Construction And Application Of Self-management Intervention Program Based On Self-efficacy Theory For PCI Patients With Type D Personality

ObjectiveThe purpose of this study is to construct a self-management intervention program based on self-efficacy theory for Percutaneous Coronary Intervention(PCI)patients with type D personality,and to explore the application effect of this program in self-management of PCI patients with type D personality,so as to provide new ideas and theoretical basis for clinical medical staff to study patients with type D personality.MethodsBased on the self-efficacy theory,this study preliminarily formulated the intervention program through literature review and group discussion.The Delphi method was used for 2 rounds of expert consultation and pre-experiment were conducted to modify and determine the intervention program.Then the convenience sampling method was used to select 58 PCI patients with type D personality who were hospitalized in the first and second ward of cardiology in a Grade A Class Three hospital in Qingdao from April 2019 to October 2019 as the research objects.Among them,the subjects in the first ward were control group,and the subjects in the second ward were intervention group,29 cases in each group.The control group was given routine health education in the cardiology and 2 outpatient follow-ups after discharge,and the intervention group was given self-management intervention based on self-efficacy theory on this basis.From the four ways of direct experience,indirect experience,verbal persuasion,and physiological and emotional states,the measures to enhance patients’ self-efficacy were put forward to promote patients to take self-management behavior.The coronary artery disease self-management scale,cardiac self-efficacy scale,hospital anxiety and depression scale were used to compare the self-management ability,self-efficacy and negative emotion scores of the two groups before intervention,1 month after intervention and 3 months after intervention.Statistical methods such as chisquare test,t-test,and repeated measures analysis of variance were used to analyze the data by SPSS 22.0 software to evaluate the implementation effect of the self-management intervention program based on the self-efficacy theory.Results1.Construction of the intervention program: the positive coefficients of the tworounds of consultation experts were 100% and 90%;the authoritative coefficients of the two rounds of consultation experts were 0.89 and 0.91;the coordination coefficients(Kendall’s W)of the two rounds of consultation experts were 0.329 and 0.348(P<0.05).The self-management intervention program based on the self-efficacy theory includes positive psychological intervention,emotional relaxation training,guiding patients to make self-management plan,model demonstration,providing family and social dual support,etc.2.Application of intervention programs:(1)Comparison of baseline data between the two groups of patients before the intervention:general data,self-management ability,self-efficacy and negative emotion scores between the two groups were not statistically significant(P >0.05),and were comparable.(2)The intervention effect of self-management ability showed that: 1 month after the intervention,the total score of self-management and other dimensions of patients in the intervention group were higher than those in the control group(P<0.05)except for the dimension of medical management of disease(P >0.05).3 months after the intervention,the total score of self-management and scores of all dimensions in the intervention group were higher than those in the control group(P <0.05).(3)The intervention effect of self-efficacy showed that: the total self-efficacy scores of the intervention group at 1 month and 3 months after intervention were(32.82±2.31)points and(36.61±2.06)points,respectively,which were higher than those of the control group(29.59±3.44)points and(32.07±3.09)points(P <0.05);the scores of each dimension in the intervention group were higher than those in the control group at 1 and 3months after intervention(P<0.05).(4)The intervention effect of negative emotion showed that: 1 month after the intervention,the total anxiety and depression scores and anxiety scores of the intervention group were lower than the control group(P <0.05);3 months after the intervention,the total anxiety and depression scores 、 anxiety scores and depression scores of the intervention group were lower than the control group(P <0.05).ConclusionThe self-management intervention program based on self-efficacy theory for PCI patients with type D personality has high authority,good enthusiasm,high degree of expert coordination and consensus of expert opinions.The intervention program is scientific to a certain extent.The intervention program is beneficial to improve the self-management ability of PCI patients with type D personality,and strengthen their self-management after surgery;it is also helpful to enhance the self-efficacy of patients and improve their confidence in overcoming diseases.It is beneficial to alleviate the negative emotions of patients,improve their positive emotions,and promote their positive response to the disease.