基于COM-B模型的稳定性冠心病患者自我护理能力与疾病感知、健康行为的相关性研究

Study on the relationship between self-care ability,illness perception and health behavior in patients with the stable coronary disease based on the COM-B model

目的调查稳定性冠心病(SCAD)患者自我护理能力及其与疾病感知、健康行为的相关性,并将有关因素映射在COM-B模型中,提出护理措施。方法选择2021年11月—2022年2月于本院住院治疗的184例SCAD患者为研究对象,问卷调查方法评价患者自我护理能力、疾病感知水平及健康行为现状,分析自我护理能力与疾病感知、健康行为的相关性。结果住院SCAD患者自我护理能力得分为166.67(133.33,184.44)分,为中等偏下水平;疾病感知得分23.64(22.50,24.88)分,提示患者仍存在负面疾病感知;健康行为得分(111.89±16.89)分,处于一般水平。相关性分析证实自我护理能力与疾病感知呈负相关(r=-0.344,P<0.01),与健康促进行为呈正相关(r=0.591,P<0.01)。多元线性回归分析显示,年龄、月收入、支架数量和健康行为是自我护理能力的影响因素(P<0.05)。结论自我护理能力与疾病感知呈负相关,与健康促进行为呈正相关。改善患者对病情的负面认知,鼓励患者进行健康促进活动可能是增强自我护理能力的有效措施。

Objective To investigate the current status of self-care ability of patients with stable coronary artery disease(SCAD)and to explore its correlation with illness perception and health behaviors,then to map the relevant factors in the COM-B model and propose nursing measures.Methods A total of 184 patients with SCAD hospitalized in the hospital between November 2021 and February 2022 were selected as study objects.The self-care ability,illness perception level,and health behavior of patients were evaluated by the corresponding questionnaire and analyzed the relationship between self-care ability,illness perception,and health behaviors.Results The score of self-care ability of inpatients with SCAD was 166.67(133.33,184.44),which was lower than the middle level.The illness perception score was 23.64(22.50,24.88),whichindicated that patients still had negative illness perception.The health behaviors score(111.89±16.89)was at a moderate level.Correlation analysis confirmed that self-care ability was negatively correlated with illness perception(r=-0.344,P<0.01)and positively correlated with health behaviors(r=0.591,P<0.01).Multivariate linear regression analysis showed that age,monthly income,number of stents,and health behaviors were the influencing factors of self-care ability(P<0.05).Conclusions Self-care ability was negatively correlated with illness perception and positively correlated with health behaviors.Improving patients’negative cognition of the disease and encouraging patients to carry out health promotion activities actively may be effective measures to enhance self-care ability.