| PurposeTo understand the quality of life and self-management and prevention knowledge of CHD patients;To analyze the secondary prevention effect of health belief education mode under the cross-theoretical model and the influence of health education intervention mode on the self-management behavior and quality of life of patients with coronary heart disease;To explore health education methods suitable for secondary prevention of coronary heart disease.MethodThe convenient sampling method was used to select 400 patients with coronary heart disease who met the inclusion criteria in the department of cardiovascular medicine of a third-grade hospital in Kaifeng City from November 2017 to May 2018.The subjects were randomly divided into the intervention group and the control group with 200 cases each.The control group received routine nursing and education.Patients in the intervention group changed the stage according to their behavior while they were receiving routine nursing,and then they had been given the health belief education mode intervention program which was corresponding to their stages.All enrolled patients signed informed consent and volunteered to participate in the study.Before and after the intervention,the self-management scale of coronary heart disease patients and the quality of life scale of Chinese cardiovascular patients were used to evaluate and compare the self-management ability and quality of life of patients in the two groups.The secondary prevention effect was compared according to the incidence of acute cardiovascular events and the readmission rate between the two groups within 6 months after the intervention.At the time of final data collection,there were 14cases of sample loss in the intervention group and 22 cases in the control group.There was no statistically significant difference in the loss rate of research objects in the two groups,and the effective recovery rate was 91%.The collected data were collated,and software package was used to establish a database for descriptive analysis,t-test,?~2 test,et al.Result1 General data of patients in the two groups were comparedAge,gender,education level,marital status,complications,cardiac function level,residence status,economic status,payment method,etc.,and the differences were not statistically significant(P>0.05).2 Self-management abilityInformation support from hospitals,such as the operability of medical orders and the understandability and enforceability of health education;The patient's own conditional support,such as the patient's behavioral habits,cognitive level and family supervision and other factors will affect the patient's self-management level.2.1 Comparison of self-management level between the two groups before and after intervention Before intervention,the self-management score of the control group was 78.57±12.98,and that of the intervention group was 78.11±13.58.There was no statistically significant difference between the two groups before the intervention.t=-0.33,P>0.05);The score of the control group after the intervention was79.22±12.98,and the intervention group scored 89.84±13.46.After the intervention,the intervention group scored higher than the control group,and the difference was statistically significant(t=7.66,P<0.05).After intervention,the self-management level of the intervention group was significantly improved compared with the control group.2.2 Comparison of self-management level before and after intervention in the intervention group The self-management score before intervention was 78.11±13.58,and the post-intervention score was89.84±13.46.The score after intervention was significantly higher than that before intervention,and the difference was statistically significant(t=-31.73,P<0.05).2.3 Comparison of self-management level before and after intervention in the control group The self-administration score before intervention was 78.57±12.98,and the post-intervention score was79.22±12.98.The score after intervention was slightly higher than that before intervention,but the difference was not statistically significant(t=-1.97,P>0.05).3 Quality of life comparison?3.1 Comparison of quality of life scores before and after intervention between the two groups Before intervention,the quality of life score of the intervention group was 71.30±19.79,and that of the control group was 72.37±16.87.There was no significant difference in the quality of life score between the two groups before intervention(t=-0.55,P>0.05).After intervention,the quality of life score of the intervention group was 85.22±18.90,and that of the control group was 73.16±18.22.The quality of life scores of the two groups were statistically significant(t=6.20,P<0.05).After intervention,the quality of life of the intervention group was significantly better than that of the control group.3.2 Comparison of quality of life scores before and after intervention in the intervention group The quality of life score before intervention was 71.30±19.79,and the score after intervention was 85.22±18.90.The difference in quality of life scores before and after intervention in the intervention group was statistically significant(t=-42.13,P<0.05).?3.3 Comparison of quality of life scores before and after intervention in the control group The quality of life score before intervention was 72.37±16.87,and the score after intervention was 73.16±18.22.There was no significant difference in quality of life scores before and after intervention(t=-1.66,P>0.05).?4 Rehospitalization rate and incidence of cardiovascular accidents4.1 Rehospitalization rates of the two groups within 6 months after intervention were 32 patients(18.0%)in the control group and 16 patients(8.6%)in the intervention group.The difference between the two groups was statistically significant(P<0.01).4.2 The incidences of cardiovascular accidents in the two groups within 6 months after intervention were 25 cases(14.0%)in the control group and 14 cases(7.5%)in the intervention group.The difference between the two groups was statistically significant(P<0.05).ConclusionA variety of factors affect the quality of life of patients with coronary heart disease,making it generally lower than the general population,the disease and medical conditions are the most important factors affecting their quality of life.The patient's self-management level has a good effect on the quality of life.The self-management level will increase the quality of life,and the higher the self-management level,the higher the quality of life.The transtheoretical model combined with the health belief model of health education can significantly improve the self-management ability and quality of life of patients with coronary heart disease,reduce the incidence of cardiovascular accidents and the rate of re-hospitalization,and improve the secondary prevention effect.This health education model evaluates and predicts the behavior change stages of patients with coronary heart disease,and provides the corresponding education contents according to the results,which can improve the effect and practical feasibility of health education. |
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