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中国全科医学 ›› 2021, Vol. 24 ›› Issue (31): 3990-3994.DOI: 10.12114/j.issn.1007-9572.2021.00.256

所属专题： 心血管最新文章合辑； 疾病康复与健康最新文章合辑

• 专题研究 • 上一篇    下一篇

信息-动机-行为技巧模型联合动机性访谈在社区冠心病患者心脏康复中的应用

孟佳1，杜少英1*，王彦1，娄士宁2   

  1. 1. 071000河北省保定市，河北大学护理学院　2. 071000河北省保定市，中国乐凯集团有限公司职工医院
    *通信作者：杜少英，副教授；E-mail：fzcdsy326@163.com
  • 出版日期:2021-11-05 发布日期:2021-11-05
  • 基金资助:
    河北省高等学校科学技术研究项目（QN2019178）；河北省重点研发计划项目（18277735D）

Use of Information-motivation-behavioral Skills Model and Motivational Interviewing in Cardiac Rehabilitation for Patients with Coronary Heart Disease in the Community　

MENG Jia1，DU Shaoying1*，WANG Yan1，LOU Shining2   

  1. 1.College of Nursing，Hebei University，Baoding 071000，China
    2.Staff Hospital of China Lekai Group Corporation，Baoding 071000，China
    *Corresponding author：DU Shaoying，Associate professor；E-mail：fzcdsy326@163.com
  • Published:2021-11-05 Online:2021-11-05

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摘要： 背景　心脏康复是冠心病规范康复的重要组成部分，但30%~40%的患者在参与心脏康复6个月后会退出此项目，50%的患者在1年后会退出心脏康复。目的　探讨信息-动机-行为技巧模型（IMB模型）联合动机性访谈在社区冠心病患者心脏康复教育中的应用效果。方法　2019年5—6月，采取随机数字表法将从某社区卫生服务站遴选的冠心病患者分为试验组40例和对照组42例。对照组接受系列心脏康复教育讲座，试验组在对照组干预基础上，实施IMB模型联合动机性访谈。比较两组干预前、干预后3个月、6个月自我效能、自我管理行为和运动依从性情况。结果　试验组、对照组完成随访的患者例数分别为36、41例。重复测量方差结果显示，两组冠心病患者自我效能、自我管理行为的改善差异均有统计学意义（F组间=4.176，P组间<0.05；F组间=4.436，P组间<0.05）；两组干预方法与时间之间（自我效能）的交互作用有统计学意义（F交互=5.173，P交互<0.05）；两组组内不同时间点自我管理行为差异有统计学意义（F时间=50.573，P时间<0.05）。干预3、6 个月后，试验组患者的运动依从性均高于对照组，差异有统计学意义（P<0.05）。结论　IMB模型联合动机性访谈有助于提高冠心病患者参与心脏康复的自我效能和行为。

关键词: 冠心病, 心脏康复, 信息-动机-行为技巧模型, 动机性访谈, 自我管理

Abstract: Background　Cardiac rehabilitation is an important part of standardized rehabilitation for coronary heart disease（CHD），but 30%-40% of the patients will drop out of the program after 6 months and 50% will drop out after 1 year.  Objective　To explore the effect of information-motivation-behavioral skills（IMB） model and motivational interviewing used in cardiac rehabilitation education for CHD patients in the community. Methods　CHD patients recruited from a community health station during May to June 2019 were randomized into the experimental group（n=40） and control group（n=42），receiving a series of lectures on cardiac rehabilitation plus IMB model-based education and motivational interviewing，and a series of lectures on cardiac rehabilitation，respectively. The self-efficacy，self-management behaviors and exercise adherence of the two groups were compared before the intervention，and 3 and 6 months after the intervention. Results　The number of patients who completed follow-up in the experimental group and the control group were 36 and 41 respectively. Analysis using a repeated measures ANOVA revealed that the improvement in self-efficacy differed significantly across the two groups（F=4.176，P<0.05）. The interaction effect generated by intervention contents and duration on self-efficacy was statistically significant（F=5.173，P<0.05）. There was a statistically significant intergroup difference in the improvement in self-management behaviors（F=4.436，P<0.05）. The self-management behaviors differed significantly by intervention duration（F=50.573，P<0.05）. The experimental group showed statistically higher exercise adherence than the control group either at three or six months after the intervention（P<0.05）. Conclusion　IMB model and motivational interviewing may contribute to the improvement of self-efficacy and self-management behaviors of patients with CHD.

Key words: Coronary disease, Cardiac rehabilitation, Information-motivation-behavioral skills model, Motivational interviewing, Self-management

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