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自我管理支持方案对心血管疾病患者的患者激活和内在力量的影响。

The effect of self-management support program on patient activation and inner strength in patients with cardiovascular disease.

机构信息

School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad 6814993165, Iran.

Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.

出版信息

Patient Educ Couns. 2021 Dec;104(12):2979-2988. doi: 10.1016/j.pec.2021.04.018. Epub 2021 Apr 27.

Abstract

OBJECTIVE

The aim of the present study was to evaluate the effect of a self-management program on activation and inner strength in patients with cardiovascular diseases (CVDs).

METHODS

This study assigned 86 patients with CVDs to an experimental and a comparison group utilizing alternate allocation based on a quasi-experimental design. The experimental group participated in a self-management program based on a theoretical framework in three stages, i.e. orientation-recognition, reinforcing-engaging and monitoring-follow-up; whereas the comparison group received routine care. The supportive program was administered through holding five individual face-to-face sessions, providing educational booklets and performing four phone-call follow-ups during three months after discharge. The outcomes were measured using the patient activation measure (PAM) and the inner strength scale (ISS).

RESULTS

The between group analysis indicated a statistically-significant difference in the mean score of patient activation (P < 0.001) in the two groups. Nevertheless, there was not a statistically-insignificant difference in the mean score of inner strength between the two groups (P < 0.104).

CONCLUSION

Although a three-month nurse-led self-management support program was found to improve patient activation levels, it was ineffective in promoting inner strength.

PRACTICE IMPLICATIONS

Psychosocial dynamics should be integrated in providing self-management program by nurses. To promote patient activation, tailored consultations is recommended.

摘要

目的

本研究旨在评估自我管理方案对心血管疾病患者的积极性和内在力量的影响。

方法

本研究采用准实验设计,根据交替分配法将 86 名心血管疾病患者分为实验组和对照组。实验组参加了基于理论框架的三个阶段的自我管理方案,即定向识别、强化参与和监测随访;而对照组则接受常规护理。支持方案通过举行五次个别面对面会议、提供教育手册和在出院后三个月进行四次电话随访来实施。采用患者激活度量表(PAM)和内在力量量表(ISS)来衡量结果。

结果

组间分析表明,两组患者的积极性平均得分存在统计学显著差异(P<0.001)。然而,两组内在力量的平均得分没有统计学显著差异(P<0.104)。

结论

尽管为期三个月的护士主导的自我管理支持方案被发现可以提高患者的积极性水平,但它对促进内在力量无效。

实践意义

应将社会心理动态纳入护士提供的自我管理方案中。为了提高患者的积极性,建议进行量身定制的咨询。

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