Status And Influencing Factors Of Self-management Behavior In Patients With Coronary Heart Disease ——Based On Health Ecology Model

Objective :To understand the status of self-management behavior of patients with coronary heart disease（CHD）;to comprehensively and systematically analyze the influencing factors of selfmanagement behavior of CHD patients based on the five levels of the health ecology model.Methods:From April 2021 to October 2021,a total of 228 CHD patients who met the admission and discharge standards in a cardiovascular disease diagnosis and treatment center of a tertiary firstclass hospital in Huzhou City,Zhejiang Province were selected as the research objects by convenient sampling.Coronary artery disease Self-management Scale（CSMS）,CHD awareness and knowledge questionnaire,Social Support Rating Scale（SSRS）,coronary heart disease selfefficacy Table（Coronary aitery disease Selfmanagement Scale,CESS）,Medical Coping Modes Questionnaire（Medical Coping Modes Questionnaire,MCMQ）were used for questionnaire survey.SPSS25.0 was used for data description,univariate analysis,correlation analysis and hierarchical linear regression analysis to analyze the influencing factors of self-management behavior in CHD patients.Results:1.In this study,the total score of self-management behavior of CHD patients in Huzhou area was（71.64±21.60）,of which the score of bad habit management dimension was（11.70±2.76）,the score of daily life management dimension was（12.01±3.18）,and the score of symptom management dimension was（12.01±3.18）.was（10.11±3.80）,the score of disease knowledge management dimension was（11.65±4.93）,the score of treatment compliance management dimension was（9.34±3.48）,the score of emergency management dimension was（5.85±2.99）,and the score of emotional cognitive management dimension was（10.99±4.76）.2.Univariate analysis showed that the total score of self-management behavior had statistical significance in gender,age,course of disease,number of complications,marital status,educational level,occupation,main economic source,medical payment method,number of previous visits for coronary heart disease,heart function grade and cholesterol（p<0.05）.3.Correlation analysis showed that self-management behavior was positively correlated with CHD knowledge（r=0.565,p<0.01）,social support（r=0.444,p<0.01）,self-efficacy（r=0.451,p<0.01）,MCMQ-face dimension（r=0.779,p<0.01）,and negatively correlated with MCMQavoidance dimension（r=-0.367,p<0.01）,MCMQ-surrender dimension（r=-0.435,p<0.01）.4.Hierarchical linear regression analysis showed that gender,cholesterol,CHD knowledge,CHD self-efficacy,coping style,marital status,education level and occupation were the independent influencing factors of CHD patients’ self-management behavior.The factors together explained 77.0% of the total variability of self-management behavior in CHD patients.Conclusion:1.The CSCM score in this study is generally low,and it needs medical staff to achieve precise prevention and control on the basis of multi-level and comprehensive management.2.The five levels of health ecology explain the total variation of CHD patients’ selfmanagement behaviors to a high degree,reaching 77%,gender,cholesterol in the personal trait layer,CHD knowledge,CHD self-efficacy,coping in the behavioral characteristic layer Mode,marital status in the interpersonal network layer,education level and occupation in the work and living conditions layer are the independent influencing factors of self-management behavior.It is suggested that when intervening on the self-management behavior of patients with CHD,nursing staff should focus on the role of related factors in the behavioral characteristics layer under the premise of comprehensively considering the five levels of the health ecology model,so as to achieve comprehensive prevention and control and precise nursing.3.The health ecology model can be used as a theoretical basis for the research on the selfmanagement behavior of CHD patients.