冠心病患者自我管理行为现况及其预测因子分析

Self-management Behavior and Its Predictors in Patients with Coronary Heart Disease

目的了解冠心病患者的自我管理行为现况,并探讨冠心病患者的疾病知识水平、自我效能、社会支持对自我管理行为改变的预测程度。方法采用横断面调查,以目的抽样法选择符合纳入标准的冠心病患者195例,采用冠心病知识问卷、冠心病自我效能量表、慢性疾病资源简表、健康促进生活方式评定量表分别测定患者的冠心病知识水平、自我效能程度、社会支持度及自我管理行为。结果 195例冠心病患者的疾病知识、自我效能、社会支持和自我管理行为的平均得分分别为(13.45±2.34)、(36.42±10.38)、(2.82±0.52)和(108.67±17.29)分;疾病知识、自我效能、社会支持与自我管理行为间呈显著正相关(P<0.05);多元线性回归模型中社会支持、自我效能、工作状态共同解释自我管理行为总变异量的47.5%。结论冠心病患者的自我管理行为不理想,存在一定的疾病知识缺乏,自我效能和社会支持属中等水平;为使患者长期坚持自我管理行为,需重视社会支持作用,提高患者的自我效能感,并给予针对性的健康教育。

Objective To investigate the status of self-management behavior in patients with coronary heart disease（CHD）and to explore the relationship between prediction level of changes of self-management behavior and CHD knowledge level,self-efficacy,social support and general population characteristics.Methods The purposive sampling method was used to recruit 195 CHD inpatients into the cross-sectional study.The participants were asked to complete a set of survey questionnaires which included CHD awareness and knowledge questionnaire,cardiac self-efficacy scale,brief chronic illness resources,health lifestyle promotion profileⅡ,to measure the status of CHD knowledge,self-efficacy level,social support level and self-management behavior.Results Of the 195 CHD patients,the average scores of CHD knowledge,self-efficacy,social support and self-management behavior were 13.45±2.34,36.42±10.38,2.82±0.52 and 108.67±17.29 respectively.A significant positive correlation among these variables was observed（P0.05）.In multi-regression model,social support,self-efficacy and work status totally predicted 47.5% of the variance of self-management behavior.Conclusion Self-management behaviors of CHD patients are far from satisfaction.The self-efficacy and social support are in moderate level.Patients＇ long-term adherence to self-management can be guaranteed by enhanced social support,self-efficacy and targeted health education.