摘要
Objective： To explore and identify the concept of adherence in the context of cardiac rehabilitation. This conceptanalysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence tocardiac rehabilitation programme. Method： Walker and Avant’s framework was used to analysis the concept ofadherence. Results： Adherence is defined as patients collaboration with health care provider, active involvement in thetreatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributesof adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents ofadherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors.Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standardinstrument to measure adherence. Conclusion： Based on the concept analysis, in order to improve patients’ adherence tocardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan andpromote patients’ self-efficacy and prevention relapse.
目的：通过概念分析法探索和明确“信守”在心血管疾病病人进行心脏康复环境下的定义.为健康照护者进行临床决策,制定干预措施以及构建相关护理理论提供依据.方法：采用Walker和Avant的概念分析模型进行分析.结果：在心脏康复环境下,“信守”是指患者与健康照护者共同合作,积极参与到康复方案的制定中,并在自我效能感的促进下坚持康复方案,防止故态复萌.“信守”的定义性特征包含“合作性关系”;“自我效能促进”和“预防故态复萌”.前因包括“健康照护者提供的处方”;“患者对疾病的认知”;“社会、经济、环境因素”.信守可以提高患者的主要临床结局,但目前关于信守的测量工具不明确,需要进一步研究和开发.结论：心血管病患者进行心脏康复的过程中,健康照护者应从“信守”的定义性特征出发,鼓励患者积极参与康复方案的制定,促进患者的自我效能感,采取措施预防患者故态复萌,从而提高心血管疾病病人对心脏康复的“信守”.
