La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
Faculty of Biology and Medicine, Institute of Higher Education and Research in Health Care (IUFRS), Lausanne, Switzerland.
J Clin Nurs. 2023 Sep;32(17-18):6415-6426. doi: 10.1111/jocn.16656. Epub 2023 Feb 23.
Identify and compare learning needs, levels of self-efficacy and their association among inpatients and outpatients of a cardiac care unit with coronary heart disease who have undergone percutaneous coronary intervention (PCI) in a Swiss university hospital.
After primary PCI, 42% of patients will suffer a recurrent ischemic cardiovascular event. Although adherence to therapeutic regimen contributes to prevent recurrence, patient adherence remains low. To strengthen it, learning needs and self-efficacy must be considered when developing effective therapeutic patient education (TPE).
Learning needs and self-efficacy were assessed using the Cardiac Patient Learning Needs Inventory (CPLNI) and the Cardiac Self-Efficacy Scale among inpatients and outpatients. The STROBE checklist for cross-sectional studies was used in reporting this study.
Ninety-three patients participated in the study with a participation rate of 73.9%. The CPLNI median total score was significantly higher in inpatients than in outpatients: 4.23 (3.82, 4.64) versus 3.67 (3.33, 4.09), p < .001. In both units, participants declared that the most important need was related to 'anatomy and physiology' of the heart. Despite the high score, the least important need was about 'physical activity' for inpatients and 'miscellaneous information' for outpatients. No statistically significant differences were found among patients from both units regarding their self-efficacy level.
This study shows that after PCI, patients have high learning needs and moderate levels of self-efficacy that require addressing.
Patient's individual learning needs and self-efficacy level must be assessed prior/after PCI. A tailored TPE that considers individual learning needs and self-efficacy is recommended as a preventative measure to reduce recurrent ischemic cardiovascular events. Nurses can play a key role in this process.
For feasibility reasons, patients and public were not involved in the design, conduct, reporting or dissemination plans of this research.
在瑞士一所大学医院接受经皮冠状动脉介入治疗 (PCI) 的冠心病住院和门诊患者中,识别和比较学习需求、自我效能水平及其相关性。
PCI 后,42%的患者会再次发生缺血性心血管事件。尽管坚持治疗方案有助于预防复发,但患者的依从性仍然较低。为了加强这一点,在制定有效的治疗性患者教育 (TPE) 时,必须考虑学习需求和自我效能。
使用心脏患者学习需求清单 (CPLNI) 和心脏自我效能量表在住院患者和门诊患者中评估学习需求和自我效能。本研究采用 STROBE 横断面研究检查表进行报告。
93 名患者参与了研究,参与率为 73.9%。住院患者的 CPLNI 总分中位数明显高于门诊患者:4.23(3.82,4.64)比 3.67(3.33,4.09),p<0.001。在这两个单位,参与者都表示最重要的需求与心脏的“解剖和生理学”有关。尽管得分较高,但住院患者中最不重要的需求是关于“体力活动”,而门诊患者中最不重要的需求是关于“杂项信息”。来自这两个单位的患者在自我效能水平方面没有发现统计学上的显著差异。
本研究表明,PCI 后患者的学习需求较高,自我效能水平中等,需要解决。
在 PCI 前后,必须评估患者的个体学习需求和自我效能水平。建议采用考虑个体学习需求和自我效能的个体化 TPE 作为预防措施,以降低缺血性心血管事件的复发。护士可以在这个过程中发挥关键作用。
由于可行性原因,本研究的设计、进行、报告或传播计划没有涉及患者或公众。