A longitudinal study of self-management ability in acute myocardial infarction patients after percutaneous coronary intervention

Ying Han, Xia He, Mei Lin
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Abstract

Objective To understand the development trajectory of self-management ability of acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI) , to explore the predictive roles of perceived control force and hospital discharge readiness so as to provide a theoretical basis for working out the phased and personalized self-management plan. Methods From May to September 2018, this study selected 168 AMI inpatients with PCI of Cardiac Care Unit at a ClassⅢ Grade A general hospital in Tianjin as subjects by convenience sampling. All patients were investigated with the Self-management Scale for Patients Undergone Coronary Artery Stent Implantation, the Chinese Version of Control Attitudes Scale-revised and the Readiness for Hospital Discharge Scale. Data were collected at discharge (Time 1, T1) , 3 months (Time 2, T2) , 6 months (Time 3, T3) , 9 months (Time 4, T4) , 12 months (Time 5, T5) after discharge. Results Among 168 AMI patients, the scores of self-management ability in T1, T2, T3, T4 and T5 were (34.91±5.03) , (38.89±7.22) , (43.78±9.32) , (47.76±10.33) and (53.29±11.48) respectively. The scores of perceived control force and hospital discharge readiness in T1 were (20.63±6.70) and (59.85±21.42) respectively. Conditional model fit indexes all reached the standard. The development trajectory of self-management ability was a linear form and a significant rise. There were individual differences in the initial levels and development speeds. Perceived control force and hospital discharge readiness could positively predict the initial level of self-management ability. Perceived control force could positively predict the development speed of self-management ability. Conclusions Self-management ability of AMI inpatients after PCI shows a sustainable development which can be promoted by improving the perceived control force and hospital discharge readiness. Key words: Acute myocardial infarction; Self-management; Perceived control force; Hospital discharge readiness; Latent growth curve modeling
急性心肌梗死患者经皮冠状动脉介入治疗后自我管理能力的纵向研究
目的了解急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后自我管理能力的发展轨迹,探讨感知控制力和出院准备的预测作用,为制定分阶段、个性化的自我管理计划提供理论依据。方法采用方便抽样的方法,选取天津市某三甲综合医院心脏监护室168例AMI PCI住院患者为研究对象。所有患者均采用冠状动脉支架植入患者自我管理量表、修订版控制态度量表和出院准备量表进行调查。在出院后(时间1,T1)、3个月(时间2,T2)、6个月(日期3,T3)、9个月(期限4,T4)、12个月(时段5,T5)收集数据。结果在168例AMI患者中,T1、T2、T3、T4和T5的自我管理能力得分分别为(34.91±5.03)、(38.89±7.22)、(43.78±9.32)、、(47.76±10.33)和(53.29±11.48)。T1患者的感知控制力和出院准备度得分分别为(20.63±6.70)和(59.85±21.42)。条件模型拟合指标均达到标准。自我管理能力的发展轨迹是线性的,并且显著上升。在初始水平和发育速度上存在个体差异。感知的控制力和出院准备度可以正向预测自我管理能力的初始水平。感知控制力可以正向预测自我管理能力的发展速度。结论AMI患者PCI术后的自我管理能力呈持续发展趋势,可通过提高控制力和出院准备来促进其自我管理能力的提高。关键词:急性心肌梗死;自我管理;感知控制力;出院准备情况;潜在增长曲线建模
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