Study On The Relationship Between Self-Management Behavior And Risk Perception,Self-Efficacy In Patients With Coronary Heart Disease

Background Coronary Heart Disease(CHD)is a common chronic cardiovascular disease,and it is one of the important diseases that threaten human health and life.Due to the change of medical model,more and more patients participate in the management of the disease.Self-management is one of the important measures for the secondary prevention of coronary heart disease.A large number of studies have confirmed that the level of self-management behavior of patients with coronary heart disease is not ideal.Coronary heart disease as a behavior-related disease,exploring the correlation and impact of risk perception,self-efficacy and self-management behavior can provide a theoretical basis for clinical implementation of individualized and effective self-management education,and thus improve the coronary heart disease Self-management level.Objectives To describe the current situation of self-management behavior and risk perception,self-efficacy in patients with CHD;To analyze the correlation between self-management behavior and risk perception or self-efficacy in patients with CHD;To explore the factors affecting self-management behavior about patients with CHD.Methods This study is a cross-sectional study,using a convenient sampling survey method.A total of 330 patients with coronary heart disease who met the inclusion criteria from a cardiology department of a tertiary hospital from December 2018 to December 2019 were selected.A total of four questionnaires were used to investigate the subjects,including the basic situation questionnaire,the coronary heart disease self-management behavior scale(CSMS),the coronary heart disease self-efficacy questionnaire,and the chronic disease risk perception questionnaire.The data were analyzed by software SPSS22.0.Results 1.The level of self-management behavior in patients with CHD The total score was(76.64 ± 26.14),which was at a low level.The scores for each dimension are: the emotional cognitive management dimension was(12.60±3.83),the disease knowledge management dimension was(15.06±4.84),the symptom management dimension was(11.27±4.05),the daily life management dimension was(11.20±4.01),and the bad hobby management dimension was(10.84±4.81),the First aid management dimension was(7.90 ± 3.23),the treatment compliance management dimension was(7.73±3.21).2.The level of risk perception patients with CHD The total score of risk perception was(27.36±9.89),which was in the middle level.The scores of three dimensions from the highest to the lowest were as follows : The economic risk score is(9.30±4.23);the physical diagnosis and treatment risk score is(11.39±3.76);the social psychological risk score is(6.60±2.72).3.The level of self-efficacy of patients with CHD The total score of self-efficacy was(36.15±14.01),and the score index was 56.48%,which was at a low level.The scores of the two dimensions from the highest to the lowest were as follows: symptom maintenance score is(27.13±10.63);functional maintenance score is(9.01±3.67).4.The correlation between self-management behavior and risk perception in patients with CHD There was a positive correlation between the total score of risk perception and the total score of self-management(r=0.253,P<0.01);The scores between the seven dimensions of self-management behavior were positively correlated,except that economic risk dimension,the social psychological risk dimension,and bad hobby management dimension were negatively correlated.5.The correlation between self-management behavior and self-efficacy in patients with CHD There was a positive correlation between the total self-efficacy score and the total self-behavioral management score(r=0.935,P<0.05).There was also a positive correlation between the scores of self-efficacy and the scores of self-management behavior about each dimension(r=0.678~0.944,P<0.01).6.Correlation between self-efficacy and risk perception in patients with coronary heart disease There was a positive correlation between self-efficacy and risk perception in all dimensions and total scores(r=0.199~0.627,P<0.01)7.The single affecting factor analysis about self-management behavior of patients with CHD such as gender,age,education level,occupation,marriage,place of residence,residence method,monthly household income,medical payment form,duration of illness,past causes The scores of coronary heart disease admissions,family history,comorbidities,etc.They were statistically significant in the total score of self-management behavior(P<0.05).8.The multiple linear stepwise regression analysis of self-management behaviors of patients with coronary heart disease There were six factors which entered the regression model,including self-efficacy,treatment,economic status,age,number of hospitalizations,and time of illness.After F test,F=40.47,P<0.05,the fitted multiple linear regression equation has statistical significance.Conclusions 1.The self-management behavior level of Patients with CHD is still unsatisfactory,their risk perception level is relatively high,and their self-efficacy is low.2.The self-management behavior and risk perception,self-efficacy of patients with CHD had a mutually reinforcing relationship.An increase in self-efficacy level will promote the improvement of patient self-management behavior level,and the level of perception about risk was increased,and heighten the standard of self-management behavior.Patients with high self-efficacy also have a higher level of risk perception.3.Self-efficacy,treatment,economic status,age,number of hospitalizations,and time of illness were the main influencing factors about self-management behavior in patients with CHD.