中西医结合护理 (Jun 2024)
Construction and application of kinesiophobia intervention program for patients with acute myocardial infarction after percutaneous coronary intervention based on Behavior Change Wheel theory (基于BCW理论的急性心肌梗死PCI术后患者运动恐惧干预方案的构建与应用效果评价)
Abstract
Objective The purpose of this study is to construct and evaluate a kinesiophobia intervention plan based on the Behavior Change Wheel (BCW) theory in patients with acute myocardial infarction after percutaneous coronary intervention (PCI). Methods A total of 90 patients with acute myocardial infarction and fear of exercise who underwent PCI at Xuzhou Central Hospital from October 2022 to October 2023 were selected. To ensure that basic characteristics were balanced and comparable between groups, 45 cases were assigned to each intervention group and control group. The control group implemented a routine nursing plan, while the intervention group implemented a kinesiophobia intervention plan based on BCW theory on the basis of the control group. Firstly, an intervention team and expert group were formed to construct and implement a kinesiophobia intervention plan based on BCW theory. Both groups of patients were intervened for 3 months. Compare the differences in kinesiophobia levels, anxiety and depression levels, and exercise self-efficacy levels between two groups of patients after intervention. Results After intervention, the scores of tampa scale for kinesiophobia heart kinesiophobia(TSK-SV Heart), Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire–9(PHQ-9) in the intervention group were lower than those in the control group at discharge from hospital, one month after discharge and three months after discharge, with significant difference (P＜0. 05). After intervention, the Self-Evaluation Exercise (SEE) scores of patients in the intervention group were higher than those in the control group at all time points, with significant difference (P＜0. 05). Conclusion The intervention plan for kinesiophobia in patients with acute myocardial infarction after PCI, designed based on the BCW theory, is detailed in content, scientifically systematic, and highly practical, providing useful guidance for clinical practice. This intervention plan can not only reduce patients' level of kinesiophobia, alleviate negative emotions such as anxiety and depression, but also enhance patients' exercise self-efficacy, thereby improving their postoperative quality of life. (目的 探究基于行为改变模式(BCW)理论的急性心肌梗死经皮冠状动脉介入治疗(PCI)术后患者运动恐惧干预方案的构建与应用效果评价。方法 选取2022 年10月—2023年10月徐州市中心医院收治的急性心肌梗死PCI 术后并存在运动恐惧的患者90 例。按照组间基本特征均衡且具有可比性的原则分为干预组和对照组, 各45例。对照组实施常规的护理方案, 干预组在对照组的基础上施行基于BCW理论制定的运动恐惧干预方案, 首先组建干预团队和专家组, 构建基于BCW理论的运动恐惧干预方案并实施。两组患者均干预3个月。干预后比较两组患者的运动恐惧水平、焦虑抑郁水平以及运动自我效能水平的差异性。结果 经过干预后, 出院当天、出院后1 个月、出院后3 个月干预组患者的心脏病患者运动恐惧量表(TSK-SV Heart)得分、广泛性焦虑障碍(GAD)-7量表和患者健康问卷抑郁症状群量表(PHQ-9)得分均低于对照组, 差异有统计学意义(P＜0. 05)。经过干预后, 出院当天、出院后1 个月、出院后3 个月干预组患者的运动自我效能感量表(SEE)得分均高于对照组, 差异有统计学意义(P＜0. 05)。结论 基于BCW理论设计的急性心肌梗死PCI术后患者运动恐惧干预方案, 内容翔实, 体系科学, 实用性强, 为临床实践提供了有益的指导。此干预方案不仅能够降低患者运动恐惧水平, 缓解焦虑和抑郁等负面情绪, 还能增强患者的运动自我效能, 进而改善患者术后生活质量。)
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