Effect of continuous nursing on treatment compliance and side effect management of coronary heart disease

Abstract

BACKGROUND

There are relatively few studies on continuing care of coronary heart disease (CHD), and its research value needs to be further clarified.

AIM

To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD.

METHODS

This is a retrospective study with patients from January 2021 to 2023. The study was divided into two groups with 30 participants in each group. Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS) were used to assess patients' anxiety and depression, and medical coping questionnaire was used to assess patients' coping styles. The pelvic floor dysfunction questionnaire (PFDI-20) was used to assess the status of pelvic floor function, including bladder symptoms, intestinal symptoms, and pelvic symptoms.

RESULTS

SAS score decreased from 57.33 ± 3.01before treatment to 41.33 ± 3.42 after treatment, SDS score decreased from 50.40 ± 1.45 to 39.47 ± 1.57. The decrease of these two indexes was statistically significant (P < 0.05). PFDI-20 scores decreased from the mean 16.83 ± 1.72 before treatment to 10.47 ± 1.3the mean after treatment, which was statistically significant (P < 0.05).

CONCLUSION

The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients' treatment compliance, reducing anxiety and depression levels, and improving coping styles and pelvic floor functional status.

Key Words: Coronary heart disease; Continuing care; Treatment compliance; Anxiety and depression; Coping style; Pelvic floor function status; Pioneering study

Core Tip: After the implementation of the pioneering intervention, patients' anxiety and depression levels were significantly reduced, treatment compliance was significantly improved, more positive coping styles, and pelvic floor functional status was significantly improved. In the intervention group, Self-rating Anxiety Scale and Self-rating Depression Scale scores were significantly reduced, the proportion of treatment compliance was significantly increased, the scores of face dimension were increased, the scores of avoidance and obedience dimension were decreased, and the pelvic floor dysfunction questionnaire scores were also significantly decreased. These results show that the intervention has a significant effect on psychological support and treatment coordination, which helps to improve the quality of life of patients and promote the rehabilitation process.

INTRODUCTION

Coronary heart disease (CHD) is a heart disease caused by insufficient blood supply to the coronary arteries with symptoms such as myocardial infarction or angina, and is one of the major health problems worldwide[1-3]. According to the World Health Organization, CHD causes millions of deaths each year, placing a huge burden on patients' quality of life and cardiovascular system[4-6]. Continuous nursing is very important for the management of patients with CHD, in which the comprehensive evaluation and intervention of treatment compliance, anxiety and depression, coping style and pelvic floor function are particularly critical[7-10]. Over the past few decades, scientists and medical experts have been trying to find effective ways to improve the quality of life and prevent complications in patients with CHD. In this context, the promotion of pioneering research becomes particularly important, bringing new understanding and approaches to the field of medicine[11]. This study was designed to explore a pioneering study of continuous care for CHD, looking at its impact on treatment adherence and side effect management. By comprehensively evaluating the psychological state, treatment compliance and functional status of patients, we hope to provide a strong basis for improving the overall nursing of patients with CHD.

In the course of the treatment of CHD, the patient's treatment compliance is a crucial factor[12-15]. Whether the patient can comply with the doctor's advice and actively cooperate with the medical team's treatment plan is directly related to the control of the disease and the speed of the patient's recovery[16-19]. However, many patients with CHD face various psychological pressures during treatment, especially anxiety and depression. These psychological problems may not only affect patients' enthusiasm for treatment, but also lead to a decline in the effectiveness of treatment and even increase the risk of complications[20-22]. In order to understand the psychological state and coping style of the patients more comprehensively, we used the Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS) to assess the anxiety and depression of the patients. Through the evaluation of these two scales, we can more accurately understand the psychological changes experienced by patients in the course of treatment, and provide scientific basis for the development of personalized psychological intervention programs.

