经皮冠状动脉介入术后冠心病患者健康促进行为与健康信念的相关性研究

doi:10.13217/j.scjpm.2019.0309

摘要/Abstract

摘要： 目的探讨冠心病经皮冠状动脉介入术后患者健康促进行为与健康信念的相关性,为指导患者形成正确的健康信念和健康促进行为提供依据。方法以2015年6月至2016年6月在海南省中医院行PCI手术的所有患者为调查对象,应用一般情况调查表、改良健康促进生活方式量表Ⅱ（HPLPⅡ）及健康信念量表对患者术后健康促进行为及健康信念状况进行调查。分析健康促进行为与健康信念的影响因素及相关性。结果共对104例成功行PCI手术的冠心病患者进行调查,其中男性70例,女性34例,平均（55.72 ± 13.69）岁,病程平均（78.64 ± 31.57）个月,BMI平均为（27.67 ± 3.46）。多元线性回归分析结果显示：性别与文化程度是影响PCI术后患者健康信念的主要因素（β=7.165、4.856,P<0.05或P<0.01）;文化程度、家庭人均月收入、BMI是影响PCI术后患者健康促进行为的主要因素（β=5.114、3.625、8.160,均P<0.05）。PCI术后冠心病患者健康促进行为与健康信念呈正相关（r=0.216）;感知到严重性评分与自我实现、运动锻炼得分呈负相关（r=-0.213、-0.236）,感知健康行为益处评分与健康促进行为得分及自我实现、营养、压力管理3个维护评分呈正相关（r=0.238、0.246、0.279）,健康动力与健康促进行为总分及各维度评分呈正相关（r=0.358、0.374、0.326、0.204、0.304、0.318、0.301）。结论健康信念与PCI术后冠心病患者的健康促进行为具有一定的相关性,感知健康行为益处越大,维护健康动力越强,其健康促进行为水平就越高。

关键词: 冠心病, 冠状动脉介入, 健康促进, 健康信念

Abstract: Objective To investigate the correlation between health promotion behavior and health belief of patients with coronary heart disease （CHD） after percutaneous coronary intervention （PCI）. Methods All patients who underwent PCI in Hainan Provincial Hospital of Traditional Chinese Medicine from June 2015 to June 2016 were enrolled. The health promotion behavior and health beliefs of patients after PCI were investigated by general situation questionnaire,the improved health promoting lifestyle scale Ⅱ （HPLP Ⅱ） and health belief scale. Factors influencing health promotion behavior and health beliefs and their correlation were analyzed. Results A total of 104 patients who underwent PCI were investigated, including 70 males and 34 females, with an average age of （55.72 ± 13.69） years. The average duration of disease was （78.64 ± 31.57） months and average body mass index （BMI）was（27.67 ± 3.46）. The multiple stepwise regression model showed that gender and education level were main factors influencing the health beliefs of patients after PCI （β=7.165, 4.856,P<0.05 or P<0.01）; the education level, per capita monthly income of families, and BMI were main factors influencing the health-promoting behaviors of patients after PCI （β=5.114, 3.625, 8.160; P<0.05 for all）. The health promotion behavior was positively correlated with health beliefs in patients with CHD after PCI （r=0.216）; perceived severity score was negatively correlated with self-actualization and physical exercise scores （r =-0.213, -0.236）; perceived health benefit score was positively correlated with the overall scores of health promotion behavior and self-actualization, nutrition and stress management （r=0.238, 0.246, 0.279）; the healthy motivation was positively correlated with total score of health promotion behavior and the score of each dimension （r=0.358, 0.374, 0.326, 0.204, 0.304, 0.318, 0.301）. Conclusion Health beliefs was correlated with health promotion behaviors of patients with CHD after PCI; the greater the perceived benefit of health behavior and the stronger the motivation to maintain the health, the higher the level of health promotion behavior.

Key words: Coronary heart disease, Percutaneous coronary intervention, Health promotion, Health belief

中图分类号:

R543.3

林雪琴, 黄文娟. 经皮冠状动脉介入术后冠心病患者健康促进行为与健康信念的相关性研究[J]. 华南预防医学, 2019, 45(4): 309-313.

LIN Xue-qin, HUANG Wen-juan. Correlation between health promotion behavior and health belief of patients with coronary heart disease after PCI[J]. South China Journal of Preventive Medicine, 2019, 45(4): 309-313.

参考文献

[1] 韩雅玲. 2017年冠心病介入进展、问题和展望(上)[J].中华医学信息导报,2018,33(2):20-21.
[2] 鲍本霖. 授权教育对中青年PCI术后患者健康促进生活方式的影响研究[D].天津:天津医科大学,2017.
[3] 王韵,刘坤,曲小璐.延续性护理干预对急性心肌梗死PCI治疗患者的效果研究[J].实用临床医药杂志,2017,21(4):167-170.
[4] 葛支忱,赵飞飞,孙党红,等.信息网络技术对经皮冠状动脉介入治疗术后患者认知行为的影响[J].实用临床医药杂志,2018,22(16):16-19.
[5] Davidson PM,Salmonson Y,Rolley J,et al.Perception of cardiovascular risk following a percutaneous coronary intervention:a cross sectional study[J].Int J Nurs Stud,2011,48(8):973-978.
[6] 张小培. 出院后脑卒中患者的健康行为与生活质量的相关性研究[D].广州:中山大学,2009.
[7] 张萌,王彦鑫,金昌德.冠心病健康信念量表的编制与信效度研究[J]. 中国实用护理杂志,2014,30(29):40-43.
[8] Chen J,Chen Z,Collins R,et al.Adherence to healthy lifestyle and cardiovascular diseases in the Chinese population[J]. JACC,2017,69(9):1116-1125.
[9] 郭艳灵. 全程护理在改善冠心病合并糖尿病患者介入治疗后生活质量和降低心血管不良事件风险中的应用效果[J].齐齐哈尔医学院学报,2017,38(15):1858-1859.
[10] 袁园,黄颖梅.冠心病PCI患者疾病管理能力与负性情绪对创伤后成长的影响[J].齐鲁护理杂志,2017,23(21):4-6.
[11] 唐莲,刘春雪,李泱.中老年冠心病患者行冠状动脉介入术后心脏康复认知度与运动依从性相关的调查研究[J]. 中华老年多器官疾病杂志,2018,17(1):66-69.
[12] 范滟,余小萍,于岚,等.健康促进模式在老年稳定性冠状动脉硬化性心脏病支架置入术后患者健康教育中的应用效果[J]. 解放军护理杂志,2016,33(2):71-73.
[13] 高俊俊,靳艳.中青年冠心病患者健康行为及其影响因素研究[J].护理管理杂志,2017,17(7):460-462.
[14] 张秀杰. 急性冠脉综合征患者1年内再入影响因素研究[D].济南:山东大学,2017.
[15] 张素容,黄秀霞,方燕娜.冠心病住院患者健康教育中健康信念模式的应用研究[J].海南医学,2018,29(10):1478-1480.
[16] 徐娟娟,肖爱玲.健康信念模式在脑卒中患者健康教育的应用[J].中西医结合心血管病电子杂志,2018,6(9):3-4.
[17] 李槟,蒋健,刘芳.健康信念教育模式对脑梗死偏瘫患者遵医行为及自我管理能力的影响[J].医学临床研究,2018,35(6):1243-1245.
[18] 方蘅英,张美芬,陈妙霞.冠心病患者健康行为水平调查研究[J].护理学杂志,2006,21(15):58-60.