Al-Smadi Ahmed Mohammad, Tawalbeh Loai Issa, Ashour Ala, Hweidi Issa M, Gharaibeh Besher, Slater Paul, Fitzsimons Donna
Faculty of Nursing, American University of Madaba, Amman Jordan.
Faculty of Nursing, Al-AlBayt University, P. O. Box: 130040, Al-Mafraq 25113, Jordan.
Int J Nurs Sci. 2017 Jun 23;4(3):271-277. doi: 10.1016/j.ijnss.2017.06.007. eCollection 2017 Jul 10.
This study aims to determine if patients with acute myocardial infarction differ in illness perception and secondary prevention outcomes depending on the treatment they received.
A repeated measures design was used to compare patients with acute myocardial infarction receiving three different treatment modalities: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non ST-elevation myocardial infarction treated by medication. A convenient sampling technique was used to recruit 206 patients with acute myocardial infarction who agreed to participate in the current study. Patients' illness perception, physical activity, and demographical and clinical data were collected during hospital admission and again at 6 months.
A total of 186 patients completed the study. Results showed that the primary percutaneous coronary intervention group perceived their illness as acute rather than chronic ( = 0.034) and has lower personal control ( = 0.032), higher treatment control ( = 0.025), and higher perception of illness coherence ( = 0.022) compared with patients receiving thrombolytic therapy and treated after non-ST segment infarction. Moreover, they report low control of their blood pressure ( = 0.013) and less physical activity ( = 0.001).
The results of this study revealed that patients' treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment. Further research is recommended to confirm this association with longer follow-up study and among different cultures.
本研究旨在确定急性心肌梗死患者根据所接受的治疗，在疾病认知和二级预防结果方面是否存在差异。
采用重复测量设计，比较接受三种不同治疗方式的急性心肌梗死患者：接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者、接受溶栓治疗的ST段抬高型心肌梗死患者以及接受药物治疗的非ST段抬高型心肌梗死患者。采用便利抽样技术招募了206名同意参与本研究的急性心肌梗死患者。在患者入院时和6个月后再次收集患者的疾病认知、身体活动以及人口统计学和临床数据。
共有186名患者完成了研究。结果显示，与接受溶栓治疗和非ST段梗死治疗的患者相比，直接经皮冠状动脉介入治疗组认为他们的疾病是急性而非慢性的（P = 0.034），个人控制感较低（P = 0.032），治疗控制感较高（P = 0.025），疾病连贯性认知较高（P = 0.022）。此外，他们报告血压控制不佳（P = 0.013）且身体活动较少（P = 0.001）。
本研究结果显示，与经皮冠状动脉介入治疗和溶栓治疗等其他治疗方式相比，接受直接经皮冠状动脉介入治疗的患者在住院6个月后疾病认知消极，行为改变有限。建议进一步研究以通过更长时间的随访研究以及在不同文化中确认这种关联。
