Purpose The aim of this study was to identify the coping profiles of patients with coronary artery disease and to examine their associations with cardiac health behavior. Methods In this cross-sectional study, data from 203 patients undergoing percutaneous coronary intervention for coronary artery disease were analyzed. Data collection occurred between September 2020 and June 2021, utilizing self-report questionnaires and electronic medical records at a cardiology outpatient clinic. Descriptive statistics, latent profile analysis, and logistic regression were employed for data analysis. Results The Type I coping profile was characterized by the greater use of most coping strategies, particularly problem-focused approaches, relative to the other profiles. The Type II coping profile exhibited below-average use of all coping strategies, except for substance use. The Type III coping profile displayed higher tendencies toward venting, self-blame, denial, behavioral disengagement, and substance use compared to the other profiles. Patients with the Type I coping profile displayed greater engagement in cardiac health behavior than those with Type II and Type III, as indicated by odds ratios of 2.57 (95% confidence interval=1.31~5.07) and 7.19 (95% confidence interval=2.10~24.56), respectively. Conclusion Participation in cardiac health behavior varies according to the coping profiles of patients with coronary artery disease. Healthcare providers should recognize and support appropriate coping strategies in these patients to promote healthy behaviors. A longitudinal study investigating how changes in coping profiles relate to cardiac health behavior could assist patients with coronary artery disease in maintaining such behaviors.
Purpose This study identified and compared the pain and associated symptoms of stable coronary artery diseases and acute coronary syndrome. Methods The study participants comprised 180 patients with stable coronary artery diseases and acute coronary syndrome. The data were collected from August 25, 2020, to October 30, 2020. Results We found that 77.2% of participants had pain and associated symptoms, and 85.6% had one or more associated symptoms. In the associated symptoms, patients with acute coronary syndrome expressed squeezing, and patients with stable coronary artery diseases expressed expanding. Patients with stable coronary artery diseases reported increased pain during exercise. Moreover, although there was no statistically significant difference, drinking, eating, and cold weather often exacerbated pain in patients with acute coronary syndrome.
The average pain intensity of patients with stable coronary artery diseases was moderate (4.09±2.79). The average pain intensity of acute coronary syndrome patients was severe (5.68±3.34). Patients with acute coronary syndrome mainly reported cold sweat and loss of consciousness. Palpitations and dizziness were prevalent complaints in patients with stable coronary artery diseases. Conclusion Based on this study's results, a nursing assessment can be performed when managing patients with coronary artery disease. In addition, a nursing assessment protocol could be developed based on the analysis results regarding pain and associated symptoms in patients with stable coronary artery diseases and acute coronary syndrome.
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Purpose This study aimed to determine the impact of health literacy, self-efficacy, and social support on the Health-Related Quality of Life (HRQoL) of Korean patients with Acute Coronary Syndrome (ACS) after Percutaneous Coronary Intervention (PCI). Methods A cross-sectional design was used, and a total of 189 participants were enrolled. Data were collected using self-reported questionnaires and patient medical records between September and November of 2021. Health literacy, self-efficacy, social support, and HRQoL were measured. The HRQoL was measured using the 12-item Short Form Survey, which included Physical Component Summary (PCS) and Mental Component Summary (MCS). Data were analyzed using hierarchical multiple regression with SPSS/WIN 26.0 program. Results The findings revealed statistically significant differences in the PCS according to gender, presence of hypertension, exercise, and sleep state. Furthermore, there were statistically significant differences in the MCS according to disease period and stress management. Hierarchical multiple regression analysis showed that higher social support was a significant factor of better PCS (p<.005). Higher health literacy, self-efficacy, and social support were significant factors of better MCS (p<.005). Conclusion Nurses should play a key role in providing social support to ACS patients, particularly to female patients and patients with hypertension and poor sleep state and no regular exercise for better PCS. Also, nurses should think about how to promote health literacy, self-efficacy, and social support for better MCS, particularly in ACS patients who had undergone PCI, had longer diagnosis periods, and had no stress management.
