation,hospitalized times,heart function rating and BMI were the influential factors for the CHD patients' physical activity.These factors explained 20.3% of the total variance.5.Of the 373 patients with coronary heart disease in community,55.8% patients needed to know about sexual knowledge,66.8% patients considered patients' spouse need to be educated about the sexual knowledge,and 72.1% patients refused to consult community medical staff about their sexual knowledge,84.5% patients reported that no community nursing staff educated sexual knowledge for them.6.The total scores of sexual knowledge awareness of the patients were(8.66±3.18),the score ranged from 5.00 to 25.00.Age,marital status,degree of education,hospitalized times were the influential factors for the CHD patients' sexual knowledge awareness.These influential factors explained 19.0% of the total variance.The total scores of sexual education needs of the patients were(22.20±9.68),the score ranged from 10.00 to 50.00.Gender,age,marital status,occupation,the number of chronic diseases,heart function rating and habitation manner were the influential factors for the CHD patients' sexual education needs.These factors explained 23.9% of the total variance.7.There was a positive correlation between self-management and drug compliance in patients with community coronary heart disease(r=0.142,P<0.01);there was a negative correlation between drug compliance and anxiety(r=-0.193,P<0.01),negative correlation between drug compliance and total energy consumption of physical activity(r=-0.166,P<0.01),negative correlation between drug compliance and sexual education needs(r=-0.117,P<0.05);anxiety and total energy consumption of physical activity were negatively correlated(r=-0.187,P<0.01),negative correlation between anxiety and sexual education needs(r=-0.343,P<0.01);there was a positive correlation between total energy consumption of physical activity and energy consumption of minor physical activity(r=0.936,P<0.01),positive correlation between total energy consumption of physical activity and energy consumption of low physical activity(r=0.925,P<0.01),and positive correlation between total energy consumption of physical activity and moderate physical activity energy consumption(r=-0.965,P<0.01),positive correlation between total energy consumption of physical activity and sexual education needs(r=0.190,P<0.01);there was a positive correlation between sexual knowledge awareness and sexual education needs(r=0.140,P<0.01).8.After intervention,self-management and its dimension scores respectively were(75.97±7.03),(17.70±1.43),(9.35±1.81),(11.46±2.57),(8.64±2.16),(10.45±3.35),(10.81±2.48),(7.54±1.52)] which more significantly improved than before [(54.83±8.93),(15.81±2.08),(5.43±1.65),(7.32±3.36),(5.91±3.09),(6.94±3.85),(8.97±4.29),(4.43±0.98)],respectively(P<0.05).9.After intervention,drug compliance scores were(6.67±1.08)which more significantly improved than before(5.13±2.32)(P<0.05);anxiety scores were(51.25±4.65)which more significantly improved than before(59.05±9.01)(P<0.05).10.After intervention,energy assumption of physical activity respectively were [(3152.10±3076.61),(1728.50±1048.86),(844.01±676.20),(835.16±669.95)] which more significantly improved X than before [(2057.49±1730.72),(1202.65±701.84),(474.60±524.18),(481.07±539.75)](P<0.05);However,after intervention,high energy assumption of physical activity(52.74±107.28)had no significant difference compared with before intervention(27.62±117.67)(P>0.05).11.After intervention,sexual knowledge awareness scores were(13.56±2.73)which more significantly improved than before(10.91±1.68)(P<0.05);sexual education needs scores were(29.02±5.03)which more significantly improved than before(17.56±5.91)(P<0.05);patients' satisfaction scores were(52.18±5.51)which more significantly improved than before(33.67±8.27)(P<0.05).12.After intervention,systolic pressure was(128.45±15.65)mm Hg which more significantly improved than before(138.64±18.14)mm Hg(P<0.05);BMI was(21.92±2.30)kg/m~2 which more significantly improved than before(22.99±1.76)kg/m~2(P<0.05);low-density lipoprotein cholesterol was(2.61±0.40)mmol/L which more significantly improved than before(2.91±0.60)mmol/L(P<0.05).Conclusions1.Patients' self-management was at a low level,drug compliance was at a moderate level,anxiety was at a mild level,energy consumption of physical activity was mainly related to minor consumption physical activity,sexual knowledge awareness and sexual education needs were at a low level.2.Nursing intervention based on IMCHB could improve the selfmanagement level,drug compliance level,energy consumption of physical activity level,sexual knowledge awareness and sexual education needs level,patient satisfaction level and could reduce anxiety level,systolic pressure(mm Hg),BMI(kg/m~2),LDL cholesterol(mmol/L),which can provide a reference for community nursing staff to provide reference for secondary prevention health education and intervention for community patients with coronary heart disease. |
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