| Objectives:This paper describes the physical activity status of patients with coronary heart disease after stent implantation,analyzes the influencing factors,and probes into the relationship between physical activity and exercise self-efficacy,anxiety,depression,fatigue,social support.In order to arouse the attention of medical staff on the physical activity of patients with coronary heart disease after stent implantation and provide scientific and effective basis and reference information for making long-term physical activity intervention guidance and exercise rehabilitation education for patients with coronary heart disease after stent implantation,so as to reduce the recurrence of cardiovascular events and improve the level of physical activity of patients with coronary heart disease after stent implantation.Methods:This survey was used in a cross-sectional survey.From January to October 2019,inpatients review in the cardiovascular department who had successfully undergone coronary stent implantation for 6 months or more at a third-class A general hospital in Henan Province were selected as research object.A total of 280 patients were investigated according to the criteria for inclusion and exclusion.The survey tools included: a self-designed general information questionnaire,the International Physical Activity Questionnaire-Long Form(IPAQ-L),the Exercise Self-Efficacy Questionnaire(ESES),Multi-dimensional Fatigue Scale(MFI-20),the Social Support Rating Scale(SSRS),the Hospital Anxiety and Depression scale(HADS).Database was established by Epidata 3.1,analyzed by SPSS 22.0 and Amos 24.0.Statistical methods include descriptive statistical analysis,univariate analysis,Spearman correlation analysis,multiple linear regression analysis,structural equation models and so on.Results:1.Physical activity status of patients with coronary heart disease after stent implantationThe total energy consumption of patients with coronary heart disease after stent implantation ranged from 0 to 14164 MET-min/week,the median was 1512.00 MET-min/week,and the quartiles P25 and P75 were 438.00 MET-min/week and 2426.50 MET-min/week.According to the classification method of individual physical activity level of IPAQ,47 patients(18.1%)had adequate physical activity,101 patients(38.8%)had moderate physical activity and 112patients(43.1%)had insufficient physical activity.According to the recommended standard of secondary prevention of cardiovascular disease issued by AHA/ACC in 2013,102 patients(39.2%)with physical activity achieved the guideline standard and 158 patients(60.8%)did not meet the guidelines.2.The status of social support,exercise self-efficacy,fatigue,anxiety and depression in patients with coronary heart disease after stent implantationThe average score of social support was(37.98±7.11).The social support level of 215 patients(82.7%)was in the middle level,39 patients(15.0%)had high social support level,and only 6 patients(2.3%)had low social support level.The average score of fatigue was(57.05±11.03).The scores of each dimension: general fatigue score was(11.10±2.48),physical fatigue score was(12.01±2.69),decreased activity score was(12.36±2.85),decreased motivation score was(11.54±2.40)and mental fatigue score was(10.07±2.32).The average score of exercise self-efficacy of patients with coronary heart disease after stent implantation was(49.59±12.47)close to the middle level.The mean score of anxiety and depression was(3.65±2.11)and(3.47±2.38)respectively.27 patients(10.4%)had anxiety symptom and 19 patients(7.3%)had depression symptom.3.Influencing factors of physical activity in patients with coronary heart disease after stent implantationUnivariate analysis results showed that the differences of age,occupational type,home location,BMI,the NYHA classification,combined chronic disease status,postoperative time,and LVEF of patients with coronary heart disease after stent implantation in physical activity energy is statistically significant(P<0.05);Spearman correlation analysis showed that anxiety,depression,and fatigue were negatively correlatedwith the scores of physical activity energy consumption,while social support and exercise self-efficacy were positively correlated with the scores of physical activity energy consumption,the difference was statistically significant(P<0.01).The results of multiple linear regression analysis showed that: the NYHA classification,LVEF,fatigue,exercise self-efficacy,combined chronic disease status and social support finally entered the regression equation,which showed that these six variables accounted for 59.9% of the total variation of physical activity in patients with coronary heart disease after stent implantation.4.Structural equation model of physical activity in patients with coronary heart disease after stent implantationBased on the theoretical framework of this study and the review of relevant literature,this paper further tests the interaction mechanism among the five variables of exercise self-efficacy,fatigue,anxiety,depression,social support and physical activity status by fitting structural equation,so as to clarify the path relationship among the influencing factors of physical activity.The results show that exercise self-efficacy,fatigue and social support can directly affect the physical activity of patients with coronary heart disease stent implantation;anxiety and depression can indirectly affect the physical activity of patients with coronary heart disease stent implantation through exercise self-efficacy;In addition,anxiety,depression,fatigue,exercise self-efficacy and social support of patients with coronary heart disease stent implantation explain physical strength activity 45%.Conclusions:1.The patients with coronary artery disease stent implantation had lower levels of physical activity,the physical activity items mainly focus on low and moderate intensity physical activity,60.8% of patients do not meet the recommended amount of guidelines,and their physical activity level needs to be further improved.2.Through the analysis of the influencing factors of physical activity in patients with coronary heart disease stent implantation,the results showed that the status of physical activity was affected by the NYHA classification,LVEF,exercise self-efficacy,fatigue and social support.3.The structural equation model of health promotion model has a better explanation for the physical activity of patients with coronary heart disease after stent implantation. |
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