| Objectives:To construct a cognitive behavioral intervention program for acute myocardial infarction patients with kinesiophobia and compare the differences between cognitive behavior intervention and routine nursing intervention in kinesiophobia,activity of daily living,anxiety and depression in patients with acute myocardial infarction;To clarify the application value of Cognitive Behavioral Therapy in the early rehabilitation of patients with acute myocardial infarction,so as to provide evidence for further developing and improving the intervention methods of kinesiophobia in patients with heart disease.Methods:Using convenient sampling method,92 acute myocardial infarction patients with kinesiophobia who were admitted to the Department of Cardiology of a third-class A hospital in Shanxi Province from September 2020 to June 2021.All patients meet the inclusion exclusion criteria and gave their informed consent,46 hospitalized patients from September 2020 to January 2021 were selected as the control group and 46hospitalized patients from February to June 2021 as the intervention group.The control group carried out routine nursing operations,including rest and diet instruction,medication instruction,pain care,cardiac rehabilitation instruction and discharge education.While the intervention group added cognitive behavioral intervention therapy on the basis of routine nursing.At baseline(the first day after operation),at discharge,one month after discharge,and three months after discharge,the general information questionnaire,hospital anxiety and depression scale,Tampa Scale for Kinesiophobia Heart,Barthel index and other indicators were used to evaluate the application effect of cognitive behavioral therapy.The data were collected and analyzed statistically by IBM SPSS 25.0 software.Results:1.Comparison of general data of patients between the two groups before the intervention:the results showed that there were no significant differences between the two groups in age,BMI(Kg/m~2),education level,marital status,medical payment method,family monthly income(RMB),working status,smoking and alcohol consumption,cardiac function classification,and past history of chronic diseases(P>0.05),which were comparable.2.Comparison of TSK-SV Heart score,HADS scores and Barthel index between the two groups before the intervention:The results showed that there was no significant difference in TSK-SV Heart score,HADS scores and Barthel index between the two groups before the intervention(P>0.05),which was comparable.3.Comparison of TSK-SV Heart scores between the two groups after the intervention:The one-way repeated measures ANOVA showed that there were time effects(F=195.84,P<0.001)and main compare effects(F=20.545,P<0.001)and crossover effects(F=19.022,P<0.001)in TSK-SV Heart scores of the two groups on the day of discharge,one month after discharge and three months after discharge.The results of TSK-SV Heart score at each time point after the intervention showed that the intervention group was better than the control group,and the difference was statistically significant(P<0.001).4.Comparison of anxiety(HADS-A)scores between the two groups after the intervention:one-way repeated measures ANOVA showed that there were time effects(F=21.982,P<0.001)and main compare effects(F=16.123,P<0.001),and crossover effects(F=4.037,P<0.05)in HADS-A scores of the two groups on the day of discharge,one month after discharge and three months after discharge.The HADS-A score at each time point after the intervention showed that the intervention group was better than the control group,and the difference was statistically significant(P<0.001).5.Comparison of depression(HADS-D)scores between the two groups after the intervention:one-way repeated measures ANOVA showed that there were time effects(F=28.344,P<0.001)and main compare effects(F=4.727,P<0.001),and there was crossover effects(F=3.588,P<0.05)in the HADS-D scores of the two groups on the day of discharge,one month after discharge and three months after discharge.The HADS-D score of each time point after the intervention showed that the intervention group was better than the control group,and the difference was statistically significant(P<0.001).6.The comparison of the Barthel index between the intervention group and the control group showed that the Barthel index of the intervention group was higher than that of the control group at the time of discharge and one month after discharge,and the difference was statistically significant(P<0.05).But the index difference was not statistically significant in three months after discharge(P>0.05).Conclusions:Compared with conventional nursing intervention,cognitive behavioral therapy can significantly reduce the level of kinesiophobia in patients with acute myocardial infarction,relieves patients’anxiety and depression,and improve patients’daily living activities. |
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