The Effect Of Telecare On Coping Style Of Myocardial Infraction Patients After Returning To Work

ObjectiveTo develop targeted telecare measures and explore the effect of telecare on coping ability,health behavior,social support and quality of life of patients with myocardial infarction after returning to work.Methods1.From November 2017 to June 2018,92 patients with myocardial infarction who returned to work within 3 to 6 months after discharge were selected from the inpatient and outpatient department of Cardiology of comprehensive hospitals in Henan Province by convenience sampling.2.According to the random number table method,the patients were divided into the intervention group and the control group,46 cases in each group.The control group received usual hospital care,while the intervention group received 6 weeks of telecare on the basis of usual nursing.Intervention is divided into five modules.Symptom monitoring and management are carried out in real time.The other four modules are carried out according to patients’ needs and feedback.Relevant contents are provided once a day in the morning and afternoon,we summarized in the evening and got feedback at weekends.3.Medical Coping Modes Questionnaire(MCMQ),Health Promoting Lifestyle Profile II(HPLP II),Social Supporting Rating Scale(SSRS)and Medical Outcome Scale:The short scale-8(SF-8)were used to evaluate the effect of intervention before intervention(T1),one month after intervention(T2)and three months after intervention(T3).4.The main outcome indicators were coping style,and the secondary outcome indicators were health behavior,social support,quality of life,frequency of angina,readmission,blood pressure compliance rate,medication compliance,days out of work,participants’ application and compliance with intervention.5.Excel 2016 and SPSS21.0 was used for data and statistical analysis.T-test or chi-square test were use for baseline data comparison between the two groups.The difference between the two groups was compared by repeated measurement variance analysis.Cohen’s D was used to test the effect of intervention.Results1.According to the inclusion and exclusion criteria,92 patients with myocardial infarction who had returned to work in the Department of Cardiology of of comprehensive hospitals in Henan Province were selected in this study.At last,84 samples were completed,with the completion rate of 91.3%.2.There was no significant difference in the variables between the two groups before intervention.After 6 weeks of intervention(1)Both groups had higher scores in facing coping style,lower scores in yielding and avoidance,and for facing coping style,yielding and avoidance,there were significant differences in time effect,group effect and interaction effect between the two groups(P < 0.001).(2)Repeated measurement analysis of variance indicated that the main effects of intervention on total scores of quality of life between intervention group and control group were statistically significant(P < 0.05);the main effects of time on total scores of quality of life,health behavior and social support in two groups were statistically significant(P < 0.05),the score of quality of life,health behavior and social support changed with time;there were significant differences in group effect in the total scores of quality of life,health behavior and social support between the two groups(P < 0.05).There was interaction between the intervention factors and time factors in the total scores of quality of life,health behavior and social support(P < 0.05).3.Three months after the intervention,the incidence of angina,readmission and days of absence in the intervention group were less than those in the control group(P < 0.05),the rate of blood pressure compliance,medication compliance in the intervention group were better than those in the control group(P < 0.05).4.Participants have good application and compliance with the intervention.Participants can actively consult and feedback,complete the intervention content and report timely,and also can accept and complete the test and evaluation.5.At the end of the intervention,the Cohen’s D of each outcome variable in the intervention group was greater than 0.5,showing that the 6-week telecare intervention based on mobile phone application could have the good effects.6.Three months after the intervention,Cohen’s D > 0.5 in social support and quality of life,and the sustained effect of intervention was moderate.Cohen’s D was greater than 1.2 in health behavior,coping style,face,yield and avoidance.ConclusionAs a non-drug treatment method,the 6-week telecare intervention based on mobile phone application for myocardial infarction patients who have returned to work can effectively improve their coping style and increase the patients’ positive cope to the disease through symptoms monitoring and management,problem solving,health guidance,psychological counseling and behavioral changes and reduce the negative coping style of yielding to avoidance,help patients improve disease management ability,maintain healthy behavior,effectively use social support,improve the quality of life,and maintain normal work.The feasibility and operability of intervention are strong,and participants’ application and compliance to intervention are good.And in a longer period of time(3 months)the intervention has a great lasting effect.Patients can benefit a lot from the active acceptance of telecare intervention.