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Study on the Influence of Nursing Intervention on Self-efficacy Level in Patients after Percutaneous Coronary Intervention

Author: DingHongQiong
Tutor: LiuChunYan
School: Tianjin Medical University
Course: Nursing
Keywords: Coronary heart disease Percutaneous coronary intervention Self-efficacy Health education Nursing
CLC: R473.5
Type: Master's thesis
Year: 2011
Downloads: 141
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Objectives:(1)To identify the self-efficacy level of patients after percutaneous coronary intervention(PCI).(2)To analyze the relationship among the personal basic information, related knowledge on coronary heart disease, social supports and chronic disease self-efficacy, so as to provide scientific evidences for making nursing intervention measures.(3)To explore systemic health education’s impact on the level of self-efficacy of patients after PCI.Methods:A descriptive design and a quasi-experiment design were in this study. From November 2009 to July 2010,110 coronary heart disease(CHD) patients after PCI were investigted in tianjin first central hospital. All subjects completed the chronic disease self-efficacy assessment scale, questionnaire of related knowledge on coronary heart disease, social supports rating scale(SSRS) and personal basic information questionnaire. At the same time, the value of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic pressure,diastolic pressure,body mass index, abdominal circumference and fasting blood glucose were tested and collected. All the data were evaluated. The level of related knowledge on coronary heart disease, self-efficacy and social supports were described, together with self-efficacy’s related factors. In the part of quasi-experiment,100 subjects admitted were randomly selected into experimental group and control group by the number of rooms. Patients in the experimental group were given systemic health education and routine nursing. Patients in control group only received routine nursing. The duration of intervention was 6 months. Questionnaires and physiological values were collected again just after intervention. Paired t-test was used in comparing the status of chronic disease self-efficacy, related knowledge on coronary heart disease and physiological values before and after intervention. Independent t-test or rank sum test were used in comparing between experimental group and control group. Statistical analysis was performed with SPSS 15.0. Results:(1) 12.7% of patients after PCI were in the higher levels of self-efficacy, 83.6% at medium,3.6% at the low level and the overall self-efficacy was at the mid to upper level. (2) Knowledge score after PCI in patients with CHD, the total was 0.66±0.18, the highest score was the knowledge of secondary prevention after discharge(0.88±0.17), the second highest is knowledge of treatment(0.85±0.21),and knowledge about drugs is the lowest score (0.33±0.28). The mean value of social support is 41.91±7.30,39.1% of patients at higher levels of social support,59.1% at a medium level,1.8% at low level. (3) One-way ANOVA and independent t-test revealed that, education level, occupation, family income, smoking and whether diabetes were related factors of self-efficacy. (4) Score of CHD knowledge and the degree of social support using were related factors of self-efficacy or the item. (5) Compared indexs in experimental group before and after intervention:The scores of self-efficacy, symptom management, emotional control, role function, communicate with doctors, total knowledge, CHD concept, risk factors, causative fators, clinical manifestations, examination, drug knowledge and secondary prevention knowledge significantly increased after intervention. The values of TG, LDL-C, BMI, DBP and FBG significantly decreased after intervention, while the value of HDL-C significantly increased after intervention. (6) Compared indicators betweee two groups:Compared with control group, the scores of self-efficacy, symptom management, role function, communicate with doctors, total knowledge, CHD concept, risk factors, causative fators, secondary prevention knowledge significantly increased in experimental group. The decreased ranges of TG, BMI in experimental group were higher than these in control group(P<0.05).Conclusion:There were associations among self-efficacy, general characteristics, CHD knowledge and social support of patients after PCI. Systemic health education can change the level of CHD knowledge, improve their self-confidence of defeating disease, promote the improvement of health behaviors, and improve quality of life.

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