| Objective:1.Through semi-structured qualitative interviews,in-depth understanding of the problems of lower limb DVT patients in self-management behavior.2.Construct a nursing program based on the theory of empowerment education,and apply it to lower extremity DVT patients,and explore the impact of this program on the degree of disease knowledge,self-management behavior,medication compliance,exercise efficiency and complication rate of lower extremity DVT patients.Mehthods:Part 1: Qualitative research.Using the objective sampling method,13 patients with lower extremity DVT in vascular surgery of a third-class a hospital in Nan Chang city from March 2022 to April 2022 were selected as the research target,and we carried on semi-structured interviews with them.The interview information was arranged and unpacked applying Nvivo 11.0 software,and the subject was refined with Colaizzi 7-step method.Part 2: Scheme construction.Based on the early clinical practice and extensive reading of domestic and foreign literature,combined with the results of semi-structured interviews,and with the theory of empowerment education as the theoretical framework,the first draft of nursing plan based on the theory of empowerment education was developed.Using the objective sampling method,13 experts were selected to conduct two rounds of expert consultation on the first draft of the intervention plan,and 8 patients with lower limb DVT were selected to conduct the pre-experiment,adjust and form the final plan based on two rounds of expert consultation opinions and pre experimental results.Part 3: Intervention studies.Using the convenient sampling method,80 patients with lower limb DVT diagnosed by vascular surgery in a Class III Class a hospital in Nan Chang city from May 2022 to December 2022 and meeting the inclusion and exclusion criteria were selected as the study subjects.40 patients from May 2022 to August 2022 were included in the control group,and 40 patients from September 2022 to December 2022 were included in the experimental group.The control group implemented routine nursing measures,while the experimental group implemented nursing programs based on the theory of empowerment education on the basis of routine nursing.Before intervention,one month after discharge,and three months after discharge,the lower limb DVT patients’ knowledge,belief,and behavior questionnaire,self-management scale,and exercise efficacy scale were used to assess the degree of disease knowledge,self-management behavior,and exercise self-efficacy of the two groups of patients;The medication compliance of the two groups of patients was assessed using the medication compliance scale 2 weeks,1 month,and 3 months after discharge,respectively;At 3 months after discharge,the number of complications in the two groups was counted.Results:Part 1: A total of 13 patients with lower extremity DVT were interviewed,and their problems in self-management behavior were analyzed.Finally,five topics were extracted: patient has missed medication behavior,lack of cognition of lower extremity DVT related knowledge,demand for out-of-hospital rehabilitation behavior guidance,demand for diversified health education methods,and demand for out-of-hospital drug purchase and review.Part 2: 13 experts participated in both rounds of inquiry,and the response rates of the questionnaire were 100%,the authority coefficients of experts are 0.96 and 0.97,and the harmonious coefficient of savant advices were 0.26 and 0.31.The coefficient of variation for each item was less than 0.25.On the basis of preliminary clinical practice,extensive literature review,and semi-structured interview results,this research plan has been scientifically and feasible through expert consultation and preliminary experiments.The final plan includes six themes: introduction of disease knowledge and treatment plan,rehabilitation training(physical prevention),lifestyle habits and regular follow-up,drug prevention,complication identification,and evaluation of patient selfmanagement status.Part 3:(1)Comparison of baseline data: A total of 80 patients with lower extremity DVT were included in this study,40 in the control group and 40 in the experimental group.There was no statistically significant difference between the two groups in general data,score of disease knowledge before intervention,self-management score and motor efficiency score(P>0.05).(2)Comparison of scores of disease knowledge mastery: Comparison between groups showed that the scores of patients in the experimental group at different time points after intervention were higher than those in the control group(P<0.05);Intragroup comparison showed that the scores of disease knowledge mastery of patients in the two groups at 1 month and 3 months after discharge were higher than those before intervention(P<0.05),while there was no statistically significant difference between the scores of disease knowledge mastery of patients in the experimental group at 1month and 3 months after discharge(P>0.05).The scores of disease knowledge mastery of patients in the control group at 1 month after discharge were higher than those at 3months after discharge(P<0.05).The trend chart shows that over time,the score of disease knowledge mastery of patients in the experimental group shows an upward trend,while the score of patients in the control group reaches the highest one month after discharge,and then shows a downward trend.(3)Comparison of self management scores: Comparison between groups showed that the scores of patients in the experimental group at different time points after intervention were higher than those in the control group(P<0.05);Intragroup comparisons showed that the self management scores of the two groups of patients at1 month and 3 months after discharge were higher than those before intervention(P<0.05),and the scores at 1 month after discharge were higher than those at 3 months after discharge(P<0.05).The trend chart shows that over time,the self management scores of both groups of patients reached the highest level one month after discharge,and then showed a downward trend.However,the scores of patients in the experimental group are still higher than those in the control group.(4)Comparison of medication compliance scores: Comparison between groups showed that the scores of patients in the experimental group at different time points after intervention were higher than those in the control group(P<0.05);Intragroup comparison showed that the scores of medication compliance of patients in both groups at 2 weeks after discharge were higher than those at 1 and 3 months after discharge(P<0.05),while there was no statistically significant difference between the scores of medication compliance of patients in the experimental group at 1 and 3 months after discharge(P>0.05).The scores of medication compliance of patients in the control group at 1 month after discharge were higher than those at 3 months after discharge(P<0.05).The trend chart shows that over time,the scores of medication compliance in both groups reached the highest at the time of discharge for 2 weeks,and then showed a downward trend.However,the scores of patients in the experimental group are still higher than those in the control group as a whole.(5)Comparison of motor performance scores: Comparison between groups showed that the scores of patients in the experimental group at different time points after intervention were higher than those in the control group(P<0.05);Intragroup comparison showed that the scores of motor performance of patients in the experimental group at 1 month and 3 months after discharge were higher than those before intervention(P<0.05),and there was no statistically significant difference between the scores at 1 month after discharge and those at 3 months after discharge(P>0.05).However,there was no statistically significant difference between the scores of patients in the control group before intervention,1 month and 3 months after discharge(P>0.05).Trend chart display over time,the motor performance scores of both groups of patients reached their highest level at the time of discharge for 1 month,and there was no significant change thereafter.(6)Comparison of complication rate: There was no statistically significant difference in the incidence of complications between the two groups at 3 months after discharge(P>0.05).Conclusions:The nursing program based on the theory of empowerment education can significantly improve the degree of disease knowledge,self-management behavior,medication compliance and exercise efficiency of lower extremity DVT patients,and the effect of the intervention can be maintained for a long time over time.At the same time,the program has a positive effect on reducing the incidence of complications of lower extremity DVT patients and promoting the long-term adherence to self-behavior management of lower extremity DVT patients. |
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