Application Of A Cardiac Rehabilitation Intervention Program Based On Interactive Theory Of Goal Attainment In Patients After PCI

ObjectiveThis study aims to construct a cardiac rehabilitation care intervention programme for post-PCI patients based on interactive theory of goal attainment and to investigate the effects of this program on post-PCI patients’ self-management ability,aerobic exercise endurance,cardiac rehabilitation knowledge,quality of life and readmission rate.Methods1.Constructing a cardiac rehabilitation intervention programme based on interactive theory of goal attainment.This study used the interactive theory of goal attainment as a framework to develop the first draft of a cardiac rehabilitation care intervention protocol for post-PCI patients based on a literature review,combined with relevant guidelines and consensus.Fifteen experts in the field of cardiac rehabilitation were selected to conduct 2 rounds of Delphi correspondence,and the first draft of the intervention protocol.Finally,five post-PCI patients were selected for a pre-test to finalise the intervention protocol for cardiac rehabilitation of patients after PCI.2.Implementation of a cardiac rehabilitation intervention programme based on interactive theory of goal attainment.A convenience sampling method was used to select 72 patients admitted to the cardiology department of a tertiary care hospital in Qingdao from August to December 2020 after PCI,with 36 cases in the control group and 36 cases in the intervention group,respectively.The control group implemented conventional nursing interventions and the intervention group implemented a nursing intervention programme based on the interactive theory of goal attainment on the control group.The coronary artery disease self-management behaviour scale,the 6min walk test,the cardiac rehabilitation information knowledge questionnaire for patients with coronary heart disease and the China questionnaire of quality of life in patients with cardiovascular diseases were used to compare the self-management ability,aerobic exercise tolerance,knowledge of cardiac rehabilitation,quality of life and readmission rate of the two groups before and after the intervention.Use SPSS 25.0 software was used for data analysis.Statistical methods such as t-test,chi square test,rank sum test,repeated measurement analysis of variance and generalized estimation equation analysis were used to evaluate the application effect of cardiac rehabilitation intervention scheme based on interactive theory of goal attainment in patients after PCI.Results1.Constructing a cardiac rehabilitation intervention programme based on interactive theory of goal attainment.A preliminary draft of cardiac rehabilitation intervention program for patients after PCI was formed by literature review.Through 2 rounds of Delphi expert letter consultation,finally13 experts put forward the modification opinions.The secondary and tertiary entries of the intervention programme were revised in line with expert opinion,one tertiary indicator was deleted,three tertiary indicators were added,one secondary indicator and five tertiary indicators were modified.The positive coefficients of the two rounds of consultation with experts were 86.67% and 100% respectively;The authority coefficients are 0.83 and 0.85;The Kendall coefficients of experts in the two rounds of correspondence were 0.199 and 0.262respectively(P < 0.05).2.Effect evaluation of cardiac rehabilitation intervention program based on the interactive theory of goal attainment.(1)A total of 72 subjects were included.One person in the control group fell down due to refusing follow-up,and there were 35 in the final control group and 36 in the intervention group.(2)Self-management skills: After 1 and 3 months of intervention,the total score of selfmanagement in the intervention group was higher than that before intervention(P < 0.05),and significantly higher than that in the control group(P < 0.05).(3)Athleticism: After 1 and 3 months of intervention,the 6-minute walking distance of patients in the intervention group was significantly increased compared with that before intervention(P < 0.05),and the distance was significantly longer than that in the control group(P < 0.05).(4)Rehabilitation knowledge: After 1 and 3 months of intervention,the total score of cardiac rehabilitation knowledge in the intervention group was significantly increased compared with that before intervention(P < 0.05),and significantly higher than that in the control group(P < 0.05).(5)Quality of life: After 1 and 3 months of intervention,the total score of quality of life in the intervention group was significantly increased compared with that before intervention(P < 0.05),and significantly higher than that in the control group(P < 0.05).(6)Readmission rate: After 1 and 3 months of intervention,there was no significant difference in the readmission rate between the two groups(P > 0.05).Conclusions1.In this study,a scientific and feasible cardiac rehabilitation care intervention programme for post-PCI patients was constructed based on the interactive theory of goal attainment through literature review and expert correspondence.2.Through the quasi-experimental research method to plan the feasibility and effectiveness of a preliminary validation,results show that the programme improves disease self-management,knowledge related to cardiac rehabilitation,enhanced exercise capacity and improved quality of life in patients after PCI.