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Purpose This study was conducted to confirm the effect of providing video-program-related information on coronary disease to patients undergoing Percutaneous Coronary Intervention (PCI) on anxiety, vital signs, pain, and knowledge level related to coronary disease.
Methods: A quasi-experimental design of nonequivalent control group pretest-posttest was used. The subjects of this study were 60 coronary heart disease patients hospitalized in the heart treatment center for Video educational Program (VP)-PCI (30 in the experimental group, 30 in the control group) in a general hospital in Gyeonggido Province. Data were collected from May 10 to November 30, 2019. Subjects of the experimental group were provided common nursing care and viewed a video education program before the PCI. The control group was provided common nursing care before the PCI. The data were analyzed via the χ2 test, independent t-test, and repeated measured ANOVA through the SPSS 23.0 program.
Results: There were significant differences in the pain of the puncture site (F=6.83, p=.011) and knowledge related to coronary disease (F=89.94, p<.001) between the experimental group and the control group.
Conclusion: Based on the findings, this study suggested that the nursing education program related to knowledge of coronary disease provided by tablet PC to PCI patients was effective to decrease the perception of pain and enhance levels of knowledge related to coronary disease. Therefore, the result is useful in nursing practice and should be utilized as a tool of nursing intervention to improve the knowledge of coronary disease patients.
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PURPOSE This study aimed to examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life in patients with coronary artery disease. METHODS A descriptive cross-sectional study design was conducted using the data from the 2016 Korea Community Health Survey. The participants comprised 6,072 patients with coronary artery disease aged 19 years or older. Depressive symptoms, physical activity, and health-related quality of life were assessed. The collected data were analyzed by a complex sample test using SPSS/WIN 24.0 program. Bootstrapping methodology was utilized to examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life with SPSS PROCESS macro Model 4. RESULTS The results of the hierarchical linear regression analysis showed that depressive symptoms (t=−22.37, p<.001) and physical activity (t=12.12, p<.001) were significant predictor of health-related quality of life. A mediation analysis further revealed that physical activity mediates the relationship between depressive symptoms and health-related quality of life. CONCLUSION This study suggests that the negative impact of depressive symptoms on health-related quality of life can be improved through physical activity. Healthcare providers should consider these finding during early assessment of depressive symptoms in patients with coronary artery disease. Moreover, developing intervention strategies to enhance the level of physical activity could improve health-related quality of life of patients.
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PURPOSE The purpose of this study was to construct and test a predictive model for physical activity adherence for secondary prevention among patients with coronary artery disease. METHODS Two hundred and eighty-two patients with coronary artery disease were recruited at cardiology outpatient clinics in four general hospitals and the data collection was conducted from September 1 to October 19, 2015. RESULTS The model fit indices for the final hypothetical model satisfied the recommended levels: χ2/dF=0.77, adjusted goodness of fit index=.98, comparative fit index=1.00, normal fit index=1.00, incremental fit index=1.00, standardized root mean residual=.01, root mean square error of approximation=.03. Autonomy support (β=.50), competence (β=.27), and autonomous motivation (β=.31) had significant direct effects on physical activity adherence for secondary prevention among patients with coronary artery disease. This variable explained 35.1% of the variance in physical activity adherence. CONCLUSION This study showed that autonomy support from healthcare providers plays a key role in promoting physical activity adherence for secondary prevention among patients with coronary artery disease. The findings suggest that developing intervention programs to increase feelings of competence and autonomous motivation through autonomy support from healthcare providers are needed to promote physical activity adherence for secondary prevention among patients with coronary artery disease.
