Su Xu, Zhang Yimei, Zhou Huilin, Ma Fang, Jin Xiaorong, Bai Yangjuan, Wei Wei, Zhang Xiong, Zhou Min
Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China.
Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China.
Patient Prefer Adherence. 2024 Mar 6;18:591-606. doi: 10.2147/PPA.S452943. eCollection 2024.
Studies had reported some influencing factors of health behavior among patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI). However, considering that human perceptions are complex, unrestricted and dynamically changing. A longitudinal qualitative study was conducted to explore the determinants of health-related behaviors of patients after PCI and dynamic changes of these determinants at the 1st, 3rd, and 6th months.
Using purposive sampling, 18 patients undergoing PCI were interviewed. The conventional content analysis method was used to identify categories and subcategories. Semi-structured, face-to-face or telephone in-depth interviews were conducted at the cardiology unit of a tertiary referral hospital in Yunnan Province, China from March 2022 to January 2023.
Seven categories with some subcategories were constructed from the data, categorized into three domains. Firstly, individual factors include (i) Personal coping with healthy lifestyle requirements (tried but failed; I can do it), (ii) individual perception and feeling toward disease (knowing about the disease; belief of cure; fears of relapse), and (iii) personal benefits (improved health; meaning of life). Secondly, social factors include (i) social facilitators (family resources; healthcare support), (ii) social barriers (inconvenient medical care service; conflicting information). Finally, cultural factors include (i) way of living (dietary habits; key roles of (cigarette) and (alcohol) in Chinese society), (ii) way of thinking (fatalism and Confucian familism).
The determinants of health-related behaviors of patients after PCI are multifaceted and dynamic. Different interventions should be formulated to promote patients' adherence to health behaviors. Moreover, priority should be given to the impact of traditional Chinese philosophy on the health behaviors of patients after PCI, and the health promotion program for these patients should be culturally sensitive. In addition, future research should further explore the determinants of health behaviors among diverse ethnic minorities after PCI, which has not been fully inquired in this study.
已有研究报道了经皮冠状动脉介入治疗(PCI)后冠心病(CHD)患者健康行为的一些影响因素。然而,考虑到人类的认知是复杂、不受限制且动态变化的。本研究开展了一项纵向定性研究,以探讨PCI术后患者健康相关行为的决定因素以及这些决定因素在第1、3和6个月时的动态变化。
采用目的抽样法,对18例行PCI的患者进行访谈。运用传统内容分析法确定类别和子类别。2022年3月至2023年1月在中国云南省一家三级转诊医院的心内科,进行了半结构化的面对面或电话深度访谈。
从数据中构建了七个类别及一些子类别,分为三个领域。首先,个体因素包括:(i)个人应对健康生活方式要求的情况(尝试但失败了;我能做到),(ii)个体对疾病的认知和感受(了解疾病;治愈信念;对复发的恐惧),以及(iii)个人利益(健康改善;生活意义)。其次,社会因素包括:(i)社会促进因素(家庭资源;医疗支持),(ii)社会障碍(医疗服务不便;信息冲突)。最后,文化因素包括:(i)生活方式(饮食习惯;(香烟)和(酒精)在中国社会中的关键作用),(ii)思维方式(宿命论和儒家家族主义)。
PCI术后患者健康相关行为的决定因素是多方面且动态变化的。应制定不同的干预措施以促进患者坚持健康行为。此外,应优先考虑中国传统哲学对PCI术后患者健康行为的影响,针对这些患者的健康促进计划应具有文化敏感性。此外,未来研究应进一步探索PCI术后不同少数民族健康行为的决定因素,本研究尚未对此进行充分探究。