目的: 分析基于“信息-知识-信念-行为”（information-knowledge-belief-behavior,IKAP）模式的同理心干预对冠心病（coronary heart disease,CHD）患者自我感受负担及管理能力的影响。方法: 通过随机数字表法将2023年6月—2024年5月江苏省人民医院心血管内科收治的CHD患者120例分为常规干预组（n=60）、IKAP组（n=60）。常规干预组接受常规干预,IKAP组在常规干预基础上接受基于IKAP模式的同理心干预,两组均持续干预3个月。比较两组干预3个月后治疗依从性、自我感受负担,干预前、干预3个月后自我管理能力、生活质量,干预3个月后干预满意度。结果: 干预3个月后,IKAP组治疗依从性、自我感受负担优于常规干预组。与干预前比较,干预3个月后两组CHD自我管理行为量表（self management behavior scale,CSMS）各项（日常生活管理、疾病医学管理、情绪管理）评分、世界卫生组织生活质量-100（WHOQOL-100）各维度（生理、心理、独立性、环境、社会关系、精神支柱）评分升高,且IKAP组更高。干预3个月后常规干预组、IKAP组总满意率比较,IKAP组更高。结论: 基于IKAP模式的同理心干预可降低CHD患者自我感受负担,提高治疗依从性、自我管理能力及生活质量,获得患者认可。
Abstract
Objective To analyze the effects of empathy intervention based on information-knowledge-belief-behavior (IKAP) model on self-perceived burden and management ability of patients with coronary heart disease (CHD). Methods 120 patients with CHD admitted to the cardiovascular Department of Jiangsu Provincial People's Hospital from June 2023 to May 2024 were divided into the routine intervention group (n=60) and the IKAP group (n=60) by random number table method. The conventional intervention group received the conventional intervention, the IKAP group received the empathy intervention based on the IKAP model on the basis of routine intervention, and both groups continued to intervene for 3 months. Treatment compliance, self-perceived burden after 3 months of intervention, self-management ability and quality of life before and after intervention, and satisfaction after 3 months of intervention were compared between the two groups. Results After 3 months of intervention, the treatment compliance of the IKAP group was better than that of the conventional intervention group. The self-perceived burden of the IKAP group was better than that of the conventional intervention group after 3 months of intervention. The scores of coronary heart disease self management behavior scale (CSMS) (daily life management, medical disease management, emotional management) and world health organization quality of life 100 (WHOQOL-100) (physical, psychological, independence, environment, social relations, spiritual support) of the two groups increased after 3 months of intervention, the IKAP group was higher. After 3 months of intervention, the total satisfaction rate between the conventional intervention group and the IKAP group, the IKAP group was higher (P<0.05). Conclusion Empathy intervention based on IKAP model could reduce the self-perceived burden of patients with coronary heart disease, improve the treatment compliance, self-management ability and quality of life of patients, and obtain the recognition of patients.
关键词
冠心病 /
“信息-知识-信念-行为”模式 /
同理心 /
自我感受负担 /
自我管理能力 /
依从性
Key words
coronary heart disease /
information-knowledge-belief-behavior /
empathy /
self-feeling burden /
self-management ability /
compliance
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 许海燕. 冠心病患者的精细化管理[J]. 中华老年心脑血管病杂志, 2023, 25(7): 673-675.
[2] RAMACHANDRAN HJ, JIANG Y, TAM WWS, et al.Effectiveness of home-based cardiac telerehabilitation as an alternative to phase 2 cardiac rehabilitation of coronary heart disease: a systematic review and meta-analysis[J]. Eur J Prev Cardiol, 2022, 29(7): 1017-1043.
[3] 任维东, 于鹏飞. IKAP健康管理模式对白银市老年心血管高危人群护理效果的影响[J]. 中华健康管理学杂志, 2024, 18(4): 289-294.
[4] 中华医学会心血管病学分会介入心脏病学组, 中华医学会心血管病学分会动脉粥样硬化与冠心病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会, 等. 稳定性冠心病诊断与治疗指南[J]. 中华心血管病杂志, 2018, 46(9): 680-694.
