多群组模型在老年经皮冠状动脉介入患者不同疾病阶段自我管理研究中的应用

Application of Multi-Group Equation in a Study of Self-Management at Different Disease Stages in Elderly Patients After Percutaneous Coronary Intervention

目的 探究老年经皮冠状动脉介入治疗(PCI)患者术后不同疾病阶段的自我管理行为差异。方法以自我管理理论为基础,采用冠心病自我管理量表,选取2020年12月至2022年1月成都医学院第一附属医院心血管内科PCI术后149例老年冠心病患者作为研究对象,构建院内康复期、院外早期康复期和院外长期康复期的自我管理模型,以不同疾病阶段为分组变量进行多群组分析。结果 老年PCI患者在不同疾病阶段的总自我管理得分为63(4.00)、69(3.00)、74(3.25)分,得分指标均处于低水平(46.57%、50.96%、55.25%);多群组模型分析显示,院外早期康复期模型与院外长期康复期模型差异无统计学意义(P>0.05),院外早期康复期、院外长期康复期的疾病医学管理和日常生活管理对总自我管理的影响作用强于院内康复期(P<0.05)。结论 医护人员应结合PCI患者在不同疾病阶段的特点,采取针对性的自我管理干预措施,构建心脏康复全过程服务,弥补各疾病阶段之间的裂隙,形成冠心病的持续性医疗模式,切实改善老年PCI患者术后不同疾病阶段的自我管理能力。

Objective To explore the differences of self-management behavior at different disease stages in elderly patients after percutaneous coronary intervention(PCI).Methods Based on the theory of self-management,149 elderly patients with coronary heart disease(CHD)after PCI in the cardiovascular medicine department of the First Affiliated Hospital of Chengdu Medical College from December 2020 to January 2022 were selected as the research objects by using coronary artery disease self-management scale(CSMS)to construct the self-management model of patients in the in-hospital rehabilitation period,the out-hospital early rehabilitation period and the out-hospital long-term rehabilitation period.Multi-group analysis was conducted with different disease stages as grouping variables.Results The scores of self-management of elderly patients in the three disease stages after PCI were 63(4.00),69(3.00)and 74(3.25),respectively,and the scoring indexes were all at a low level(46.57%,50.96%,and 55.25%,respectively).Multi-group analysis showed that there was no difference between the out-hospital early rehabilitation period model and the out-hospital long-term rehabilitation period model(P>0.05).The influence of disease medical management and daily life management on overall self-management was stronger in the out-hospital early rehabilitation period model and the out-hospital long-term rehabilitation period model than that in the in-hospital rehabilitation period model(P<0.05).Conclusion Medical staff should take targeted self-management intervention measures according to the characteristics of elderly patients at different stages after PCI,build the whole process of medical service for CHD rehabilitation,fill the gaps between different stages of the disease,form a continuous medical model for CHD,and effectively improve the self-management ability of elderly patients after PCI.