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PURPOSE The purposes of this study were to investigate the moderating effect of lifestyle and Type-D personality on the relation between metabolic syndrome and severity of coronary artery disease and to provide practical knowledge and directions for nursing intervention. METHODS The participants were 111 adult outpatients with coronary artery disease in the cardiology department of a medical center in Korea. The study tools included diagnostic criteria for metabolic syndrome, lifestyle evaluation tool for patients with metabolic syndrome, the Korean Type-D scale-14, and measures of severity of coronary artery disease. The data were obtained by electronic medical record reviews and surveys using structured questionnaires and interviews. Data were analyzed using descriptive statistics, χ2 test, independent t-test, one-way ANOVA, Pearson's correlation coefficient, multiple linear regression analysis and two-way ANOVA. RESULTS The severity of coronary artery disease was positively correlated with the presence of metabolic syndrome (r=.26, p=.006) and type-D personality (r=.49, p < .001). There was a significant negative correlation (r=−.54, p < .001) between the severity of coronary artery disease and lifestyle. Lifestyle had the moderating effect on the relationship between metabolic syndrome and severity of coronary artery disease (β=−.22, p < .001), but type-D personality had no moderating effect (F=0.13, p=.719) on it. CONCLUSION Based on the results of this study, it is necessary to establish individualized intervention considering the condition of the patients according to the criteria of the metabolic syndrome diagnosis when establishing the lifestyle intervention plan. And also it is necessary to define influencing factors including the personality on lifestyle change.
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PURPOSE This study was to develop the patient-tailored education and counseling program (PTECP) for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), and to identify the effects of PTECP on awareness of risk factors, knowledge, self-efficacy, self-care behavior, and blood cholesterol profile (BCP). METHODS A non-equivalent control group pre-post design was used. Sixty patients who were newly diagnosed with CAD and treated PCI were recruited and participated either in an intervention group or a control group, thirty each. The PTECP focused on managing their own risk factors consisted of two individual educations, two individual counselings, three telephone counselings, and two short message services for eight weeks. Data were collected two times at baseline and 8 weeks after beginning of the program. RESULTS After eight weeks, the patients' awareness of risk factor (p < .001), knowledge (p=.015), self-efficacy (p < .001), and self-care behavior (p < .001) in the intervention group were significantly different from those of the control group. However, no difference in BCP was found between the groups. CONCLUSION The PTECP was effective in improving the patients' awareness of CAD risk factors, knowledge, self-efficacy, and self-care behavior. Successful PTECP might lead to better health outcome in patients with CAD through effective self-management.
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PURPOSE The purpose of this secondary data analysis was to identify factors influencing a relapse among patients with coronary artery disease (CAD). METHODS Of 250 participants enrolled in the original study 75 were selected as there was no relapse for more than one year following the initial treatment and 54 were selected because there was a relapse. Data were analyzed using χ² test, t-test or F test to determine if there were any significant differences in the study variables relative to the status of relapse. Predictors were calculated by logistic regression. RESULTS Autonomy supported by healthcare providers was the significant predictor for relapse in patients with CAD. Patients with low autonomy supported by healthcare providers was 3.91 times more likely to relapse than patients with high autonomy supported. Patients with diabetes were at greater risk of recurrence. CONCLUSION Secondary prevention of CAD is a major task for patients with CAD. Behavioral strategies for cardiovascular risk reduction are essential and autonomy supported by healthcare providers should be included in their strategies.
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PURPOSE The aim of this study was to investigate the influencing effects of type D personality on symptom experiences and quality of life in percutaneous coronary intervention patients. METHODS A descriptive, cross-sectional study design was used. A total of 158 patients with percutaneous coronary intervention participated in this study, between July 1 and November 1, 2015. Data were analyzed by means, standard deviations, t-test, χ2 test, ANCOVA, and stepwise multiple regression analysis using SPSS 22.0 program. RESULTS About 53.8% of participants were classified as type D personality. The type D personality group reported statistically significantly higher symptom experience, lower cardiac function, and lower cardiovascular-specific quality of life compared to non-type D personality group. On stepwise multiple regression, the most significant factor of quality of life was symptom experiences (adjusted R²=.25, p<.001), followed by type D personality (adjusted R²=.31, p<.001). CONCLUSION Personality trait assessment is recommended for patients with percutaneous coronary intervention to assess symptom experiences and quality of life. In addition, development of nursing intervention might be beneficial to manage symptom experience and quality of life in percutaneous coronary intervention patients with type D personality.
