Study On The Psychological Intervention Framework For Type A Behavior Coronary Heart Disease Patients

Objective:The purpose of this study is to found a psychological intervention framework of type A behavior coronary heart disease patients,validate the effect of it and improve the framework and the content by clinical practice,so as to provide a practicable reference to clinical nurses.Method:①We demonstrated the direction of the study by the reference of native and foreign lectures,stipulated for the idiographic policy by the results of the qualitative descriptive research then conceived the "psychological intervention framework of type A behavior coronary heart disease patitents" by the support of Orem's theory psychological nursing and other correlated theories.②Clinical controlled trial:the ideographic process was selecting 68 A type coronary heart disease patients through "type A behavior checklist",divided into intervention group and control group by clinical controlled trial method,two groups all received cardiology therapy while the intervention group was be done by the psychological intervention of the framework,mainly rectifying the A type behavior 40 minutes once,3 times a week.The tools of measuring the two groups are The Mental Status Scale in Non-Psychiatric Settings(MSSNS) and the Type A Behavior Coronary Heart Disease Other-Rating Questionnaire.③The "intervention framework" and the implement project were rectified by the clinical controlled experiment result.④The investigation after patients leaving hospital was to evaluate the A type behavior changing by the patients family after patients left hospital one month.Result:①The intervention group mental status was compared before and after the intervention,the anxiety,loneliness,depression,anger and total score are all distinctly different(P＜0.01). It was showed that the intervention group mental state has been improved.While the lonely and depressive score of the control group before and after the intervention have no statistic meaning(P＞0.05),the anxious and angry score after the intervention were higher than before(P＜0.01),it was showed that the anxiety and anger status became seriously. The comparison of two groups showed that all the mental status were improved because the intervention group score were less than the control group's.②The investigation after the patients leaving hospital showed that two groups were different in CH TH and total score,so we can draw the conclusion the A type behavior of the intervention group changed more.③We did regressive analysis by the independent variable such as sex,age, education,inpatient time,bachelordom or not,relationship of the family,having myocardial infarction/other systematic disease or not,accepting PTCA or others and inpatient time because of the coronary heart disease and the dependent variable were anxious,loneliness,depression,anger and total score.The factor of "bachelordom or not" was passively correlated with loneliness and negatively correlated with anxious and total score;the factor of "inpatient time" was negatively correlated with loneliness;the factor of age was passively correlated with loneliness.Conclusion:The effect of the clinical psychological nursing using the "intervention framework" are satisfied,A type behavior and the inpatients' negative mood were improved,so we could say that the framework may help the A type behavior patients rectify the wrong cognition and improve the mental status. Because of the limit of the study,the intervention group's long-dated effect needs to be tailed after,the estimate implement of the intervention and the effect evaluation guideline need to be emended,the contents of the framework need to be consummated.