환자 맞춤식 교육·상담 프로그램이 경피적 관상동맥중재술을 받은 환자에게 미치는 효과

Abstract

In Korea, morbidity and mortality rates of coronary artery disease have increased greatly due to the prolongation of life expectancy and westernized lifestyle. Although patients with coronary artery disease can be successfully treated with advanced medical technologies in acute stage, they need to modify their risk factors related to lifestyle such as exercise or diet in order to prevent recurrence of the disease. However, it is so difficult to change lifestyles that health professionals need to develop the effective intervention programs for them in order to change and maintain the health behaviors. The purpose of this study was to examine the effects of patients-tailored education and counseling program on disease-related knowledge, self-efficacy, self-care behavior and physiologic indexes of coronary artery disease (CAD) patients with percutaneous coronary intervention (PCI). Study design was a non-equivalent control group pre-post design. The subjects were hospitalized 60 patients who were newly diagnosed of CAD and then treated PCI at a university hospital located in J city. They were assigned to an experimental group (n=30) and a control group (n=30). The data were collected from December 13th, 2013 to August 31st, 2014. The experimental group was provided the patients-tailored education and counseling program that was consisted of nine times twice individual face-to-face education, twice individual face-to-face counseling, three times telephone counseling and twice text messages, for 8 weeks by the researcher. Nurses in the unit provided a routine discharge education with a booklet to both the control and experimental group on the day of discharge. If the control group wants to participate in the patients-tailored education and counseling program, they will be provided after the end of the study. The data of the experimental and control groups were collected before the intervention and after 8 weeks when the intervention finished. Disease-related knowledge, self-efficacy and self-care behavior were measured using a structured self-report questionnaire and physiological data were collected by review of electronic medical records for the evaluation of the intervention. The collected data were analyzed with descriptive statistics, χ²-test, t-test, Fisher's exact test, paired t-test, and independent t-test using the SPSS WIN 18.0 program. The findings of the study were as follows: 1. Disease-related knowledge score in the experimental group was statistically significantly higher than the score of the control group (t=-6.61, p<.001). 2. Self-efficacy score in the experimental group was statistically significantly higher than the score of the control group (t=-11.11, p<.001). 3. Self-care behavior score in the experimental group was statistically significantly higher than the score of the control group (t=-12.75, p<.001). 4. There were no significant differences in physiologic data between the experimental and control groups. 1) The level of total cholesterol decreased in both experimental and control groups, but there was no significant difference in both groups (t=0.46, p=.643). 2) The level of triglyceride decreased in both experimental and control groups, but there was no significant difference in both groups (t=0.29, p=.770). 3) The level of high density lipoprotein cholesterol decreased in both experimental and control groups, there was no significant difference in both groups (t=0.60, p=.548). 4) The level of low density lipoprotein cholesterol decreased in both experimental and control groups, but there was no significant difference in both groups (t=0.52, p=.599). In conclusion, the patients-tailored education and counseling program for the CAD patients with PCI was effective in improving the disease-related knowledge, self-efficacy, and self-care behavior.