| ObjectiveTo understand the current situation of the fatigue,fatigue cognition,self-management and quality of life of patients with Coronary Heart Disease in community,and to analyze the influencing factors of fatigue.And to explore the effect of health education based on PRECEDE-PROCEED Model on fatigue of patients with Coronary Heart Disease in community,in order to provide reference for community medical staff in fatigue management of patients with Coronary Heart Disease.Methods1.From May 2020 to July 2020,the study selected patients with Coronary Heart Disease in the health records information system of 5community service centers in Hengyang City who met the criteria as subjects by multistage sampling.Total 245 patients with Coronary Heart Disease were investigated with the General Information Questionnaire,Fatigue Scale-14,Fatigue Cognition Questionnaire,Coronary Artery Disease Self-management Scale and China questionnaire of quality of life in patients with cardiovascular diseases.In order to investigate the current situation of the fatigue,fatigue cognition,self-management and quality of life of patients with Coronary Heart Disease in community,and to analyze the influence factors of fatigue.2.From October 2020 to December 2020,randomly selected two community service centers from the five community service centers in our cross-sectional study,Each community service center acted as a unit for randomization by tossing a coin.Patients with Coronary Heart Disease who met the inclusion and exclusion criteria were randomly selected from the health records information system of two community service centers as the subjects of intervention group and control group,respectively,the number of each group of 41 patients,and used the PRECEDE-PROCEED Model as theoretical framework to formulate a health education programs.Patients in the control group received routine health education,patients in the intervention group received 12 weeks of the health education based on the PRECEDE-PROCEED Model in addition to the routine health education.Due to the loss of follow-up in two groups,36 patients in the intervention group and 38 patients in the control group completed the study.The scores of the general data,fatigue,fatigue cognition,self-management and quality of life of the two groups were tested before the intervention,after 6-week and 12-week of the intervention.3.Data were analysed using SPSS 18.0 software.The measurement data were described by mean,standard deviation,median and quartile,the count data were described by the frequency and composition ratio.Statistical analysis methods included one-factor ANOVA,pearson correlation analysis,Kruskal-Wallis,multiple stepwise regression analysis,t test,separate variance estimation F-test,chi-square test,and repeated measures analysis of variance.Results1.The total score of fatigue of patients was(7.18±2.16),the score ranged from 2.00 to 12.00,of which 62.04% were diagnosed as fatigue.The total score of fatigue cognition of patients was from 1 to 10,with a median of 6(4,7).The total score of self-management of patients was(79.78±9.37),the score ranged from 57.00 to 111.00.The total score of fatigue of patients was(74.07±13.58),the score ranged from 35.00 to137.00.2.Heart function classification,education,exercise time and BMI were the influential factors of fatigue,these factors explained 13.6% of the total variance.3.The scores of fatigue and its dimensions of patients with Coronary Heart Disease were negatively correlated with the total scores of fatigue cognition,self-management and quality of life(P<0.01).The total score of fatigue cognition was positively correlated with the total scores of self-management and quality of life(P<0.01).The total score of self-management was positively correlated with the total score of quality of life(P<0.01).4.Before the intervention,there were no significant differences in the general data,the scores of fatigue,fatigue cognition,self-management and quality of life between the two groups(P>0.05),indicating comparability.5.The scores of fatigue,physical fatigue and mental fatigue in the intervention group after 6-week and 12-week of the intervention were lower than those in the control group,and the differences were statistically significant(P<0.05).Repeated measures analysis of variance results showed that the scores of fatigue,physical fatigue and mental fatigue of patients in the two groups had statistically significant differences in different times and different groups(P<0.05),and there was an interaction between time and groups(P<0.05).6.The total score of fatigue cognition and the scores of its dimension in the intervention group after 6-week and 12-week of the intervention were higher than those in the control group,and the differences were statistically significant(P<0.05).Repeated measures analysis of variance results showed that the scores of fatigue cognition,fatigue causes and manifestations,fatigue classification,the relationship between fatigue and coronary heart disease,fatigue measurement and relief methods in the two groups had statistically significant differences in different groups(P<0.05).The scores of fatigue cognition,fatigue causes and manifestations,fatigue classification,the relationship between fatigue and coronary heart disease,the influence of fatigue on coronary heart disease,fatigue measurement and relief methods in the two groups had statistically significant differences in different times(P<0.05),and there was an interaction between time and groups(P<0.05).7.The total score of self-management and the scores of its dimension in the intervention group after 6-week and 12-week of the intervention were higher than those in the control group,and the differences were statistically significant(P<0.05).Repeated measures analysis of variance results showed that the scores of self-management,daily life management,symptom management,disease knowledge management and treatment compliance management in the two groups had statistically significant differences in different groups(P<0.05).The total score of self-management and the scores of its dimension in the two groups had statistically significant differences in different times(P<0.05),and there was an interaction between time and groups(P<0.05).8.The scores of quality of life,daily life,medical condition,condition of illness,condition of social psychologic condition in the intervention group after 6-week and 12-week of the intervention were higher than those in the control group,and the differences were statistically significant(P<0.05).Repeated measures analysis of variance results showed that the scores of quality of life,daily life,medical condition,condition of illness in the two groups had statistically significant differences in different groups(P<0.05).The scores of quality of life,daily life,medical condition,condition of illness,condition of social psychologic condition,working condition in the two groups had statistically significant differences in different times(P<0.05),and there was an interaction between time and groups(P<0.05).9.There were no significant differences in the scores of systolic blood pressure,diastolic blood pressure,mean arterial pressure and BMI between the two groups after 6-week of the intervention(P>0.05).The scores of systolic blood pressure,diastolic blood pressure in the intervention group after 12-week of the intervention were lower than those in the control group,and the differences were statistically significant(P<0.05).Repeated measures analysis of variance results showed that there were no significant differences in the scores of systolic blood pressure,diastolic blood pressure,mean arterial pressure and BMI in the two groups in different groups(P>0.05).The scores of systolic blood pressure,diastolic blood pressure and mean arterial pressure in the two groups had statistically significant differences in different times(P<0.05).The scores of systolic blood pressure,diastolic blood pressure and mean arterial pressure in the two groups had an interaction between time and groups(P<0.05).Conclusion1.The fatigue of patients with Coronary Heart Disease was at a moderate level,fatigue cognition was at a low level,self-management was at a low level,and quality of life was at a poor level.2.Education,Heart function classification,exercise time and BMI are the main influencing factors of fatigue in patients with Coronary Heart Disease.Fatigue and its various dimensions were negatively related to fatigue cognition,self-management and quality of life.3.Health education based on PRECEDE-PROCEED Model could alleviate the fatigue level,improve the level of fatigue cognition,self-management and quality of life,and improve the blood pressure,which could provides a reference for community medical staff to conduct fatigue management for patients with coronary heart disease in community. |
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