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经皮冠状动脉介入治疗患者对冠心病及其危险因素的认知水平是否足够?

Is Knowledge Level of Coronary Heart Disease and Risk Factors Among Post-Percutaneous Coronary Intervention Patients Adequate?

作者信息

Nolan Mary T, McKee Gabrielle

机构信息

Mary T. Nolan, MSc Clinical Nurse Manager, Cardiac Catheterisation Laboratory, St James's Hospital, Dublin, Ireland.Gabrielle McKee, PhD Director of Research, School of Nursing and Midwifery, University of Dublin, Trinity College, Ireland.

出版信息

J Cardiovasc Nurs. 2016 May-Jun;31(3):E1-9. doi: 10.1097/JCN.0000000000000291.

Abstract

BACKGROUND

Percutaneous coronary intervention (PCI) is now commonly used in the treatment of coronary heart disease. However, shorter hospital stays after intervention may affect patients' knowledge and subsequent required lifestyle changes.

OBJECTIVE

The aim of this study is to investigate participants' risk factor profile, knowledge of coronary heart disease, and the influence of demographic and risk factors on this knowledge.

METHODS

This prospective, cross-sectional 1-site study recruited both elective and emergency PCI patients postdischarge. The questionnaire collected data on demographics, risk factor profile, and coronary heart disease knowledge as measured on the Bergman Heart Disease Knowledge Questionnaire. Bivariate and multivariate analyses were used to analyze the influence of 11 risk and sociodemographic factors on knowledge.

RESULTS

The response rate was 67% (n = 84). The sample was mostly male and aged 65.79 ± 9.9 years, and 59% had an elective PCI. Risk factor burden was high; 2 or more risk factors were seen in 66% of participants. Mean knowledge score overall was 51%, with the highest score achieved in the risk factor domain (61%). Lowest scores were in the medical and symptoms domains (both 46%). Neither the bivariate nor the multivariate analyses were significant. A large proportion of patients believed that coronary heart disease was no longer a concern for them after PCI.

CONCLUSIONS

As expected, the risk factor profile of post-PCI patients was high. However, their knowledge levels and awareness were unrelated to risk factor profile and poor in comparison with studies in other cardiac patients. This, in addition to the short stay in hospital and the low attendance of this cohort at cardiac rehabilitation, identifies this group of patients as a priority for further targeted education. Innovations are needed to increase knowledge and begin behavioral change predischarge after PCI. This should include target and goal setting for lifestyle change to avail of this critical education opportunity.

摘要

背景

经皮冠状动脉介入治疗(PCI)目前常用于冠心病的治疗。然而,介入治疗后较短的住院时间可能会影响患者的认知以及后续所需的生活方式改变。

目的

本研究旨在调查参与者的危险因素概况、冠心病知识,以及人口统计学和危险因素对该知识的影响。

方法

这项前瞻性、横断面的单中心研究招募了出院后的择期和急诊PCI患者。问卷收集了有关人口统计学、危险因素概况以及通过伯格曼心脏病知识问卷测量的冠心病知识的数据。采用双变量和多变量分析来分析11种风险和社会人口学因素对知识的影响。

结果

应答率为67%(n = 84)。样本大多为男性,年龄为65.79±9.9岁,59%接受了择期PCI。危险因素负担较高;66%的参与者有2种或更多危险因素。总体平均知识得分是51%,在危险因素领域得分最高(61%)。最低得分在医学和症状领域(均为46%)。双变量和多变量分析均无统计学意义。很大一部分患者认为PCI后冠心病不再是他们担心的问题。

结论

正如预期的那样,PCI术后患者的危险因素概况较高。然而,他们的知识水平和认知与危险因素概况无关,与其他心脏病患者的研究相比情况较差。此外,由于住院时间短以及该队列参加心脏康复的比例低,这表明这群患者是进一步针对性教育的重点对象。需要创新方法来增加知识并在PCI术后出院前开始行为改变。这应包括设定生活方式改变的目标,以利用这一关键的教育机会。

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