| Objective "bio- psycho- social medical model" since made, it has been facing lack of appropriate clinical assessment system, standardize viable operating system and many other issues. In view of this, on the basis of full investigation, attempts has been made to establish operational physiological- psychosocial- ethical integrated treatment model in clinical department of cardiology, referred as "Three Li" treatment model.(1) According to the relevant psychosocial factors of clinical cardiology disease, we try to establish " Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual", as part of the “Three Li" treatment model in clinical applications for assessing patients' psychosocial factors with diseases.(2) In accordance with the "Physiological- Psychosocial- Ethical Treatment Model Operation Manual" and "Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual", implement "Three Li" treatment model in clinical department of cardiology to study coronary heart disease or high blood pressure patients' psychosocial status as well as the effectiveness of the model.Methods(1) Based on the literature review and experts' advice, considering psychosocial factors related to the preparation of clinical cardiovascular disease, we establish "Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual". Assessed 200 hospitalized patients from two general hospital cardiovascular medicine in Zhengzhou, who hospitalized from September- December 2014 and over the age of 18, according to "Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual". 186 valid questionnaires were got to analyze the reliability and validity of the manual.(2) Selecting 100 hospitalized patients in a Department of Cardiology of a general hospital in Henan, who hospitalized from June to September 2015 and aging 35-70 years, in line with the standard set of patients. According to "Physiological- Psychosocial- Ethical Treatment Model Operation Manual" and "Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual" to implement the "three Li" treatment model. The final effective data is 93. Data were analyzed using spss21.0.Results(1) The correlation index of item scores and total, factor scores and total were all significant and greater than 0.3; scale Cronbach's ? coefficients were respectively 0.709, 0.718, 0.672, 0.843; test-retest reliability were 0.908, 0.949, 0.914, 0.980, and all significant; cumulative variance contribution rates of the scale factors of psychological symptoms, lifestyle and social situation were 91.03%, 90.62%, 79.21%.(2) Overall, male patients' lifestyle scores were significantly higher than female patients', whose social situation scores were significantly lower than female patients'. Leaders' scores of lifestyles and social circumstances were significantly higher than ordinary workers and peasants; hypertensive patients' scores of lifestyles and social circumstances were significantly higher than patients with coronary heart disease and comorbid.(3) In population of patients with cardiovascular disease, ones who drank, smoke, or had irregular life got higher life stress scores than those not drank, not smoke, had regular life; patients with irregular life got higher type A behavior scores than the rest rules patients; positive correlation among scores of psychological symptom score, social circumstances and A-type behavior was significant.(4) When the two groups of patients admitted, there was no significant difference in the score. As a whole, the intervention group's scores of psychological symptoms, lifestyle and social situation when discharged were significantly lower than the score at admission. In follow-up, the intervention group's scores of anxiety, somatization, sodium intake, reasonable diet, life events and psychological symptoms total, social circumstances total was significantly lower than the control group.In the intervention group, patients with remarkable therapeutic effect was significant more than patients with valid therapeutic effect in hypertension and angina pectoris, electrocardiogram therapeutic effect evaluation. In the control group, only the number of patients assessed as markedly in angina was significantly higher than that for the effective assessment. The intervention group's scores of hospitalized satisfaction and follow-up items were significantly higher than that of the control group.Conclusion(1) "Physiological- Psychosocial- Ethical Treatment Model Assessment Indicators Manual" is credible and effective, can be used for implementations of"Three Li" treatment model in clinical department of cardiology.(2) Patients in department of cardiology mostly have psychological, lifestyle, social circumstances issues and the tendencies of Type A behavior, and those of different gender, retirement status, occupation and disease kind exhibit different characteristics.(3) Psychological problems, social circumstances and Type A behavior of patients with cardiovascular disease are closely related. Patients drinking, smoking, having irregular work could get more negative effect from the pressure of living;(4) "Three Li" treatment model can help to improve patients' adverse psychosocial factors, as well as their understanding of disease-related factors and hospital satisfaction, and get better results. It is feasible in the clinic. |
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