[5] 颜艳, 王彤. 医学统计学[M].5版. 北京: 人民卫生出版社, 2020: 252-254.
[6] 黄磊, 胡晔, 尹存林, 等. 中文版Morisky用药依从性问卷在儿童哮喘中的信效度评价与应用[J]. 中国中西医结合儿科学, 2023, 15(1): 76-80.
[7] 张庆娜, 李惠萍, 王德斌. 中文版自我感受负担量表在癌症患者中应用的信效度评价[J]. 中国实用护理杂志, 2013, 29(2): 1-4.
[8] WANG L, WANG Q, WANG X, et al.Development and validation of the coronary heart disease self-management scale (csms) in chinese patients[J]. J Clin Nurs, 2012, 21(15-16): 2278-2286.
[9] LI X, LIU Y, ZHANG H, et al.Effects of ikap-based nursing on quality of life in coronary heart disease: a randomized trials[J]. J Clin Nurs, 2021, 30(19-20): 2987-2996.
[10] 郁彬, 刘利, 谭诚炜, 等. 上海市淞南镇社区康复中心患者满意度调查分析[J]. 上海医药, 2023, 44(14): 17-21.
[11] 冯青静, 胡同秀, 孙丹丹. 冠心病患者康复运动知信行现状及影响因素研究[J]. 护理管理杂志, 2021, 21(1): 1-5.
[12] KHOJA A, ANDRAWEERA PH, LASSI ZS, et al.Risk factors for early-onset versus late-onset coronary heart disease (chd): systematic review and meta-analysis[J]. Heart Lung Circ, 2023, 32(11): 1277-1311.
[13] SHI W, GHISI GLM, ZHANG L, et al.Systematic review, meta-analysis and meta-regression to determine the effects of patient education on health behaviour change in adults diagnosed with coronary heart disease[J]. J Clin Nurs, 2023, 32(15-16): 5300-5327.
[14] 王铁成, 李建勋, 孙艳芳, 等. 老年脑卒中患者基于IKAP理论的口腔管理健康教育[J]. 护理学杂志, 2023, 38(2): 77-81.
[15] ZHANG L, WANG Y, CHEN J, et al.Impact of empathy-based communication skills training on perceived self-burden in coronary heart disease patients: a randomized controlled trial[J]. Patient Educ Couns, 2022, 105(5): 1201-1208.
[16] 朱艳霞, 王路, 乔丹, 等. 基于IKAP模式的延续性护理在冠心病患者中的应用[J]. 中华现代护理杂志, 2021, 27(21): 2888-2891.
[17] WANG F, ZHANG L, LI Y, et al.IKAP theory improves self-management and left ventricular function in elderly patients with chronic heart failure: a cluster randomized trial[J]. ESC Heart Fail, 2022, 9(3): 1865-1874.
[18] 张真, 王红莲, 苏畅, 等. 基于IKAP理论的协同护理模式在PICC置管患者中的应用[J]. 安徽医学, 2022, 43(8): 958-962.
[19] LIU Y, ZHANG R, ZHOU X, et al.The impact of IKAP-based nursing intervention on medication adherence and cardiac function in patients with coronary heart disease: a randomized controlled trial[J]. J Clin Nurs, 2023, 32(15-16): 4892-4901.
[20] 季静, 蔡玉芬. “信息-知识-信念-行为”模式对老年心脑血管疾病病人自我管理及治疗依从性的影响[J]. 安徽医药, 2022, 26(1): 140-142.
[21] BANDURA A, CAPRARA GV, BARBARANELLI C.Role of affective self-regulatory efficacy in patient-centered communication[J]. Health Psychol, 2021, 40(3): 189-197.
基金
2024年度重庆市自然科学基金项目“circ0067323/线粒体自/JAK-STAT/M1型巨噬细胞极化轴调控冠状动脉粥样硬化”（CSTB2024NSCQ-MSX1138）
PDF(1649 KB)
