中青年冠心病患者自我管理行为-阶段分布及影响因素分析

Analysis of Self-management Behavior-stage Distribution and Influencing Factors in Young and Middle-aged Patients with Coronary Heart Disease

目的:基于跨理论模型,探讨中青年冠心病患者自我管理行为及影响因素。方法:采用随机抽样法,选取牡丹江市3所三级甲等医院心内科的160例中青年冠心病患者作为研究对象,采用一般情况调查问卷、冠心病行为阶段问卷、冠心病自我管理行为量表进行调查。结果:中青年冠心病患者的自我管理行为各阶段分布比例为前意向阶段11.9%,意向阶段24.4%,准备阶段33.1%,行动阶段13.1%,维持阶段17.5%;冠心病自我管理行为总分为(69.51±12.06)分。Logistic回归分析结果显示,不良嗜好、一般生活、症状、疾病知识、情绪认知、治疗依从性管理、职业(退休)是影响患者自我管理行为的主要因素(P<0.01,P<0.05)。结论:大多数中青年冠心病患者处于行动前阶段,有待提高。中青年冠心病患者自我管理水平处于中低等水平,且受多因素影响,护理人员应基于可干扰因素,抓住行为转变的重要影响因素,根据患者不同行为阶段的特征制定个性化的干预措施,提高患者的自我管理行为水平。

Objective:To explore the self-management behavior and influencing factors of young and middle-aged patients with coronary heart disease based on cross-theoretical model.Methods:A total of 160 young and middle-aged patients with coronary heart disease in the department of cardiology from 3 Grade 3 Class A hospitals in Mudanjiang were randomly selected as the research objects.The question-naires on general conditions,behavioral stages of coronary heart disease and self-management behavior scale of coronary heart disease were used for the investigation.Results:The distribution proportion of self-management behavior in young and middle-aged CHD patients was 11.9%in the preintention stage,24.4%in the intention stage,33.1%in the preparation stage,13.1%in the action stage and 17.5%in the maintenance stage.The total score of CHD self-management behavior was(69.51±12.06).Logistic regression analysis showed that bad habits,general life,symptoms,disease knowledge,emotional cognitive management,treatment compliance,and occupation(retirement)were the main factors influencing patients′self-management behavior(P<0.01,P<0.05).Conclusion:Most young and middle-aged patients with coronary heart disease are in the preaction stage and need to be improved.The self-management level of young and middle-aged patients with coronary heart disease is in the low level,and is affected by multiple factors.Nursing staff should seize the important influencing factors of behavior change based on the interfering factors,and make personalized intervention measures according to the characteristics of different behavioral stages of patients,so as to improve the level of self-management behavior of patients.