心脏手册(HM)是英国领先的基于家庭的心脏康复(CR)计划,旨在从心肌梗死和血运重建中恢复。此审核探讨了与当前苏格兰相关的基于家庭的CR的患者报告结果,英国和欧洲的指导方针。
英国各地的患者在完成HM计划后将问卷返回给HM部门(NHSLothian)。
2011年至2018年间返回的457份问卷的定性数据被纳入主题分析。从准则中确定了七个主题。这种指导了初始演绎编码,并为归纳子主题的出现提供了基础。
主题包括:(1)健康行为改变和可修改的风险降低,(2)社会心理支持,(3)教育,(4)社会支持,(5)医疗风险管理,(6)职业康复和(7)长期战略和维护。据报道,(1)和(2)对患者的日常生活影响最大。(1)的子主题包括:指导,订婚,意识,后果,态度,没有变化和动机。社会心理支持包括:压力管理,起搏,放松,自我效能感增强,验证,心理健康和自我认知。其次是(3)和(4)。较少提及的患者(5),(6)和(7)。其他主题强调了HM计划的影响,患者将最大的影响归因于上述所有主题的组合。
此次审核强调了HM是苏格兰提出的全面和包容的关键要素,英国和欧盟的指导方针。患者报告说,这对他们的日常生活产生了深远的影响,并证明对CR有利。
The Heart Manual (HM) is the UK\'s leading facilitated home-based cardiac rehabilitation (CR) programme for individuals recovering from myocardial infarction and revascularisation. This audit explored patient-reported outcomes of home-based CR in relation to current Scottish, UK and European
guidelines.
Patients across the UK returned their questionnaire after completing the HM programme to the HM Department (NHS Lothian).
Qualitative data from 457 questionnaires returned between 2011 and 2018 were included for thematic analysis. Seven themes were identified from the
guidelines. This guided initial deductive coding and provided the basis for inductive subthemes to emerge.
Themes included: (1) health behaviour change and modifiable risk reduction, (2) psychosocial support, (3) education, (4) social support, (5) medical risk management, (6) vocational rehabilitation and (7) long-term strategies and maintenance. Both (1) and (2) were reported as having the greatest impact on patients\' daily lives. Subthemes for (1) included: guidance, engagement, awareness, consequences, attitude, no change and motivation. Psychosocial support comprised: stress management, pacing, relaxation, increased self-efficacy, validation, mental health and self-perception. This was followed by (3) and (4). Patients less frequently referred to (5), (6) and (7). Additional themes highlighted the impact of the HM programme and that patients attributed the greatest impact to a combination of all the above themes.
This audit highlighted the HM as comprehensive and inclusive of key elements proposed by Scottish, UK and EU
guidelines. Patients reported this had a profound impact on their daily lives and proved advantageous for CR.