急性心肌梗死患者心脏运动康复依从动机的质性研究

Motivation for Adherence to Exercise-based Cardiac Rehabilitation in Patients with Acute Myocardial Infarction:A Qualitative Study

目的探究急性心肌梗死(acute myocardial infarction,AMI)行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗患者心脏运动康复的依从动机,为提升患者运动康复参与及行为改变提供建议和依据。方法采用描述性质性研究,通过目的抽样法选取2021年7月至2022年1月在上海某三级甲等医院复诊的29例AMI患者进行半结构式深度访谈,其中18例来源于心脏康复中心、11例来源于随访门诊。采用内容分析法整理访谈资料。结果共提炼3个主题和9个亚主题:患者的运动体验(康复获益感、风险感知),患者的心理状态(悲观、恐惧、积极心态)和社会支持(家庭依恋及支持、专业指导及支持、同伴交流及支持、物理资源及支持)。结论护理人员应重视AMI行PCI治疗患者的运动体验、心理状态及社会支持情况,以提高患者心脏运动康复依从动机。

Objective To explore motivational factors influencing exercise-based cardiac rehabilitation adherence among patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and to provide suggestions and evidence for promoting patients’positive behaviors in exercise-based cardiac rehabilitation.Methods A descriptive qualitative study was conducted.Purposive sampling method was used to select 29 patients with AMI for semi-structured in-depth interviews,who were revisited at a tertiary hospital in Shanghai between July 2021 and January 2022.18 patients were from a cardiac rehabilitation center and 11 from a follow-up clinic.The content analysis method was used for analyzing the interview data.Results Three themes and nine sub-themes were extracted,including patient’s exercise experience(sense of benefit from exercise-based cardiac rehabilitation,perception of exercise-related risks),psychological state(pessimism,fear and positive mental attitude),and social support(family attachment and support,professional instruction and support,peer communication and support,physical resources and support).Conclusions Nurses should pay attention to the patient’s exercise experience,psychological state,and social support during the post-AMI period,so as to enhance their motivation for adherence to exercise-based cardiac rehabilitation.