Nursing Department, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China.
School of Nursing, HeBei University of Chinese Medicine, Shijiazhuang, Hebei, China.
PLoS One. 2018 Jul 30;13(7):e0200246. doi: 10.1371/journal.pone.0200246. eCollection 2018.
Low self-efficacy in chronic disease patients is one of the main disturbances which require physical and mental rehabilitation, calling for the development of a home accessible way to improve self-management.
The purpose of this study was to explore the effectiveness of a community based Baduanjin exercise on self-efficacy in adults with cardiovascular disease.
A randomized controlled trial, longitudinal research design was employed.
After screening by health documents in Community Health Service Station, a total of 134 patients with records of cardiovascular diseases were had been enrolled according to the following inclusion criteria: (1) Community dwelling adults in Xili Community; (2) Patients diagnosed with cardiovascular diseases by community doctors, or other clinicians in health records in the past 3 years (2013-2015); (3) independent walking. Participants were excluded if they: (1) had impaired mobility and limited extremities functionality; (2) had not been in stable health condition and could not adhere to the exercise regime; (3) had communication difficulties and limited ability to follow instructions.
Participants were randomly assigned to the Baduanjin group or the control group. Those in the Baduanjin group received 16 weeks of Baduanjin exercise training, while those in the control group kept the original exercise mode unchanged. The Self-Efficacy for Managing Chronic Disease 6-item Scale (SEMCD6) was administered to subjects before and after intervention.
Demographic data showed that 65.12% of the enrolled 129 participants were aged 65 or older, 92.25% received less than 12 years of education, and 68.21% participants' monthly income was less than 1999 RMB. Before intervention, SEMCD6 scores of 86.36% participants in Baduanjin group were below 7 points, while 85.71% in control group; after 16 weeks of Baduanjin exercise, SEMCD6 scores lower than 7 points in Baduanjin group (21.21%) were significantly lower than that of the control group (84.13%). The increase of SEMCD6 scores in Baduanjin group was statistically significant in the confidence to keep the fatigue, to keep the physical discomfort or pain, to keep the emotional distress and do the different tasks and activities (P<0.01).
Adults with cardiovascular diseases in community have lower level of education, most of whom have a low monthly income; thus, community dwelling cardiovascular disease patients are more suitable for an economic program to persist their long term management of the disease. Baduanjin is a traditional Chinese medicine regimen with less physical and cognitive demand; community based exercise of Baduanjin could help to increase self-efficacy in patients with cardiovascular diseases, thus better self-management of rehabilitation process.
慢性病患者的自我效能感低是需要身心康复的主要障碍之一，因此需要开发一种家庭可及的方法来改善自我管理。
本研究旨在探讨基于社区的八段锦锻炼对心血管疾病成人自我效能感的影响。
采用随机对照试验、纵向研究设计。
通过社区卫生服务站的健康档案进行筛选后，根据以下纳入标准共纳入 134 名有心血管疾病记录的患者：（1）在西丽社区居住的成年人；（2）过去 3 年（2013-2015 年）被社区医生或其他临床医生诊断为心血管疾病的患者；（3）独立行走。如果患者存在以下情况，则被排除在外：（1）行动不便且四肢功能受限；（2）健康状况不稳定，无法坚持锻炼方案；（3）沟通困难，难以听从指导。
参与者被随机分配到八段锦组或对照组。八段锦组接受 16 周的八段锦锻炼训练，而对照组保持原有的锻炼方式不变。在干预前后，使用慢性病自我管理效能感 6 项量表（SEMCD6）对受试者进行评估。
人口统计学数据显示，纳入的 129 名患者中，65.12%的患者年龄在 65 岁或以上，92.25%的患者受教育程度低于 12 年，68.21%的患者月收入低于 1999 元人民币。干预前，八段锦组 86.36%的患者 SEMCD6 评分低于 7 分，对照组为 85.71%；经过 16 周的八段锦锻炼后，八段锦组 SEMCD6 评分低于 7 分（21.21%）的患者明显低于对照组（84.13%）。八段锦组在保持疲劳、保持身体不适或疼痛、保持情绪困扰以及完成不同任务和活动的信心方面，SEMCD6 评分的增加具有统计学意义（P<0.01）。
社区中患有心血管疾病的成年人受教育程度较低，大多数人月收入较低；因此，社区居住的心血管疾病患者更适合采用经济方案来长期管理疾病。八段锦是一种对身体和认知要求较低的中医药方案；基于社区的八段锦锻炼有助于提高心血管疾病患者的自我效能感，从而更好地管理康复过程。
