| Objective1.Construct an intervention plan for exercise fear in patients with acute myocardial infarction after PCI.2.To evaluate the effect of exercise fear intervention program for patients with acute myocardial infarction after PCI.MethodsThe first part: the construction of exercise fear intervention program for patients with acute myocardial infarction after PCI.Systematically search domestic and foreign databases and relevant literature on exercise fear intervention,extract the main content of the intervention measures;clarify the intervention goals based on the influencing factors of exercise fear in the previous retrieved literature,and further combine behavior change technology to determine the intervention function and intervention technology,in strict accordance with the "BCW Intervention Design The first draft of the intervention plan was formed through the process of the "Guidelines",12 experts were selected for expert meeting consultation,and 10 patients were selected for preliminary experiments to evaluate and revise the intervention plan to form the final draft of the exercise fear intervention plan for patients with acute myocardial infarction after PCI.The second part: the application study of the intervention program of exercise fear in patients with acute myocardial infarction after PCI.A total of 84 patients with acute myocardial infarction in a tertiary hospital in Guangdong Province from February 2022 to September 2022 were selected.The patients were required to undergo PCI for the first time and had exercise fear.Using a quasi-experimental research method,patients were divided into control group and intervention group,with 45 patients in each group.The control group was given routine cardiology nursing measures,and the intervention group was given an exercise fear intervention program for patients with acute myocardial infarction after PCI on the basis of the control group.Exercise fear,anxiety and depression,exercise self-efficacy,quality of life,incidence of adverse events three months after operation,and average length of hospital stay were used as outcome indicators to verify the feasibility and effectiveness of the program.Data was entered using Office Excel 2010,and SPSS 24.0 was used for statistical analysis of the data.Results1.Construction of exercise fear intervention program for patients with acute myocardial infarction after PCI.First set up an intervention plan construction team,clarify the research objectives,and search the Chinese and English literature on sports fear intervention before the establishment of the database until January 2022,screen the 671 retrieved literature,finally include 9 literature,and review the literature information Extract as the source of intervention measures;and develop the first draft of the intervention plan according to the process of "BCW Intervention Design Guidelines" by determining the intervention function and intervention technology.The first draft was consulted at the expert meeting.The effective recovery rate of the 12 expert questionnaires was 100%,and the expert authority coefficient was 0.88.The pre-experiment was carried out after the program was revised according to the expert opinions,and the intervention program was further revised according to the results of the pre-experiment.Finally,the final exercise fear intervention program was formed.draft.2.Application and effect evaluation of exercise fear intervention program in patients with acute myocardial infarction after PCI.(1)Dropout of research subjects: At the beginning of the intervention,a total of 90 patients with exercise fear after PCI with acute myocardial infarction were included;at the end of the intervention,6patients were lost to follow-up for various reasons,and the final sample size was 84 patients.(2)Before interventionThe general data and scores of each scale data of the two groups of patients showed that there was no statistically significant difference between the two groups(P>0.05),and they were comparable.(3)After the intervention(1)TSK-SV Heart: the corrected repeated measures ANOVA results showed that after the intervention,the TSK-SV Heart scores of the two groups had a statistically significant between-group effect(P<0.001);a time effect had a statistically significant(P<0.001);time and group There was an interaction between the two groups(P<0.05);the TSK-SV Heart scores of the two groups were compared at any time point,and the differences were statistically significant(P<0.05).(2)Comparison of anxiety and depression scores: the results of the generalized estimating equation showed that after the intervention,the GAD-7 scores of the two groups were statistically different(P<0.05),and the time effect was statistically significant(P<0.001).There was an interaction effect between them(P<0.05);the GAD-7 scores of the intervention group at each time point after the intervention were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).The results of repeated measures analysis of variance showed that the between-group effect of the PHQ-9 scores of the two groups of patients after the intervention was statistically significant(P<0.001),the time effect was statistically significant(P<0.001),and there was an interaction between time and grouping(P<0.05);the PHQ-9 score of the intervention group was significantly lower than that of the control group on the day of discharge and 3 months after discharge,and the difference was statistically significant(P<0.05).(3)Exercise self-efficacy: The results of the generalized estimating equation showed that there was a statistically significant between-group effect on the SEE scores of the two groups of patients after the intervention(P<0.001),and there was an interaction between time and grouping(P<0.001);The SEE score of the intervention group three months after discharge was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).(4)Quality of life: The results of the generalized estimating equation showed that there was a statistically significant between-group effect between the MIDAS scores of the two groups of patients(P<0.001),and there was an interaction effect between time and group(P<0.001);Each time point was better than that of the control group,and the difference was statistically significant(P<0.05).(5)Incidence of cardiac adverse events: Cardiac adverse events occurred in 3 cases(7.1%)in the intervention group and 10 cases(23.8%)in the control group within 3 months after operation.Compared with the control group,the incidence of cardiac adverse events was lower in the intervention group and the difference was statistically significant(P <0.05).(6)Average postoperative hospitalization days: The average postoperative hospitalization days in the intervention group was 6.95 days,and 8.40 days in the control group,the difference was statistically significant(P<0.05).Conclusion1 Based on BCW theory,the exercise fear intervention plan for patients with acute myocardial infarction after PCI involves comprehensive content,scientific and reasonable plan,clear intervention measures,strong operability,and has certain guiding significance for clinical practice.2 The exercise fear intervention program for patients with acute myocardial infarction after PCI can reduce the level of exercise fear,relieve anxiety,depression and negative psychology,enhance exercise self-efficacy and improve the quality of life of patients after myocardial infarction.3 The exercise fear intervention program for patients with acute myocardial infarction after PCI can reduce the incidence of cardiac adverse events within three months after surgery,reduce the average length of hospital stay after surgery,reduce the economic burden of patients,and improve the prognosis of patients. |
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