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PURPOSE The purpose of this study was to determine the relationships among health locus of control, resilience, social support, and health promoting behavior in patients with coronary artery diseases. METHODS This study utilized a descriptive correlational design using a survey method. The subjects were 165 coronary artery disease patients at the cardiology out-patient clinic of the C university hospital. Data were collected through Health Locus of Control Scale, Resilience Scale, ENRICHD Social Support Instrument, Health Promoting Lifestyle Profile scale. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and hierarchial regression. RESULTS There were significant positive bivariate correlations of health promoting behavior with internal health locus of control, doctors health locus of control, resilience and social support respectively, and correlation between resilience and social support. Among predictors, internal health locus of control (beta=.28), social support (beta=.28) and resilience (beta=.25) had statistically significant influences on health promoting behavior. CONCLUSION These results proposed that internal health locus of control, social support and resilience have important influences on health promoting behavior. Nursing interventions to enhance internal health locus of control, resilience and social support might be essential for patients with coronary artery disease in order to promote their health behaviors.
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PURPOSE The aim of this study was to identify the levels of and the related factors to health literacy and health behavior compliance in patients with coronary artery disease. METHODS A cross-sectional survey was conducted with a convenience sample of 121 hospitalized patients with coronary artery disease. The structured questionnaires were used to measure the levels of health literacy and health behavior compliance. RESULTS The average linguistic health literacy score was 32.23+/-21.46, the functional health literacy score was 6.51+/-5.08, and the health behavior compliance score was 61.66+/-15.53. The levels of education (beta=.35), income (beta=.27), and perceived health status (beta=.21) were found significant, explaining 41.8% of the variance in linguistic health literacy. The levels of education (beta=.23), income (beta=.27), age (beta=-.24), and family support (beta=.22) were found to be significant, explaining 50.9% of the variance in functional health literacy. The levels of education (beta=.27), family support (beta=.20), and linguistic health literacy (beta=.40) were found to be the significant factors, which explained 45.1% of the variance in health behavior compliance. Linguistic health literacy specifically explained 9.5% of health behavior compliance. CONCLUSION Health literacy was associated with health behavior compliance, influencing the factors of health behavior compliance. These findings suggest that the interventions for improving health literacy are necessary to enhance health behavior compliance in patients with coronary artery disease.
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PURPOSE The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease. METHODS The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group. RESULTS The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom. CONCLUSION The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.
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PURPOSE Cardiovascular risk factor modification is important for patients with coronary artery disease to prevent poor progression of the disease. Without an understanding and an awareness of risk factors, patients with coronary artery disease are not able to reduce their risk by the lifestyle modification. The aims of this study were to assess patient's awareness of risk factors and to identify predictors of awareness of risk factors. METHODS A descriptive correlational study using a cross-sectional survey method was performed. The sites of the study were three hospitals in Seoul, Korea. The sample consisted of 214 subjects. The awareness of risk factors and other subjects' characteristics were measured by a questionnaire developed for this study. RESULTS A range of subjects (gender: 72.0%; hyperlipidemia: 51.9%; hypertension: 40.7%; obese: 37.4%; age: 35.5%; smoking: 22.4%; diabetes: 19.2%; family history: 18.2%) were not able to accurately identify the risk factors. Among predictors, gender (beta=-.17) and diabetics (beta=-.25) had statistically significant influences on awareness of risk factors. CONCLUSION Our findings highlight the lack of awareness of risk factors for coronary artery disease. The findings have important implications for nursing practice in terms of guiding educational strategies for the modification of risk factors for coronary heart disease.
