Coronary Stent Restenosis' Patients With Medical Behavior Investigation And Countermeasures Of Research

BackgroundCoronary heart disease (CHD) is a common chronic heart disease for today's world. According to the national disease statistics of China's annual monitoring in 1999, new cases of coronary heart disease (CHD) patients attain 75 million people in China,the incidence of cardiovascular disease is increasing.Each year the number patients who died of cardiovascular disease was up to 20-30million,so chronic heart disease is "the first killer" of the population.Cardiovascular disease has become the first death cause of urban residents in China, and it's mortality rate is higher than that of France, Switzerland, Belgium and other developed regions. The world health organization predicted, even if we take effective preventive measures right now, "epidemic height" of coronary heart disease will lasted to 2020. The application of percutaneous coronary intervention to coronary heart disease treatment brought the revolutionary change, for the therapeutic effect is more reliable and more ideal than drugs, in addition, it is simple and convinent, and the trauma is more smaller than the coronary artery bypass surgery, so it became the main treatment technology of chronic heart disease.There are three method of modern coronary heart disease treatment:drug therapy, interventional therapy and coronary artery bypass grafting. Pure drug treatment often will not ease the serious coronary heart disease of the patient and need further trauma-treatment, rebuild coronary blood supply, alleviate myocardial ischemia. Coronary artery bypass grafting can effectively relieve symptoms, significantly improve survival, high blood vessels recanalization rate, but there are many complications, severe traumatic, high rate of mortality in perioperative period, so it was not easy for patients to accept.Percutaneous coronary intervention treatment technique (PCI) (including coronary angiography, PTCA art Intracoronary stenting) is developing very quickly in recent years the coronary heart disease diagnosis and treatment of important methods. Currently selective coronary angiography (CAG) is a diagnosis of coronary heart disease, coronary artery pathological changes of judgment and narrow degree of "gold standard", of which features can not be replaced by other nontraumatic method. Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery intracoronary stenting (CAI) are two percutaneous coronary intervention methods developed on the basis of in coronary angiography. Interventional treatment is the effective way for the treatment of coronary artery atherosclerosis and coronary heart disease, featuring the advantages such as high success rate, direct effectiveness, traumatic less, easy to operate, the time of hospitalization is short, low costs, especially improvement of relevant equipment and operating personnel technology, the number diagnosis and treatment of patients in the whole world is on the rise year by year.The application of percutaneous coronary intervention to coronary heart disease treatment brought the revolutionary change, for therapeutic effects are more reliable and more ideal than drugs, and more simple and convenient, less trama than coronary artery bypass surgery and so become the main treatment technology of intravascular diseases.Campared with balloon dilatation, Intracoronary Stenting decrease complication and incidence of restenosis after operation, but there are still 10%～60% incidence of restenosis. It is generally considered that migration and proliferation of the intercellular layer smooth muscle of blood vessels are the main mechenism of ental membrane hyperplasy and restenosis. Many clinical experiment show that operation and stend leading to the injury of blood vessels are one of the main mechanism of restenosis in the stent, but some research show that the severity degree of pathological changes, especially the stenosis degree, unstablility of pathological changes are more apt to lead to the reparation reaction.Protocal of percutaneous coronary intervention surgical treatment show that: contrlo of risk factors of coronary heart disease control after for PCI, mainly change of bad living habits and acception of drugs treatment as well as positive control of changes the risk factors can reduce adverse events and improve prognosis. PCI currently has been widely used in the clinical treatment of coronary heart disease, and the postoperative forward effect also is cardiovascular interventional domain focus of concern. Including postoperative patients according to clinical medical behavior, cure effect and the patient's health recovery affected. The need degree of health knowledge of post PCI patients, mode of health education, compliance behavior, affect greatly to the recovery of health. The medical workers are very necessary to understand the compliance behavior of the patients, perform health education and nursing intervend systematicaly and purposefuly, as well as preform periodically follow-up so as to improve medical behavior of patients, reduce the incidence of cardiovascular events of postoperative patients.ObjectiveCoronary artery disease is a kind of disease closely relating to personal mode of action and life. As a main method of treating coronary artery disease, PCI is wide used in clinical work, but the incidence of restenosis, rehosiptalizaion and mortality will rise if we do not attach importance to the effective contrlo of danger factors of coronary artery disease or do not pay not enough attention to compliance behavior. By using questionnaire of the patients with restenosis of coronary artery stent, this study is to analyse the need degree of heath knowledge, mode of health education, compliance behavior, provide reference foundation for the the peformance of health education and intervene and coping measures for the patients with restenosis of coronary artery stent.MethodsThis study includes two parts:investagation of health education of the patients with restenosis of coronary artery stent and compliance behavior of the patients with restenosis of coronary artery stent.Selected from Jiangxi province four 3-A-grade hospitals from October,2008 to August,2010, by using by angiography, seventy-two patients were successful proved to suffer restenosis of coronary artery stent after PCI. Questionnaire including: general demographic data questionnaires, medication medical behavior scale, sports as medical behavior scale, diet as medical behavior scale, as health behavior scale, periodic review of medical behavior scale as. Get informed consent to questionnaire for the tool, the patients take face-to-face way, carried on the questionnaire survey, restenosis coronary stents as medical behavior of patients. Using data from the SPSS17.0 package of statistical analysis, data are expressed as means±SEM of the indicated number of separate experiments. Statistical comparison between experimental group and control was performed using unpaired two-tailed Student's t tests (for measurement data) or chi-square test (for percentage). P<0.05 was considered significant.Results1. Through the analysis of the patients with restenosis of coronary artery stent, the results show that the patients with restenosis of coronary artery stent have certain reserve of health information, but short direction of health knowledge of higher level, require more educational content which can solve pratical problems. The education modes of individual and lecture are most popular.2. The results of the investigation of compliance behavior the patients with restenosis of coronary artery stent show that:behavior of periodic recheck compliance scores 23.17%; behavior of drugs compliance scores 32.42%; behavior of health behavior compliance scores 35.33%; behavior of diet compliance scores 46.92%; behavior of movement compliance scores 49.42%; each index score was low and none attain 50%.3.Campared to medical behavior of patients, there were significant difference between group survey gender, different age, educational level, familiar, payment of disease categories, the family support degrees, economic income.Conclusion1 To understand the need degree of health knowledge and health education mode of the patients with restenosis of coronary artery stent, the medical staff can give better guidance to the pantients, appreciate the patients' information requirement and decide the prioritized order, offer individual information intervene and health guidance, reinforce the focus of information intervene, expand the depth and scope of health education.2 know the compliance behavior of the patients after coronary artery intervene treatment operation, carry out early health education and nursing intervene, can reinforce the paitents' compliance behavior, decrease the rate of rehospitalization.3. Overall assessment of the patients after coronary artery intervene treatment operation by using compliance behavior investigation measuring scale can know overall the patients' compliance behavior of such as drug, diet, recovery, movement and periodic recheck, which reflect the posive effect of compliance behavior on the patients.4 When nursing the patients after coronary artery intervene treatment, we should improve the level of recognition of diseases, reduce the influence of dangerous fators, pay attention to post operation recovery, form healthy living mode and social support system, which make the patients face the illness correctly, corrrect bad behaviors, decrease complications, improve the living quality of patients after coronary artery intervene treatment.