| Objectives:Our study based on the theory of positive psychology and stage change model,the purpose of this study was to investigate the current situation and influencing factors of patients’readiness to return to work after coronary stent implantation in patients with coronary heart disease.In order to provide clinical intervention basis for professional and psychological rehabilitation of patients with coronary heart disease after coronary stent implantation,and then enhance the level of preparation for patients to return to work,and provide strength for the healthy and stable development of the society.Methods:From December 2019 to December 2020,430 patients with coronary heart disease who received one month follow-up after coronary artery stent implantation were conveniently selected from the cardiovascular department outpatient department of three Grade A general hospitals in Jinan City,Shandong Province.The patients’general information questionnaire,RRTW,FFMQ and SSRS were used to investigate the relevant questionnaires.The real and effective data were collected by the two-person collaboration and input into Excel2019.SPSS24.0 was used for statistical analysis,and descriptive analysis,rank sum test of non-parameters such as Mann-Whiyney U or Kruskal-Wallis H,Spearman correlation analysis,ordered multiple logistics regression and so on were performed for the data.Results:1.This study investigated a total of 430 patients after coronary stent implantation,of which 239 have returned to work,with a return rate of 55.6%;191 have not returned to work,with a non-return rate of 44.4%.The scores of the non-reworked patients in each dimension stage were pre-intention(7.95±2.97)points,intention(11.66±2.26)points,action preparation-self-assessment(11.76±3.57)points,action preparation-action 4 cases(9.37±3.06)points;The scores of the reworked patients in each dimension stage were the uncertain maintenance stage(18.54±2.26)points and the active maintenance stage(15.09±3.32)points.2.In this study,the total scores of the patients with percutaneous intracoronary stent implantation who did not return to work after percutaneous intracoronary stent implantation were(117.34±10.07),and(39.64±5.77),respectively,for their readiness to return to work;The total score of the patients who had just returned to work was(118.15±9.37),and(41.24±5.34).3.Univariate analysis showed that the factors influencing the readiness to return to work of patients with percutaneous intracoronary stent implantation were age,religious belief,occupation,education level,residence,number of stents,complications,and cardiac rehabilitation exercise,which were statistically significant among patients who did not return to work(all P<0.05).Gender and occupation had statistical significance in patients who had returned to work(all P<0.05).4.The correlation analysis results show that did not return to work in patients with percutaneous intracoronary stent implantation postoperative’s readiness to return to work with mindfulness level the total score(r_s=0.472,P<0.01),observations(r_s=0.227,P<0.01),description(r_s=0.293,P<0.01),sports awareness(r_s=0.311,P<0.01),total score of social support score(r_s=0.418,P<0.01),subjective support(r_s=0.410,P<0.01)and supported the use of degrees(r_s=0.303,P<0.01),were positively correlated;In patients with percutaneous intracoronary stent implantation who had returned to work after PCI,the readiness to return to work was positively correlated with the total score of the level of mindfulness(r_s=0.145,P<0.05)and the total score of social support(r_s=0.137,P<0.05).(OR=37.540,P=0.016)5.Multivariate analysis showed that for patients with percutaneous intracoronary stent implantation,college education(OR=0.287,P=0.016)and the number of stents>3(OR=0.273,P=0.049)were risk factors for the readiness to return to work of patients who did not return to work;Patients with 10 years of coronary heart disease history of>(OR=8.874,P=0.014),level of mindfulness(OR=1.108,P<0.001)and social support(OR=1.123,P=0.010)were protective factors of readiness to return to work in patients who did not return to work.Social support(OR=1.248,P=0.009),male(OR=58.484,P<0.001)and migrant work(OR=30.034,P=0.009)were protective factors for patients who had returned to work.No understanding of the condition(OR=0.057,P=0.009)were risk factors for the readiness to return to work of patients who did not return to workConclusion:1.The overall rate of return to work is higher after percutaneous intracoronary stent implantation.The patients who did not return to work after coronary stent implantation had a medium level of readiness to return to work,which was mainly in the stage of intention and action readiness-self-assessment.Patients who had returned to work after coronary stent implantation had a low degree of readiness to return to work,which was mainly in the uncertain maintenance stage.2.The effects of education,number of stents,social support,level of mindfulness and history of coronary heart disease on the readiness to return to work of patients without reworking coronary stents implantation;The readiness to return to work of reworked patients with coronary stent implantation was affected by gender,occupational nature and social support.3.The degree of preparation for returning to work of un-reworked patients with coronary stent implantation was positively correlated with the total score of mindfulness level,observation,description,conscious movement,total score of social support,subjective support and utilization of support.the readiness of reworked patients to return to work was positively correlated with the total score of mindfulness level and social support.4.The history of coronary heart disease over 10 years,the level of mindfulness and social support were the protective factors for the work readiness of patients who did not rework;The education level and the number of stents were the risk factors for the readiness to return to work of the patients who did not rework.Male,social support and working outside were the protective factors for the patients who had returned to work.In this regard,more social care should be provided to the patients after coronary stent implantation,and intervention strategies should be adopted to improve the level of mindfulness,so as to help and encourage the patients concerned to continuously improve their readiness to return to work. |
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