To Study The Application Of Respiratory Exercise Based On Self-efficacy Theory In Patients With Chronic Heart Failure

Objective:The purpose of this study is to provide referential experience for Chinese medical staff to guide patients with chronic heart failure with respiratory rehabilitation exercise and improve their heart function and quality of life by using self-efficacy theory as the framework and taking breathing exercise as the direct experience.Method:1.Construction of breathing exercise intervention program based on self-efficacy theory.(1)Research methods based on literature retrieval.Chinese and English search terms were formulated,and literature search was conducted in the Chinese and English database from the establishment of the database to June30,2021.The topic of literature retrieval was the Randomized Controlled Trial(RCT)about patients performing autonomous breathing exercise.The methods and respiratory parameters of respiratory exercise in the included literature were summarized and summarized,and the methods of autonomous breathing exercise for this study were formulated.(2)Based on the self-efficacy theory as the framework,breathing exercise as the direct experience,the initial construction of intervention plan.(3)Modify the intervention plan after expert consultation meeting and preliminary experiment,and combine expert opinions and preliminary experiment results.2.Empirical research.A total of 98 patients with chronic heart failure who met the study criteria were selected from the third ward of the Department of Cardiology in a third-class A hospital in Henan Province from December 2021 to October 2022.98 patients with chronic heart failure were randomly divided into intervention group and control group,with 49 patients in each group.Patients in the control group were given routine nursing,and patients in the intervention group were given breathing exercise program based on self-efficacy theory for clinical intervention on the basis of control group.The improvement effects of dyspnea,heart rate,6-MWT(6-m WT),anxiety level,quality of life and exercise self-efficacy were observed in both groups before intervention,1 month and 3 months after intervention.Results:1.Construction of breathing exercise intervention program based on self-efficacy theory.A total of 1923 literatures were obtained.The literatures were excluded by reading the title,abstract and full text,and 14 literatures were finally included.The methods of breathing exercise in this study were determined as follows:(1)Patients could lie down,sit and stand,with their eyes in front of them and their spine straight;(2)Inhale slowly through the nose,silently count 001,002,003,and place the right hand on the abdomen to feel the bulge of the abdomen;(3)The mouth shrank slightly,exhaled slowly,the hand felt the depression of the abdomen,the heart function of grade Ⅰ ～ Ⅱ chronic heart failure patients counted to006,the respiratory rate was 6 times /min;The patient with grade Ⅲ chronic heart failure had a silent count to 007 and a respiratory rate of 5 times /min.After a cycle can rest for 2 ～ 5s;(4)The exercise frequency was 5 days/week,30 minutes of exercise every day,which could be divided into three periods,morning,middle and evening,and the exercise time was not less than 10 minutes.With self-efficacy theory as the frame and breathing exercise as the direct experience,a breathing exercise intervention scheme based on self-efficacy theory was constructed.2.Influence of breathing exercise intervention program based on self-efficacy on patients with chronic heart failure(1)The shedding of the subject.After 1 month,4 patients in the intervention group failed to complete the breathing exercise plan because they did not exercise in accordance with the frequency,time and method of breathing exercise designed in this study or were readmitted to hospital due to cardiovascular events,etc.,and were excluded.In the control group,4 patients were excluded during follow-up because they were unwilling to cooperate or lost contact during follow-up.Finally,45 patients in the intervention group and 45 patients in the control group were included in the analysis.(2)After 1 and 3 months of intervention,the main effect and time effect of intervention on dyspnea were statistically significant(F=13.948,P < 0.001),(F=38.423,P < 0.001).And there was interaction between the time factor and intervention factor in the two groups(F=113.763,P < 0.001).(3)After 1 and 3 months of intervention,the main effect of heart rate in the two groups was not statistically significant(F=0.669,P=0.415),while the time effect and interaction effect were statistically significant(F=55.202,P < 0.001)and(F=57.414,P < 0.001).In terms of improving the 6-minute walking distance,the main effect and time effect of the two groups were statistically significant(F=7.371,P=0.008)and(F=459.405,P < 0.001),and there was an interaction effect between the time factor and the intervention factor(F=177.180,P < 0.001).(3)After 1 and 3 months of intervention,the main effect of the intervention on anxiety level in the two groups was statistically significant(F=62.680,P < 0.05;F=40.345,P < 0.05),and there was an interaction between the time factor and the intervention factor(F=107.114,P < 0.05;F=410.546,P < 0.05).(4)After 1 and 3 months of intervention,the time effect and main effect of the total score of quality of life in the two groups were statistically significant(F=57.380,P < 0.05),(F=2.795,P=0.098),and there was interaction between the time factor and the intervention factor(F=34.319,P=0.098).P < 0.05).(5)After 1 and 3 months of intervention,the main effect and time effect of the intervention were statistically significant(F=6.860,P=0.01),(F=25.133,P < 0.001),and there was an interaction between the time factor and the intervention factor(F=159.576,P < 0.05).Conclusion:1.Compared with conventional care,breathing exercise intervention program based on self-efficacy theory can not only improve patients’ compliance with breathing exercise.Moreover,it has a great promoting effect on patients’ relief of dyspnea,recovery of cardiac function and improvement of negative emotions,improves patients’ quality of life,and has a certain reference value for promoting the rehabilitation of patients with chronic heart failure.