PURPOSE The purpose of this study was to investigate the effects of an individualized cardiac health education on self-care behavior and serum cholesterol levels patients with coronary artery disease. METHODS Twenty-two patients in the intervention group and 22 in the control group were assigned randomly in this study. The intervention group received an individualized cardiac health education program which consisted of four different sessions for a total of four sessions. Specifically, two sessions occurred during the patients' hospitalization with a third session at the time of discharge with a fourth session scheduled via telephone one week post discharge. Data were collected through a questionnaire for self-care behavior and a blood test for total cholesterol at the time of admission and the two weeks after discharge. The questionnaire for self-care behavior was a standardized instrument and serum cholesterol was measured by Accutrend GC (Roche, Germany). RESULTS Self-care behavior scores included diet, medication, exercise, risk factor, blood pressure measurement, and visits to hospital were significantly more in the experimental group compared to the control group. CONCLUSION The above findings indicate that the individualized cardiac health education was effective in increasing of self-care behavior.
PURPOSE The purpose of this study was to determine the differences in the level of disease related knowledge, compliance of health behavior, and educational needs in relation to time (at discharge and 6 months after discharge) among patients underwent percutaneous coronary intervention (PCI). METHODS Data were collected from January 1, 2006 to September 30, 2006 and a total of 60 patients participated in the study. The survey was conducted in patients underwent PCI at the time of discharge right after discharge education was provided and at a follow up visit which was 6 months after discharge. RESULTS The level of disease related knowledge (p<.001), the compliance of health behavior (p<.001), educational need (p=.496), the sub-item of sexual life (p<.001), follow up (p<.001), diet (p=.021), stress (p<.001) in compliance of health behavior, and the sub-item of specific character of disease in educational needs (p=.015) were significantly different between discharge and 6 months after discharge. CONCLUSION The results of this study suggested that further education should be provided to the patients underwent PCI regarding medication, smoking cessation, daily life and exercise at a time of 6 months after discharge in order to increase patient compliance of health behavior.
PURPOSE This paper has attempted to investigate the association between the subclinical thyroid function disorder caused by natural change in thyroid hormones or thyroid remedies and the incidence of CHD. METHODS Data was analyzed of 7,675 women who had undergone health examinations in a hospital in Gyeonggi-do between January 2007 and December 2008. The covariation of the coronary risk factors such as age, BMI, HbA1C, systolic blood pressure, LDL:HDL-cholesterol ratio, CRP, smoking and exercise were analyzed by using logistic regression analysis. RESULTS A significant increase in serum TSH was observed with higher age (F=26.91, p=.00). In terms of age, the risk of CHD started to gradually increase since the 40s and sharply since the 60s (chi-square=113.29, p=.00). The serum TSH was the most significant parameter influencing CHD (B=.12, p=.00). The risk of coronary artery disease was 3.12 times higher in the subclinical hypothyroidism group (OR=3.12) while no significant difference was observed in the subclinical hyperthyroidism group. CONCLUSION Subclinical hypothyroidism may be an independent risk factors for CHD. A nurse nursing patients with thyroid disorder should be well informed of their state of subclinical thyroid function disorder and make efforts to extend their health expectancy.
PURPOSE This study was to examine the food intake and family support of patients with Coronary Artery Disease(CAD). METHODS 90 hospitalized patients who received CAD medical treatment were randomly selected. The food intake frequency and family support instrument were utilized. Collected data was analyzed by SPSS/WIN 14.0: t-test, Chi-square-test and Pearson's correlation coefficient. RESULTS The mean score of food intake frequency was 5.65(total mean score 97.50) which was relatively healthy food intake based on the CAD treatment guidelines. Undesirable food intake items were fruit, fish, milk etc. The mean score of family support was 2.44(range: 1 - 4). Food intake showed a significant(p < .001) positive correlation with family support. There was significant difference(p < .05) on family support according to exercise. There was significant difference(p < .05) on LDL level, one of the CAD risk factors, between first admission patients and readmission patients. CONCLUSION These findings suggest that nursing intervention education programs should be developed to appropriately care for CHD patients for needed changes.
