Study On The Influence Of Self-management Scheme Based On 5A Nursing Model On Self-efficacy And Negative Emotion Of UIA Patients

Objective:To develop a self-management program for unruptured intracranial aneurysm(UIA)based on the 5A care model compared with usual care,and to evaluate the effects of the 5A based care model self-management program on various aspects of UIA patients’ self-efficacy,anxiety,depression,and postoperative complications.Methods:This study adopted the convenience sampling method.From May 2019 to December 2020,80 patients with UIA who were hospitalized in the Department of Neurosurgery in Nanchang City were divided into two groups according to the hospitalization area.The observation group and the control group were both 40 patients.example.UIA patients in the control group were given routine care,and the observation group was given a self-management plan based on the 5A nursing model on the basis of routine care.The two groups of UIA patients were assessed for general self-efficacy,anxiety,depression,and the incidence of postoperative complications within 24 hours of admission,24 hours before discharge,and 3 months after discharge.The data analysis was performed using SPSS 22.0.Results:1.During the research process,5 cases were eliminated due to poor compliance and missing data,and the loss to follow-up rate was 6.25%.At the end of the study period,a total of 80 patients were included,40 in each of the observation and control groups,and a comparison of the general data between the two groups of UIA patients showed no statistical difference(P > 0.05)and were comparable.2.The GESE scores of UIA patients in the observation group before intervention all showed no statistically significant difference compared with the control group(P >0.05),and at different time points after receiving the intervention,the GESE scores of UIA patients in the observation group were all significantly higher than those of the control group,and the differences were all statistically significant(P < 0.05).GESE scores were compared using repeated measures analysis of variance within 24 h of patient admission,24 h before discharge,and 3 months after discharge.The results showed that there was a time effect(F = 63.108,P < 0.001)and intergroup effect(F =9.469,P=0.003)on GESE scores at different time points,and there was no interaction between time and group(F = 0.168,P = 0.793).The GESE scores of the two groups of UIA patients at different time points were compared pairwise within the groups,showing that the differences were all statistically significant(P < 0.05).3.The SAS scores of UIA patients in the observation group before intervention all showed no statistical significance compared with the control group(P > 0.05),and at different time points after receiving the intervention,the SAS scores of UIA patients in the observation group were all significantly lower than those of the control group,and the differences were all statistically significant(P < 0.05).SAS scores were compared between patients 24 h before admission,24 h before discharge,and 3months after discharge using repeated measures ANOVA.The results showed that there was a time effect(F = 608.201,P < 0.001)and intergroup effect(F = 17.086,P= 0.001)on SAS scores at different time points,with an interaction between time and grouping(F = 14.753,P < 0.001).The SAS scores of the two groups of UIA patients at different time points were compared pairwise within the groups,showing that the differences were all statistically significant(P < 0.05).4.The SDS scores of the UIA patients in the observation group before intervention all showed no statistically significant difference compared with the control group(P > 0.05).At different time points after receiving the intervention,the SDS scores of the UIA patients in the observation group were all significantly lower than those of the control group,and the differences were all statistically significant(P< 0.05).SDS scores were compared between patients 24 h before admission,24 h before discharge,and 3 months after discharge using repeated measures ANOVA.There was a time effect(F = 728.692,P < 0.001),no group effect(F = 2.475,P =0.120),and an interaction between group and time(F = 9.277,P < 0.001)on SDS scores.The SDS scores of the two groups of UIA patients at different time points were compared pairwise within the groups,showing that the differences were all statistically significant(P < 0.05).5.During the course of this subject study,one complication occurred in the observation group(one cerebral vasospasm);Three cases occurred in the control group,including two cases of cerebral vasospasm and one case of hematoma at the puncture site;No other types of complications occurred in either group.There were no significant differences in postoperative complications between the two groups(P >0.05).Conclusion:Compared with usual care,the self-management program based on the 5A care model can improve the general self-efficacy of patients with UIA,reduce the anxiety level of patients with UIA,and increase the confidence of patients in rehabilitation.However,the advantage was not significant in reducing the depression level of patients and postoperative complications.