| Objective1.To understand the level of health belief,medication compliance and quality of life of postoperative patients with moyamoya disease,analyze their influencing factors,and construct a nursing intervention program for patients with moyamoya disease based on health belief model according to the results of current survey and literature review.2.Intervention was carried out on patients with moyamoya disease to explore the effect of the intervention program on health belief level,medication compliance and quality of life of patients with moyamoya disease.MethodsThis study consists of three parts.1.To investigate the level of postoperative health beliefs,medication compliance,quality of life and influencing factors of patients with moyamoya disease,from a third-level first-class hospital in Zhengzhou,282 subjects who met the inclusion criteria from November 2017 to November 2018 were selected for questionnaire survey.A total of 260 questionnaires were collected,and the questionnaire recovery rate was 92.2.Single factor analysis,univariate regression analysis and multiple stepwise regression analysis were used to find the controllable influencing factors.2.Based on the results of the current situation survey,combined with literature review and health belief model,the first draft of the intervention plan was constructed,and expert consultation was carried out according to the first draft.6 subjects were included in the pre-experiment,and the test draft was modified according to the results.3.In this study,136 patients with smoke who underwent surgical intervention in a third-class hospital in Zhengzhou from November 1,2018 to June 30,20119 were selected by convenient sampling method.Patients in the five cerebrovascular disease areas were automatically included in the intervention group,and patients in the first cerebrovascular disease area were automatically included in the control group.The intervention group received 6 consecutive weeks of intervention for a total of 6 times.The patients were intervened in the form of group and one-on-one in hospital,and the patients were discharged in the form of telephone and Wechat.The control group was given routine nursing,and the intervention group was treated with health belief model intervention and routine nursing.The baseline measurement was carried out at the time of admission,and the health belief scale,medication compliance and quality of life of the patients were collected 1 month and 6 months after operation.Excel2013 is used to process the collected data,and SPSS 19.0 is used to collate and analyze the data.Resuls1.The average score of postoperative health belief of patients with moyamoya disease was 71.38,and the patients with drug compliance accounted for 64.6%.The score of health belief of postoperative patients with moyamoya disease as independent variable and drug compliance score as dependent variable were analyzed by univariate linear regression analysis,which was statistically significant(F=411.414 P<0.01).There was a positive correlation between them.Multiple stepwise regression analysis of quality of life PCS showed that medication compliance,smoking and age explained the variation of PCS score of 89.2%.The model was statistically significant.Multiple stepwise regression analysis of MCS of quality of life in patients with moyamoya disease showed that drug compliance,age and drinking history explained the variation of MCS score of 87.3%.The model was statistically significant.2.According to the results of the current situation survey,literature review and health belief model,the first draft of the intervention plan was constructed and the test draft was revised.The intervention program was implemented six times in 6 weeks,including learning the knowledge of moyamoya disease,understanding the harm of moyamoya disease,changing the behavior that led to the recurrence of moyamoya disease,overcoming the difficulties of self-management and perceiving self-health benefits.3.A total of 142 subjects were included in this study,including 6 cases of sample loss,4.2%of the loss rate and 136 cases of effective sample size.Subjects aged 18-64 years old were included in the intervention group(n=86)and the control group(n=50).The baseline data of the patients were compared before intervention,the age of the intervention group was(44.00±10.459)years old,and that of the control group was(44.18±12.197)years old.The changes of health belief,medication compliance and quality of life of patients with moyamoya disease before and after intervention were analyzed 1 month and 6 months after intervention.Univariate analysis and multivariate analysis were used to analyze the changes of scores and general data of patients before and after intervention.The total scores of health beliefs before and after intervention were(70.26 ±7.52)and(72.26±5.49)in the control group,(70.61±7.61)and(89.73±6.46)in the intervention group.The total score of health belief in the intervention group was higher than that in the control group(P<0.05).The total score of health belief in the intervention group was higher than that in the control group(P<0.05),especially in the two dimensions of "health motivation" and "perceptual disorder".With the passage of time,the level of health belief in the intervention group and the control group increased,and the improvement in the intervention group was even greater.The results of univariate analysis showed that age,education,marital status,smoking history,drinking history,living status,preoperative symptoms,self-care,family medical expenses,hypertension and other factors affected the postoperative health belief level of patients with moyamoya disease(P<0.05).Before intervention,there was no significant difference in medication compliance between the intervention group and the control group(5.43±0.57,5.25±0.43).After the intervention,the score of the intervention group and the control group was(7.31±0.76),5.02±0.49).The constituent ratio of positive response items of medication compliance in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).After intervention,the score of medication compliance in the intervention group increased more,while that in the control group changed little.The main factors affecting postoperative medication compliance of patients with moyamoya disease were age,sex,education,marital status,drinking history,living status,family medical expenses,Suzuki stage,preoperative symptoms and so on.Studies show that these factors explain a total of 35.9%of the variation.FFT 42.891(P<0.05),which showed that the model was statistically significant.Before and after intervention,the PCS scores of patients with moyamoya disease in the intervention group changed(57.24±23.48,62.36±22.77),MCS,51.77 ±17.33,62.74±16.49,respectively),while those in the control group(50.52 ± 17.74,49.26±15.78,50.52±17.74,49.26±15.78)in physiological dimension(58.12±25.44,53.23±21.11,50.52±17.74,49.26±15.78).The scores of all dimensions of quality of life in the intervention group were higher than those in the control group.The change of MCS score in the intervention group was higher than that in PCS,especially in the dimensions of "emotional function","vitality" and"mental health".Through the analysis,it was found that the quality of life score of the control group decreased with the passage of time without intervention.The influencing factors of postoperative PCS changes in patients with moyamoya disease were age,marital status,living status,self-care,family medical expenses,hypertension,diabetes,Suzuki stage,preoperative symptoms and other factors included in the regression equation.The results show that these factors explain 33.2%of the variation.F=41.507,P<0.05.It shows that the model is statistically significant.The influencing factors of postoperative MCS in patients with moyamoya disease were age,sex,education,marital status,living status,self-care,family medical expenses,Suzuki stage and preoperative symptoms,which were included in the regression equation.The results show that these factors explain 39.7%of the variation.F=56.771,P<0.05.It shows that the model is statistically significant.Conclusion1.The quality of life of patients with moyamoya disease needs to be improved after operation,and there are many influencing factors.The patients with low compliance and high level of health belief have good compliance with medication.2.Based on the results of the current survey and literature review,an intervention program based on health belief model was constructed and implemented for patients with moyamoya disease.it is concluded that the intervention program based on health belief model can improve the level of health belief of patients with moyamoya disease,improve patients’ medication compliance and improve their quality of life. |
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