中老年冠心病PCI术后患者运动康复行为影响因素的质性研究

Qualitative Study on Influencing Factors of Exercise Rehabilitation Behavior in Middle-Aged and Elderly Patients with Coronary Heart Disease after PCI

摘要: 目的：以健康信念模式和计划行为理论整合模型为框架，了解影响中老年冠心病PCI术后患者运动康复行为的因素，为构建针对性护理干预方案提供科学依据。方法：根据目的抽样法，选择2023年3~4月贵阳市某三级甲等医院心内科病房15名患者作为研究对象，采用现象学方法进行访谈，而后按照Colaizzi 7步法分析访谈内容。结果：根据健康信念模式和计划行为理论整合模型对主题进行归纳，共提炼出6个主题：1) 感知威胁(存在疾病认知薄弱、一定的不良结果易感性和严重性)；2) 感知益处(持有积极认同态度)；3) 感知障碍(一定的客观因素阻碍运动康复)；4) 主观规范(社会支持系统促进运动康复)；5) 知觉行为控制(能否运动康复取决于主观能动性和自我效能感)；6) 行为意向(对运动康复有强烈意愿)。结论：中老年冠心病PCI术后患者运动康复行为的实施受多重因素影响，医务人员应通过加强运动康复健康教育宣传工作，弥补其认知薄弱，提升其益处和威胁感知，重视和加强社会支持系统的作用，激发患者运动康复主观能动性和内在效能感，从而提升患者运动康复行为意图，促进患者运动康复行为。

Abstract: Objective: Based on the integrated model of health belief model and planned behavior theory, this paper understands the factors affecting the exercise reha-bilitation behavior of middle-aged and elderly patients with coronary heart disease after PCI, and provides scientific basis for constructing targeted nursing intervention programs. Methods: Ac-cording to the objective sampling method, 15 patients in the cardiology ward of a third-class first-class hospital in Guiyang from March to April, 2023 were selected as the research object, inter-viewed by phenomenological method, and then the interview contents were analyzed according to Colaizzi 7-step method. Results: According to the integrated model of health belief model and planned behavior theory, six themes are summarized: 1) Perceived threat (weak disease cognition, certain susceptibility and severity of adverse results); 2) Perceived benefits (holding a positive identity attitude); 3) Perceptual disturbance (some objective factors hinder sports rehabilitation); 4) Subjective norms (social support system promotes sports rehabilitation); 5) Perceptual behavior control (whether exercise rehabilitation depends on subjective initiative and self-efficacy); 6) Be-havior intention (strong willingness to exercise rehabilitation). Conclusion: The implementation of exercise rehabilitation behavior of middle-aged and elderly patients with coronary heart disease after PCI is influenced by many factors. Medical staff should make up for their weak cognition, en-hance their perception of benefits and threats, attach importance to and strengthen the role of so-cial support system, and stimulate patients’ subjective initiative and internal efficacy, so as to en-hance patients’ intention of exercise rehabilitation behavior and promote patients’ exercise reha-bilitation behavior.