冠心病患者增强居家心脏康复自我管理的策略：一项定性研究

Strategies for enhancing home-based cardiac rehabilitation self-management for patients with coronary heart disease: a qualitative study.

作者信息

Yang Zhen, Zheng Xutong, Gao Yu, Zhang Chunqi, Wang Aiping

机构信息

The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China.

The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Guta District, Jinzhou, Liaoning Province, China.

出版信息

BMC Nurs. 2025 Jan 8;24(1):27. doi: 10.1186/s12912-025-02690-0.

DOI:10.1186/s12912-025-02690-0

PMID:39780153

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11715201/

Abstract

BACKGROUND

Self-management is regarded as a crucial factor influencing the effectiveness of home-based cardiac rehabilitation for patients with coronary heart disease. In nursing practice, nurses employ a variety of strategies to enhance self-management of patients. However, there exists a disparity in nurses' perceptions and practical experiences with these strategies. This study aimed to explore the experiences and strategies of clinical nurses in enhancing home-based cardiac rehabilitation self-management for patients with coronary heart disease.

METHODS

A descriptive qualitative study was conducted across two large cardiac rehabilitation centers. Clinical nurses were selected using purposive sampling with maximum variation strategies. Semi-structured interviews were conducted to capture nurses' experiences and strategies for enhancing home-based cardiac rehabilitation self-management. Content analysis was utilized to analyze the textual data.

RESULTS

A total of 18 eligible clinical nurses participated in this study. The interviews resulted in the extraction of seven subthemes, which were consolidated into three main themes: (1) Personalized and Engaging Educational Approaches, including Precision Education-Tailored, Adaptive Approaches and Visual Aided Education-Beyond Simplification to Deep Engagement; (2) Contextual and Psychologically Grounded Nudging Strategies, comprising Information Framing-Psychological Leveraging for Informed Choices, Social Norms-Leveraging Peer Influence for Motivation, and Verbal Reminders-The Power of Consistency and Reinforcement; (3) Continuous and Personalized Support Systems, involving Regular Follow-Up-Dynamic Support for Ongoing Engagement and Collaborative Management-Building a Team for Long-Term Success. These robust strategies can effectively enhance self-management behaviors and quality of life in patients undergoing home-based cardiac rehabilitation.

CONCLUSIONS

From the perspective of clinical nurses, this study explored a variety of strategies for improving home-based cardiac rehabilitation self-management in patients with coronary heart disease. This provides theoretical support for optimizing intervention measures and promotes the effective delivery and application of self-management strategies in practice.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

自我管理被视为影响冠心病患者居家心脏康复效果的关键因素。在护理实践中，护士采用多种策略来增强患者的自我管理能力。然而，护士对这些策略的认知和实践经验存在差异。本研究旨在探讨临床护士在增强冠心病患者居家心脏康复自我管理方面的经验和策略。

方法

在两个大型心脏康复中心开展了一项描述性定性研究。采用目的抽样和最大变异策略选取临床护士。进行半结构式访谈以获取护士在增强居家心脏康复自我管理方面的经验和策略。运用内容分析法对文本数据进行分析。

结果

共有18名符合条件的临床护士参与了本研究。访谈提炼出七个子主题，这些子主题整合为三个主要主题：（1）个性化且引人入胜的教育方法，包括精准教育——量身定制、适应性方法以及视觉辅助教育——超越简化以实现深度参与；（2）基于情境和心理的助推策略，包括信息构建——利用心理杠杆做出明智选择、社会规范——利用同伴影响激发动力以及言语提醒——一致性和强化的力量；（3）持续且个性化的支持系统，涉及定期随访——为持续参与提供动态支持以及协作管理——组建团队以实现长期成功。这些有力的策略能够有效增强接受居家心脏康复患者的自我管理行为和生活质量。