| Objectives:The aim of the study was to explore the effect of the cardiac rehabilitation education program based on the Information-Motivation-Behavioral Skills model(IMB)in community patients with coronary heart diseaseMethods:This study was an intervention experiment.A total of 77 patients with coronary heart disease(CHD)who lived in the community and had cardiovascular events one year later were selected from a eommunity health service station in this city.After enrollment,the patients were randomly divided into the control group and the experimental group by the random number table method,including 41 cases in the control group and 36 cases in the experimental group.The control group attended a series of lectures on cardiac rehabilitation education,while the experimental group received the same lectures as the control group,and then adopted a cardiac rehabilitation education program based on IMB model:through the pre-survey,obtain the basic information,motivation and behavioral skills about cardiac rehabilitation of patients,and to find out the weak links according to the requirements of cardiac rehabilitation guidelines.Individualized education contents and strategies for patients with the above three elements were developed according to the weak links.Among these,based on the research subjects’ motivation to participate in and persist in cardiac rehabilitation,motivational interviews were used to select different motivational enhancement strategies,so as to construct individualized cardiac rehabilitation education programs.The educational program was implemented in the following month with a series of lectures on cardiac rehabilitation education.Changes in self-efficacy,exercise compliance,self-management behavior,quality of life and related physical fitness(grip strength,2-minute step test)of all subjects were collected at before intervention、3 and 6 months after the end of the intervention,and changes in biochemical indicators were collected after 6 months.Use SPSS21.0 statistics software to carry on the analysis,statistic data and results were commonly used descriptive statistics analysis,in addition to the exercise adherence and biochemical indicators of success rate in forms of composition ratio,the rest of the indicators in terms of(x±S,M±Q),the normal distribution of measurement data used two independent sample t-test,non-normal distribution used the Mann-Whiteney U test,count data used χ2 test,and the other used repetitive measure analysis of variance comparing the index changes of three time points,test results with P<0.05 for statistical significanceResults:1.The general data、self-efficacy、exercise compliance、self-management behavior、quality of life、Physical fitness(grip strength,2-minute step test)and biochemical indicators of the experimental group and the control group were analyzed by t test/χ2test/rank sum test,and the difference between the two groups before intervention was not statistically significant(P>0.05)2.Changes of self-efficacy of CHD patients in community:the total self-efficacy score of the experimental group was(2.50±0.30)at the 3rd month and(2.73±0.47)at the 6th month after intervention.The total self-efficacy score of the control group was(2.40+0.35)at the 3rd month and(2.40+0.15)at the 6th month.The total self-efficacy score in the two groups at the third and sixth months after intervention was statistically different(P<0.05).From baseline to 6 months after intervention,patients with above medium level self-efficacy ranged from 55.50%to 83.30%in the experimental group,while the control group increased from 65.80%to 75.60%.The difference was statistically significant(P<0.05)3.Changes of exercise compliance of CHD patients in community:the exercise compliance rate of the experimental group was 77.80%at the 3rd month after intervention,and was extended to about 6 months(75.00%).The exercise compliance rate of the control group was 56.10%at the 3rd month,and 46.30%at the 6th month.The exercise compliance of the two groups at the 3rd and 6th month after intervention was statistically significant(P<0.05)4.Changes of self-management behavior of CHD patients in community:the total score of self-management behavior of the experimental group was(87.00±5.66)at the 3rd month and(91.22±6.61)at the 6th month after intervention.The total score of self-management behavior in the control group was(83.56±7.49)at the 3rd month and(87.34±8.80)at the 6th month.There were statistically significant differences between the two groups in the total score at the 3rd month and the 6th month after intervention(P<0.05).From baseline to 6 months after intervention,patients in the experimental group with above medium level of self-management behavior ranged from 55.60%to 97.20%,while the control group increased from 56.10%to 78.00%.The difference was statistically significant(P<0.05)5.Changes of quality of life of CHD patients in community:the total score of quality of life in the experimental group was(85.72±9.16)at the 3rd month and(87.67±13.71)at the 6th month after intervention.The total score of quality of life in the control group was(81.02+10.53)at the 3rd month and(80.95±12.19)at the 6th month.Two groups in the quality of life at 3 months and 6 months after intervention difference was statistically significant(P<0.05)6.Changes of physical fitness of CHD patients in community:the grip strength of the experimental group was(20.83±6.96)at the 3rd month after intervention,and(21.89±7.15)at the 6th month after intervention.The grip strength of the control group at the third month was(24.80±10.87)and at the sixth month was(26.52±9.18).There was a statistical difference between the two groups at the third and sixth months after intervention(P<0.05).The grip strength of the experimental group was lower than that of the control group,but the increase at the 6th month was slightly higher than that of the control group.The number of steps in the experimental group was(80.00±20.00)at the 3rd month after intervention,and(95.58±27.61)at the 6th month after intervention.The number of steps in the control group was(76.00±23.00)at the 3rd month,and(84.07±19.17)at the 6th month.There was only a statistically significant difference between the two groups at the 6th month after intervention(P<0.05)7.Changes of biochemical indicators of CHD patients in community:at the 6th month after intervention,the compliance rates of blood pressure,blood glucose and blood lipid in the experimental group were 69.4%,63.9%and 30.6%,while those in the control group were 46.3%,65.9%and 9.8%,respectively.In addition to blood glucose,the blood pressure and blood lipid compliance rates in the two groups were statistically significant(P<0.05),and the number of patients reaching the standard in the experimental group was higher than that in the control group.Conclusions:This research adopted the cardiac rehabilitation education scheme based on IMB model Combining the information content with the latest cardiac rehabilitation/secondary prevention guidelines,different motivation sources and stages of study subjects were explored from the perspective of motivation to provide different conversation strategies and educational means At the same time,strengthen the behavioral skills and self-efficacy of the study subjects to improve the level of self-management of the patients,especially the exercise compliance.A series of changes improved fitness and the quality of life of the patients,and also played a positive role in risk factors such as blood pressure,blood sugar and blood lipid. |
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