Construction Of Exercise Rehabilitation Instruction Program For Patients With Chronic Heart Failure

ObjectiveBased on the health belief model,this study combined patient needs and literature content analysis to construct a scientific,systematic and complete exercise rehabilitation guidance program for patients with chronic heart failure.The purpose of this program is to help patients establish healthy exercise beliefs and provide exercise guidance for patients with chronic heart failure.MethodsIn this study,phenomenological analysis was used,and 11 patients with chronic heart failure were selected for semi-structured interviews using purpose sampling.We used the Colaizzi seven-step analysis method to analyze the interview data to explore the exercise cognition and exercise guidance needs of patients with chronic heart failure.Based on the results of the interviews,guided by the health belief model,we have constructed a program framework based on group discussions and expert opinions.We systematically searched the literature on exercise beliefs and exercise behaviors of patients with chronic heart failure,analyzed the content of the literature based on evidence-based thinking and adopted content analysis,supplemented the content of the program framework,and formed a preliminary exercise guidance program for patients with chronic heart failure.Finally,we used the Delphi method to revise the content of the first draft,and the final draft of the exercise rehabilitation guidance program for patients with chronic heart failure was formed.Results1.Through refining subject from the interview data of 11 patients,5 subjects in motor cognition and 3 subjects in demand were obtained.Exercise cognition included recognition of the benefits of exercise for physical rehabilitation,worries about the safety of exercise,controversy in the choice of exercise time,relatively single exercise mode,and unreasonable choice of exercise intensity.Guidance needs included exercise monitoring and intensity guidance,exercise style guidance and exercise time guidance.2.11 literatures were screened in the sports belief section,and these literatures analyzed 24 items including 7aspects.A total of 48 literatures were included in the sports behavior section,including 7 guidelines and 41 RCT studies,and a total of 40 items in 9 aspects were analyzed.The included literature has a high quality evaluation result,which has important reference value for constructing the first draft of the guidance program.3.We were inviting 18 experts to participate in the revision of the sports guidance program,and they put forward 15 specific suggestions.The expert’s authority coefficient was 0.833,indicating that the expert has a higher degree of authority in the field of heart failure exercise rehabilitation.After the two rounds of consultation,the experts’ coordination coefficients for the importance of the first-level indicators and specific items were 0.215 and 0.102,respectively,indicating that the experts had relatively consistent opinions.After we revised it based on the opinions of experts,we formed the final draft of the exercise rehabilitation guidance program for patients with chronic heart failure with 17 first-level indicators and 61 specific contents.Conclusions1.Through interviews with 11 patients with chronic heart failure,we analyzed the current status and needs of the patients’ exercise and the results showed that the patients are more concerned about the safety of exercise.They had a low level of awareness of the specific content of the sport and have a higher need for guidance.2.We comprehensively and systematically searched the literature on patients sports beliefs and sports behaviors.It was found that the current exercise intervention programs for patients with chronic heart failure in our country are mostly guidance for specific exercise behaviors,and lack of intervention for patients’ exercise beliefs,and few studies have incorporated the two into the patient’s health behavior promotion plan We evaluated the quality of the literature,incorporated high-quality literature and conducted content analysis,and obtained 64 sports guidance content in 16 aspects,which further supplemented the guidance program framework3.The exercise rehabilitation guidance program is formulated on the basis of three parts:qualitative research,literature analysis and expert correspondence.The experts are highly active and authoritative.The coordination coefficient of the importance of the content of the program is relatively high.The guidance program is scientific and practical,and it is of great significance to promote the exercise behavior of patients and the health education of medical staff.