Exploring The Current Situation And Influencing Factors Of Physical Activity In Community Patients With Coronary Heart Disease Based On Health Promotion Model

Objective:The purpose of this study is to investigate the current situation of physical activity of patients with CHD in the community,and systematically discuss the influencing factors of physical activity of patients with CHD based on the health promotion model.To provide theoretical guidance for community health workers to carry out effective intervention,and to effectively improve the level of physical activity of patients with CHD in the community and promote their recovery.Methods:It was a cross-sectional study.Convenient sampling method was used and a total of two hundred and forty-five patients with CHD from two community health service stations in Jinan City were selected.The research and survey tools used the International Physical Activity Questionnaire(IPAQ-L),Exercise Benefits/Barriers Scale(EBBS),Connor-Davidson Resilience Scale(CD-RISC-10),Chronic Disease Self-Efficacy Scale,Patient health questionnaire(PHQ-9),General anxiety disorder Scale(GAD-7),Social Support Rating Scale(SSRS)and self-designed general information questionnaire for data collection.The SPSS 22.0 software was used to perform statistical analysis on the data.The statistical methods included descriptive analysis,Mann-Whitney U test,Kruskal-Wallis H test,Spearman correlation analysis,and multi-class ordinal Logistic regression analysis.Results:1.Demographic date and disease-related information.Among the 245 patients with CHD in the community included,the average age was(68.31±7.98)years old,among which the elderly patients accounted for 83.7%.Male and female patients accounted for 46.5%and 53.5%,respectively.There were 85 patients with normal weight(34.7%),114 patients with overweight(46.5%),and 46 patients with obesity(18.8%),among the patients,85.7%were married and 14.3%were widowed.Most of them have junior high school or senior high school education,and only 7.8%have junior college education or above.Among the patients,90.6%were not employed;The distribution of economic level is more balanced;A small number of patients were solitary,accounting for 11%;In the included population,24.1%of patients had undergone heart surgery;and 74.7%of them had one or more other chronic diseases.2.The current status of physical activity level of patients with coronary heart disease in the communityThe total energy consumption of physical activity in community CHD patients ranged from 0 to 5988 met-min/week,with a median of 1434 met-min/week.According to the physical activity classification standard of the International Physical Activity Questionnaire,44(18%)had low physical activity level,163(66.5%)had moderate physical activity level,and 38(15.5%)had high physical activity level.Among them,leisure-related activities consumed the most energy,with a median/quaternary of 594(132,11 88)met-min/week.Only 41.2%of patients met the level of physical activity recommended by the AHA/ACC guidelines.3.Differences in general data on physical activity levels of patients with coronary heart disease in the communityUnivariate analysis showed that there were significant differences in physical activity levels in gender,age,educational level,marital status,living status,working status,economic level,age of disease,number of chronic diseases and whether cardiac surgery was performed(P<0.05).There was no statistically significant difference in BMI(P>0.05)4.Results of correlation analysisMental resilience,self-efficacy and social support were significantly positively correlated with the level of physical activity in patients with CHD in the community(P<0.05),while perception of movement disorders,anxiety and depression were negatively correlated with the level of physical activity in patients with CHD(P<0.05).5.The multi-classified and ordered Logistic regression of physical activity level of patients with coronary heart diseaseThe results showed that mental resilience(OR<1),self-efficacy(OR<1),social support(OR<1)and education level below junior college(OR<1)were protective factors for physical activity of CHD patients in the community(P<0.05).High age(OR>1)and perceived dyspraxia(OR>1)were the barriers to physical activity(P<0.05).Conclusions:1.The level of physical activity of CHD patients in the community was not ideal,only 40.2%of the patients reached the level recommended by the American Heart Association/American College of Cardiology(AHA/ACC)guidelines,which suggested that medical personnel should strengthen the importance of physical activity of CHD patients in the community.2.There was a significant positive correlation between physical activity level and mental resilience,self-efficacy,social support,and a significant negative correlation with exercise barriers,anxiety and depression.3.The education level below junior college,mental resilience,self-efficacy and social support were the factors that promote physical activity,while the old age and exercise barriers were the hindrance factors to physical activity in patients with CHD in the community.Therefore,medical staff and patients’ family members should give more social support to patients with coronary heart disease.While actively treating the disease,measures should also be taken to improve the level of mental resilience and self-efficacy of patients,and improve the adverse psychological mood of patients.