动机性访谈干预对心脏手术患者居家心脏运动康复意愿及运动转变阶段的影响

Effect of motivational interviewing intervention on the willingness and exercise transition stage of home and exercise based cardiac rehabilitation in patients undergoing cardiac surgery

目的评价动机性访谈干预对心脏手术患者居家心脏运动康复意愿及运动转变阶段的影响。方法采用平行随机对照的研究方法,选取2019年5月至2019年11月在山东省某三甲医院心脏外科住院的130例患者为研究对象,通过随机数字表将研究对象分为干预组(65例)和对照组(65例)。干预组根据制定的动机性访谈干预方案进行动机干预,对照组采取常规护理模式。在干预前分别对两组患者的基线资料进行收集;干预后收集两组患者的居家心脏运动康复意愿、疾病感知等资料。结果干预后,干预组患者居家心脏运动康复意愿得分为(6.66±0.55)分,疾病感知问卷中的认知表征得分为(7.37±1.26)分,疾病了解维度得分为(6.88±2.39)分,均高于对照组(P<0.05);两组疾病感知总分及情绪表征维度差异无统计学意义(P>0.05);干预组运动自我效能得分高于对照组(P<0.05);干预组患者运动转变阶段优于对照组(P<0.05)。结论动机性访谈干预有助于提升心脏手术患者居家心脏运动康复意愿及运动自我效能,有效改善患者的运动转变阶段,而对改善心脏手术患者疾病感知的作用还有待进一步研究。

Objective To evaluate the effect of motivational interviewing intervention on the willingness to perform home and exercise based cardiac rehabilitation(HEBCR)and the stage of exercise transition in cardiac surgery patients.Methods A parallel randomized controlled study was conducted.A total of 130 patients hospitalized in the Department of Cardiac Surgery of a tertiary care hospital in Shandong Province from September 2015 to November 2019 were selected as the study subjects.The study subjects were divided into the intervention group(n=65)and the control group(n=65)by the random number table.The intervention group received motivational interviewing intervention program,and the control group accepted the routine care model.The baseline data of the two groups were collected before the intervention;the data of HEBCR willingness and disease perception of the two groups were collected after the intervention.Results After the intervention,the score of willingness for HEBCR in the intervention group was 6.66±0.55,the score of cognitive representation in the disease perception questionnaire was 7.37±1.26,and the score of disease understanding dimension was 6.88±2.39,which were higher than those in the control group(P<0.05);there was no significant difference in the total score of disease perception and emotional representation dimension between the two groups(P>0.05);the total score of motor self-efficacy in the intervention group was higher than that in the control group(P<0.001);the motor transition stage in the intervention group was better than that in the control group(P<0.001).Conclusion motivational interviewing intervention is helpful to improve the willingness of HEBCR and exercise self-efficacy in patients undergoing cardiac surgery,and effectively improve the stage of exercise transition in patients,while the role of improving disease perception in patients undergoing cardiac surgery remains to be further studied.