Influencing factors of self-care ability after discharge of patients with acute myocardial infarction after PCI
FENG Sili1 CHEN Yaqin1 SUN Hairong1 GUO Chunling2 LIU Mei2▲
1.Department of Cardiovascular Medicine, Xuzhou Cancer Hospital Xuzhou Third People’s Hospital, Jiangsu Province, Xuzhou 221005, China;
2.Department of Nursing, Xuzhou Cancer Hospital Xuzhou Third People’s Hospital, Jiangsu Province, Xuzhou 221005, China
Abstract：Objective To observe the self-care ability after discharge of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), and to analyze the influencing factors of self-care ability after discharge of patients. Methods A total of 200 patients who met the treatment criteria for PCI and received PCI were selected from Xuzhou Cancer Hospital, Jiangsu Province from June 2018 to June 2020. After discharge, the patients were followed up for three months. At the end of follow-up, the patients were divided into low level group (≤57 points, 81 cases) and medium high level group (≥58 points, 119 cases) according to their exercise of self-care agency scale scores. A general data questionnaire was used to record the baseline data of patients and were compared. The general self-efficacy scale (GSES) was used to evaluate their self-efficacy. Multivariate analysis was used to analyze the factors affecting the self-care ability of patients with AMI treated by PCI after discharge. Results Among the 200 patients, 81 cases (40.50%) had low self-care ability, 65 cases (32.50%) had moderate self-care ability, and 54 cases (27.00%) had high self-care ability. The proportion of negative emotions and one to two kinds of medication in the low level group were higher than those in the middle and high level group, and the difference was statistically significant (P ＜ 0.05). There were statistically significant differences in educational level and GSES scores between the two groups (P ＜ 0.05). Multivariate analysis showed that low education level, negative emotion and one or two kinds of medication were independent risk factors for low self-care ability of AMI patients treated with PCI (all OR ＞ 1, P ＜ 0.05), and high GSES score was the protective factor (OR ＜ 1, P ＜ 0.05). Conclusion The level of self-care ability of AMI patients with the treatment of PCI is low after discharge, which may be affected by the factors such as low educational level, negative emotion, less types of medication and low self-efficacy, clinical should focus on the above factors to give targeted intervention measures.
[1] 周红梅.急性心肌梗死急诊PCI术后的早期康复护理体会[J].实用临床医药杂志，2017，21（22）：2-3.
[2] 李红梅，李勇新，张万玲，等.体外心肺复苏术联合急诊PCI抢救急性心肌梗死后心脏骤停的效果[J].河北医药，2018，1（40）：33-37.
[3] 陶晶晶，陈芳，刘娟．延续性护理对经皮冠状动脉介入术后患者生活质量影响的Meta分析[J].中国医药导报，2016， 13（13）：166-169.
[4] 李晓丹.延续性护理干预对PCI患者术后心脏康复的疗效研究[J].安徽医药，2017，18（6）：653-655.
[5] 王秋莉，虞舟，周琦.PCI术后患者自我护理能力与预后的相关性研究[J].上海护理，2019，19（3）：27-30.
[6] Dounya S，Mager YL，Oort FJ，et al. New York Heart Association class assessment by cardiologists and outpatients with congenital cardiac disease：a head-to-head comparison of three patient-based versions [J]. Cardiol Young，2012，22（1）：26-33.
[7] 中华医学会心血管病学分会，中华心血管病杂志编辑委员会.中国心血管疾病预防指南[J].中华心血管病杂志，2011，39（1）：3-22.
[8] Wang HH，Laffrey SC. Preliminary development and testing of instruments to measure self-care agency and social support of women in Taiwan [J]. Kaohsiung J Med Sci，2000，16（9）：459-467.
[9] Cosco TD，Doyle F，Ward M，et al. Latent structure of the Hospital Anxiety And Depression Scale：A 10-year systematic review [J]. J Psychosom Res，2012，72（3）：180-184.
[10] L?觟ve J, Moore CD，Hensing G. Validation of the Swedish translation of the general self-efficacy scale [J]. Qual Life Res，2012，21（7）：1249-1253.
[11] 周颖.聚焦解决模式对急性心肌梗死PCI术后患者心理弹性及自我护理能力的影响[J].护士进修杂志，2019， 34（7）：636-639.
[12] 王琳，刘广兰，何佰生，等.早期个性化护理干预对急性心肌梗死患者PCI术后康复的影响[J].安徽医学，2020， 41（8）：92-95.
[13] 李静，吴雷.经皮冠状动脉介入治疗后采用延续性护理干预对提高患者疾病认知和自我管理能力的有效性[J].岭南心血管病杂志，2017，23（5）：621-622.
[14] 周小英，刘子华，陈兵阳.急性心肌梗死PCI术后患者的4C延续性护理[J].护理学杂志，2018，33（18）：97-99.
[15] 周彤，周成超，唐碧，等.急性心肌梗死患者经皮冠状动脉介入术后自我管理水平的调查研究[J].蚌埠医学院学报，2016，41（1）：126-129.
[16] 苏清清，皮红英，刘春雪，等.急性心肌梗死患者经皮冠状动脉介入术后自我管理能力调查及影响因素分析[J].解放军医学院学报，2019，40（1）：11-15.
[17] 赵月元，张爱华.冠心病介入治疗患者自我管理行为与焦虑抑郁及生存质量的相关性[J].护理学杂志，2016， 31（5）：8-11.
[18] 杜密，曹琳，马红娟.急性心肌梗死患者自我管理行为与自我感受负担的相关性研究[J].检验医学与临床，2020， 17（7）：989-991.
[19] 梅桂英.延续性护理对经皮冠状动脉介入术后患者希望水平和自我管理能力的影响[J].中国医药导报，2018， 15（23）：140-143，151.
[20] 赵颖，刘桂华，张眉.延续性4C护理对经皮冠状动脉介入治疗患者自我管理能力，心血管事件及社会功能的影响[J].医学临床研究，2019，36（2）：258-260，264.
[21] 丁飙，许燕玲，彭易，等．首次行经皮冠状动脉支架植入术后患者自我管理能力现状及影响因素的调查[J].中华现代护理杂志，2015，21（16）：1867-1871.
[22] 曾丽梅，李丽爱，张小玲，等.系统性自我管理支持对心力衰竭患者生活质量及自我效能水平的影响[J].中国当代医药，2019，26（34）：196-198，203.
[23] Schonfeld P，Preusser F，Margraf J. Costs and benefits of self-efficacy：Differences of the stress response and clinical implications [J]. Neurosci Biobehav Rev，2017，75（31）：40-52.
[24] 黎丽嫦.协同护理模式对高血压病合并2型糖尿病患者治疗依从性及自我效能感的影响[J].中国医药科学，2020，10（15）：145-148.
[25] 刘辉，夏常泉，姚璐，等.自我效能护理对慢性心力衰竭患者焦虑抑郁情绪的影响[J].中国循证心血管医学杂志，2017，9（7）：859-861.
[26] 丁飙，周翌，黄晓莉，等.再次行经皮冠状动脉介入治疗术后患者自我管理能力及其影响因素[J].解放军护理杂志，2016，33（8）：7-11.
[27] 孙运兰，魏静.“医院-社区-家庭”管理模式对慢性心力衰竭患者延续护理中自我管理能力和生活质量的影响[J].中国现代医生，2020，58（34）：185-188.
[28] 韩颖，和霞，林梅.对急性心肌梗死PCI术后患者自我管理能力的纵向研究[J].中华现代护理杂志，2020，26（9）：1213-1217.
京公网安备 11010502046598号