Effects Of Kab Model Education On Knowledge-attitude Behavior And Quality Of Life Of Patients With Atrial Fibrillation Undergoing Radiofrequency Catheter Ablation

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical settings. The estimated prevalence of AF is 0.4% in the general population and increases with age. A population-based study in China revealed that 0.77% of Chinese are currently afflicted by AF. This suggests that there are over 9 million adults with AF in China. AF is likely to become more prevalent due to increasing cardiovascular risk factors, and the rising age of the population. Although AF itself is not directly life-threatening, its complications (such as stroke and cardiac dysfunction) significantly increase morbidity and mortality, thereby making AF a serious medical and social problem. Professor Braunwald said that atrial fibrillation was one of the two first urgent to cure diseases in the 21st century .In the past decade, RFCA for AF evolved rapidly and has now become a commonly performed procedure in many major hospitals throughout the world. Close attention to anticoagulation therapy of patients before, during, and after RFCA is critical to avoid the occurrence of thromboembolic event, which is recognized as one of the most serious complications of AF itself and AF ablation procedures. Antiarrhythmic drugs are commonly employed to treat all patients in the first one to three months after RFCA. Therefore, it is important to ensure drug therapy is effective and safe after an ablation, and it is meaningful to enhance self-management behavior in patients with AF.Knowledge, Attitude and behavior (KAB), also found in literature as Knowledge-Attitude-Practice (KAP), is an important theoretical model of health education, which asserts that behavior change is affected by knowledge and attitude. Previous studies have demonstrated that the majority of AF patients possess very little knowledge about their disease and anticoagulation therapy. Munschauer et al. pointed out that appropriate education can improve awareness of AF and promote their self-monitoring behavior, thereby effectively preventing stroke. However, these studies concerning health education of AF patients were all confined to drug therapy. To the best of our knowledge, no such study has examined the KAB of AF patients undergoing RFCA, specifically healthy behavior, such as periodic self-monitoring, adherence to medication regimen, periodic follow-up.With the emergence of bio - psycho - social medical model, symptoms as an indicator alone of the disease evaluation is no longer applicable, quality of life is becoming an very important evaluation and treatment goals. Quality of life (QoL) is the performance of functional ability and subjective feeling in social life, it is a comprehensive concept including biomedical and social psychology. Chaoyang Zheng and Yingmin Lu Reported the quality of life in paroxysmal and persistent atrial fibrillation patients taking radiofrequency ablation, but no study has evaluate the efficiency of education on such patients.The aim of this study is to investigate the status and influencing factors of KAB, QoL in patients with AF who undergo RFCA, and explore the efficiency of KAB education on such patients, so as to providing a foundation to develop effective education approaches to increase patient's knowledge, to form a correct attitude and self-management behavior after they undergo RFCA, to eliminate or reduce risk factors for AF, to prevent complications, thus promoting AF population health, improve their quality of life.Objective:1. To explore the status Knowledge, attitude, behavior and QoL in AF patients undergoing RFCA, and analyse the influencing factors of KAB.2. To investigate the effects of of KAB model education on knowledge, attitude, behavior and QoL of patients with Atrial Fibrillation Undergoing RFCA.Materials and Methods:1. Conducting a KAB survey utilizing specifically designed questionnaire Knowledge-Attitude- Behavior questionnaire for the patients with atrial fibrillation treated by radiofrequency ablation among 204 hospitalized AF patients undergoing RFCA, so as to investigate the status and influencing factors of KAB in these patients; SF-36 survey to investigate the AF patients' quality of life.2. Using random number table according to the time the patient admitted to hospital, they were randomly divided into control group or intervention group, each group has 102 participants. Giving the routine treatment and care to control group. Intervention group received the KAB model health education. 3 months later after the do the RFCA operation, test the knowledge, attitude, behavior, and quality of life in two groups. Statistics and analyses the parameters. Analyse the influence of KAB model health education on knowledge, attitude, behavior, and quality of life among AF ablation patients.Results:1. The SF-36 scores in all dimensions except vitality were significantly lower in AF patients treated by radiofrequency ablation than those in Chinese normal group (P<0.01).2. AF patients undergoing RFCA have knowledge deficits, female, higher education, more RFCA attempts and higer quality of life were predictors of greater AF knowledge.3. Perceived barriers attitude was poor in AF patients. Higher knowledge scores was positive predictors of AF attitude.4. AF patients have a poor monitoring behavior, Higher knowledge scores was positive predictors of AF behavior. More RFCA attempts was negative predictors.5. KAB model education improve the treatment knowledge, attitude and behavior in AF patients taking RFCA compared to the control group, the difference was significant(P <0.05).6. After taking KAB model education, the SF-36 scores in all dimensions except body pain and vitality were significantly improved (P<0.01). Conclusion:AF patients undergoing RFCA have knowledge deficits in genera, negative attitude, poor self-management behavior and lower quality of life. KAB model education can improve knowledge, attitude, behavior and quality of life in such patients.