An exploratory study on self management behaviours and health related quality of life on post coronary stenting patients

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An exploratory study on self management behaviours and health related quality of life on post coronary stenting patients

 

Author: Chan, Wan-yee Amanda
Title: An exploratory study on self management behaviours and health related quality of life on post coronary stenting patients
Degree: M.Sc.
Year: 2011
Subject: Coronary heart disease -- Patients -- Rehabilitation.
Self-care, Health.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: xii, 147 leaves ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2458034
URI: http://theses.lib.polyu.edu.hk/handle/200/6229
Abstract: Background: Coronary artery disease (CAD) is a major killer in Hong Kong while coronary stenting is its common treatment. To prevent worsening of the disease for those patients after stenting, their self management behaviours are essential. In recent years, health related quality of life (HRQoL) has been found to be a good indicator for measuring their health outcomes. However, few studies have been focusing on their self management behaviours, as well as HRQoL and its predictors. There is a need to conduct a study in these areas. Objectives of study: The objectives of the study are: (1) to examine the self management behaviours, daily functional status, and HRQoL of post stenting patients; (2) to find out the relationship of demographic and clinical characteristics with self management behaviours; with daily functional status; and with HRQoL of post stenting patients; and finally (3) to identify the predictors of HRQoL outcomes. Methods: This study was a cross-sectional study. The target population was Hong Kong Chinese CAD patients within 36 months of post stenting in Queen Mary Hospital. Three instruments were used namely, Self Management Behaviour Questionnaire, Seattle Angina Questionnaire (SAQ) and Medical Outcomes Study 36-Item Short Form (SF-36). Results: A total of 100 subjects were recruited. Mann-Whitney U test and Kruskal-Wallis test were performed for reporting significant differences in the relationship of the demographic and clinical characteristics with self management behaviours; with daily functional status; and with HRQoL of the patients. For self management behaviours, males spent statistically more time in exercises than females per week (Z = 1.87, p = 0.046), and the participation of cardiac rehabilitation programme (CRP) were differed significantly on exercise behavior (Z = 1.99, p = 0.04). Significant differences were found between subjects with different education levels on communication with physicians (x² = 8.01, df = 3, p = 0.046). For daily functional status, significant difference among the two genders were found on physical limitation (z = 3.41, p = 0.001) and angina frequency (z = 1.99, p = 0.046). Participation of CRP differed significantly on physical limitation (Z = 3.18, p = 0.001), angina stability (Z = 3.00, p = 0.003) and angina frequency (Z = 2.49, p = 0.013). Concerning HRQoL, significant difference among the two genders was found on all subscales. Participation of CRP were differed significantly on physical functioning (Z = 3.21, p = 0.001), role physical (Z = 3.48, p = 0.001), bodily pain (Z = 3.28, p = 0.001), social functioning (Z = 2.61, p = 0.009), physical component summary (Z = 2.93, p = 0.003) and mental component summary (Z = 0.98, p = 0.03). Backward linear regression analysis was performed and identified that gender (β = 1.252), participation of CRP (β = 1.188), angina frequency (β = 1.409) and disease perception (β = 1.264) predicted the physical aspect of their HRQoL. Comorbid illness (β = 0.852) and disease perception (β = 1.640) predicted the mental aspect of their HRQoL.
Discussion: In this study, gender and participation of CRP were found to be closely relevant to not only the self management behaviours, but also daily functional status and HRQoL. These findings were aligned with previous literature review. Male subjects and subjects having low chest pain frequency and less burden of CAD and participating CRP were predicted to have better HRQoL (in the physical aspect). Patients with less comorbidities and with less limitation on daily activities by angina were predicted to have better HRQoL (in the mental aspect). These findings were supported by previous studies. Nurses should assist the patients to control their symptoms, prevent the risk of getting other comorbidities and monitor their emotion to improve their outcomes. Education about CAD management by nurses should be provided to the patients. Conclusion: The findings confirmed the benefit of CRP participation on their outcomes and health maintenance. Public education through seminars, workshops or interviews should be conducted by nurses to introduce the programme. To provide holistic care to post stenting patients, nurses should pay attention to their different demographic and clinical characteristics. CRP played a significant role in their recovery and it should be widely promoted.

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