Emergency Coronary Intervention Surgery For Middle-aged And Young People Based On 5A Nursing Model Construction And Application Of Patient Self-management Plan

ObjectiveConstruct a self-management intervention plan for young and middle-aged emergency coronary intervention patients based on the 5A nursing model,and evaluate the impact of this plan on postoperative self-efficacy,self-management ability,and quality of life of patients.Methods1.The construction stage of the self-management intervention plan based on the 5A nursing model:By reviewing relevant literature on self-management intervention for patients after percutaneous coronary intervention at home and abroad,further reading,screening,and evaluating the quality of literature,extracting relevant information from the literature,and combining the 5A nursing model and clinical practice,a preliminary draft of the self-management intervention plan for young and middle-aged emergency coronary intervention patients is constructed,Revise the initial draft through expert consultation and pre trial results,and ultimately form the final intervention plan.2.Implementation stage of self management intervention plan based on 5A nursing model: 80 young and middle-aged patients who met the inclusion and exclusion criteria after emergency coronary intervention surgery from January to September 2022 were selected.The intervention group was set in Area A of the CCU ward,while the control group was set in Area B of the CCU ward.The patients were randomly divided into groups according to the order of admission.Finally,40 patients were included in each group,and the control group received routine care,The intervention group implemented a selfmanagement intervention plan based on the 5A nursing model,including 5 interventions with different themes during hospitalization and 2 interventions after discharge.Ultimately,a consensus was reached with the patients,and follow-up was conducted to observe the effectiveness of the intervention.Using the Coronary Heart Disease Self Management Behavior Scale(CSMS),Coronary Heart Disease Self Efficacy Scale(CSES),Seattle Angina Pectoris Scale(SAQ),and physiological indicators from the last follow-up examination of patients 3 months after intervention,evaluate the effectiveness of self-management plans on self-management ability,self-efficacy,quality of life,and physiological indicators control of middle-aged and young patients after coronary intervention surgery.The Coronary Heart Disease Self Management Behavior Scale,Coronary Heart Disease Self Efficacy Scale,and Seattle Angina Pectoris Scale were collected before intervention,immediately after intervention,1 month after intervention,and 3 months after intervention.Physiological indicators were collected based on the results of the admission examination before intervention and the most recent follow-up examination within 3 months after intervention.SPSS26.0 software was used for data analysis,and descriptive statistical analysis,two independent sample t-test,Chi-squared test test,corrected Chi-squared test,Fisher exact probability method,repeated measurement variance analysis and other statistical methods were used.Result1.This study searched for Chinese and English literature related to patient self-management intervention after percutaneous coronary intervention between the establishment of the database and October 2021.Through reading screening and literature quality evaluation,11 RCT studies were ultimately included.Further information related to the literature was extracted,and systematic analysis,summary,and classification were conducted from the aspects of author name,publication year,sample size,intervention form,intervention content,evaluation indicators,and evaluation time,Based on the 5A nursing model and clinical practice,the initial draft of the intervention plan was ultimately constructed.The initial draft was revised through expert consultation and pre trial feedback results,and the final draft of the selfmanagement intervention plan for young and middle-aged emergency coronary intervention patients was formed based on the 5A nursing model.2.This study included a total of 80 young and middle-aged patients who underwent emergency coronary intervention surgery.During the intervention process,there were 3 lost patients in the intervention group and 4 lost patients in the control group.Finally,there were 36 lost patients in the control group and37 lost patients in the intervention group.3.Before the intervention,there was no statistically significant difference between the two groups in terms of general population sociology data,disease-related data,self-management,self-efficacy,and quality of life scale scores,as well as physiological indicator control compliance rates(P>0.05).4.The self-management scores of the intervention group were higher than those of the control group immediately after intervention,1 month,and 3 months after intervention,and the difference was statistically significant(P<0.05).The results of repeated measurement analysis of variance showed that there were time effects(F=97.319,P<0.001)and inter group effects(F=19.632,P<0.001)in the selfmanagement scores of the two groups of patients at different time points,and there was an interaction effect between time and groups(F=29.993,P<0.001).5.The self-efficacy scores of the intervention group were higher than those of the control group immediately after intervention,1 month,and 3 months after intervention,and the difference was statistically significant(P<0.05).The results of repeated measurement analysis of variance showed that there were time effects(F=145.252,P<0.001)and inter group effects(F=6.086,P<0.05)in the self-efficacy scores of the two groups of patients at different time points,and there was an interaction effect between time and groups(F=50.689,P<0.001).6.The quality of life scores of the intervention group were higher than those of the control group immediately after intervention,1 month,and 3 months after intervention,and the difference was statistically significant(P<0.05).The results of repeated measurement analysis of variance showed that there were time effects(F=110.645,P<0.001)and inter group effects(F=5.270,P<0.05)in the quality of life scores of the two groups of patients at different time points,and there was an interaction effect between time and groups(F=40.979,P<0.001).7.After intervention,the blood pressure,blood sugar,and blood lipids of the intervention group patients were controlled to meet the standard,except for the total cholesterol control,all other physiological indicators were controlled to meet the standard,and the difference was statistically significant(P<0.05).Conclusion1.This study constructs a self-management intervention plan based on the 5A nursing model,which is evidence-based and centered on patient self-management.Through literature review,expert consultation,and pre experimental results,a self-management intervention plan is constructed to ensure the systematic and scientific nature of the intervention plan.2.A self-management intervention plan constructed based on the 5A nursing model can improve patients’ self-management ability,self-efficacy,physiological indicator control standards,and improve their quality of life.