PURPOSE This study was aimed to determine the optimum low-density lipoprotein : high-density lipoprotein-cholesterol (LDL : HDL-C) ratio for predicting coronary heart disease(CHD) in Korean people. METHODS It was analyzed this data of 5,431 adults who had undergone health examinations in a hospital in Gyeonggi-do between January 2006 and December 2007. The covariation of the coronary risk factors such as age, HbA1C, systolic blood pressure(SBP), and waist-to-stature ratio(WSR) were analyzed by using logistic regression analysis. RESULTS The LDL : HDL-C ratio in the male and female groups was mostly distributed between 1.5 and 4.0. The LDL : HDL-C ratio was the most significant cholesterol-related parameter influencing CHD(male: B = .306, p = .054, female : B = .940, p = .010), followed by LDL-C and total cholesterol. It was observed a sharp increase in the odds ratios for LDL : HDL-C ratios of 2.25 - 2.50(male) and 2.00 - 2.25(female). A significant difference was observed in both male(2.25 : chi-square = 2.494, p = .072) and female(2.00 : chi-square = 413.742, p = .000) groups. CONCLUSION The risk level of CHD was set to 2.25 for males and 2.00 for females. Therefore, the optimum LDL : HDL-C ratio for Koreans should be far lower than that for the people in western countries.
PURPOSE The purpose of this study was to explore the differences of health locus of control and treatment compliance according to general characteristics and severity in acute coronary syndrome(ACS) patients after percutaneous coronary intervention. METHODS This descriptive study was conducted with a convenient sample of 103 ACS patients. The dependent variables were measured by the scales for the Multidimensional Health Locus of Control and the Treatment Compliance. The collected data were analyzed by the Fisher's exact test, Chi-square and t-tests, and ANOVA using the SPSS/WIN program. RESULTS Pre-interventional severity was significantly different between men and women. In terms of internal health locus of control, there was a significant difference according to gender, educational status, economic status, and severity. The level of medication compliance was the lowest among the sub-scales of treatment compliance. CONCLUSION These findings suggest that clinical nurses should evaluate the general characteristics and severity of the patients with ACS for providing tailored nursing interventions.
PURPOSE The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography(CAG). METHODS A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. RESULTS 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group(t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group(t=4.580, p=.001). CONCLUSION The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.
PURPOSE The purpose of this study was to investigate the knowledge and learning needs on coronary artery disease in diabetic patients by glycemic control. METHODS The subjects consisted of 188 patients at the hospital who had diabetes mellitus. Data was obtained using a knowledge and learning needs questionnaire from January to April 2006. RESULTS Treatment method, the levels of fasting blood glucose(FBG), and 2-hour postprandial blood glucose (PP2hr) showed meaningful differences between normo-glycemic group(HbA1c<7%) and hyper-glycemic group (HbA1c> or =7%). The levels of knowledge on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. Etiology and prevention of coronary artery disease were significantly higher in normo- glycemic group than in hyper-glycemic group. The levels of learning needs on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. The learning needs on items of diet control were higher in normo-glycemic group than in hyper-glycemic group. CONCLUSION On the base of these results, we should focus on the coronary artery disease education for hyper-glycemic group. Also individual coronary artery disease educational program should be developed for the patients with different level of knowledge and learning needs.
PURPOSE The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. METHOD: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. RESULT: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD= 6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. CONCLUSION: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.
BACKGROUND AND PURPOSE: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain. METHOD Sixty-two patients were assigned to one of three groups: specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum beta-endorphin was determined before and after the three interventions. RESULT The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum beta-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups. CONCLUSION Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.
The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month.
2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a socio- pshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.
Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: 61+/-15), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows.
1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3.The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.
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