The evaluation of treatment compliance is not only concerned with whether the patient is taking the prescribed medication, but also with the patient's motivation in rehabilitation training and lifestyle changes[23]. In this study, patients' compliance during and after hospitalization was evaluated in detail through a self-made treatment compliance scale. This not only helps to understand the patient's overall treatment compliance, but also provides an important reference for future rehabilitation programs. Coping styles play a crucial role in the management of a patient's disease. Different coping styles can lead to very different therapeutic effects. In this study, we used the medical coping questionnaire (MCMQ) to assess patients' coping styles, including three dimensions of facing, avoidance, and submission. Through this assessment, we can have a more comprehensive understanding of the patient's attitude towards the disease and coping strategies, and provide more accurate guidance for personalized psychological support and rehabilitation recommendations. In addition, pelvic floor function status also plays an important role in the overall health of patients with CHD. The improvement of pelvic floor function is directly related to the improvement of life quality. Therefore, we used the pelvic floor dysfunction questionnaire (PFDI-20) to assess patients' pelvic floor functional status, including bladder symptoms, intestinal symptoms, and pelvic symptoms. Through this evaluation, we can have a more comprehensive understanding of the physiological conditions of patients and provide a scientific basis for improving the quality of life of patients.

In general, this study is committed to exploring the impact of pioneering research in continuous care of CHD on the psychological and functional status of patients, so as to provide a scientific basis for improving treatment compliance, reducing psychological burden and improving quality of life. We believe that the results of this study will have a positive impact on the comprehensive care of patients with CHD, and provide more effective support for the rehabilitation and quality of life of patients with CHD.

MATERIALS AND METHODS

Patient characteristics

In this study, patients with CHD were divided into two groups using a randomized controlled trial design, and the two groups were respectively treated with pioneering research intervention of continuous care and conventional treatment, and the differences in treatment compliance, anxiety and depression, coping style and pelvic floor function status were compared between the two groups. The study used a before-and-after design and multi-dimensional patient assessments to gain insight into the impact of pioneering research on overall patient care. A total of 60 patients meeting the inclusion criteria were recruited from patients with CHD in our hospital. The general data of the patients included age, sex, duration of CHD, comorbidities, drug use, etc. This information will contribute to a more comprehensive understanding of the patient's disease background and provide basic data for subsequent analysis (Table 1).

Table 1 Comparison of patients' general data.

Group	Experimental group	Control group	F/t	P value
Age (yr)	64.90 ± 5.31	65.73 ± 3.15	-0.736	0.46
Gender (Male/female)	13/17	14/ 16	0.59	0.44
Body mass index	24.37 ± 1.81	23.96 ± 2.13	0.80	0.42
Smoking history (pack/yr)	16/14	15/ 14	0.64	0.42
High blood pressure (Yes/No)	14/16	13/17	0.58	0.44
Diabetes (Yes/No)	8/22	7/23	0.59	0.45
Glycosylated hemoglobin (%)	6.50 ± 0.68	5.51 ± 0.72	-0.07	0.94
Total cholesterol (mmoL/L)	5.48 ± 0.68	5.68 ± 0.72	-1.09	0.28
Triglyceride (mmoL/L)	1.65.48 ± 0.49	1.58 ± 0.42	-2.53	0.20
Low density lipoprotein (mmoL/L)	3.18 ± 0.55	3.50 ± 0.45	-1.60	0.11
Phospholipid protein A1 (g/L)	1.06 ± 0.21	0.98 ± 0.17	1.58	0.12
Phospholipid protein B (g/L)	1.57 ± 0.35	1.53 ± 0.36	0.43	0.67
Lipoprotein (mg/dL)	127.25 ± 7.93	134.42 ± 9.39	-1.92	0.06

Admittance standard

Inclusion criteria: Patients aged 45 to 70 years with CHD; has a definite diagnosis of CHD and has a stable condition; good verbal communication skills, able to complete relevant assessment and intervention; patients who did not receive other psychological intervention; willing to participate and sign informed consent.

Exclusion criteria: Presence of other important cardiovascular diseases, such as heart failure; Have cognitive impairment or mental illness; have received relevant psychological treatment; the presence of other serious underlying diseases, such as cancer; Pregnant or lactating women.

Grouping situation

According to the principle of randomized controlled trial, patients who met the inclusion criteria were randomly divided into two groups: The intervention group and the control group. There are 30 people in each group. The patients in the two groups were similar in age, gender, and course of disease to reduce the interference of other factors of intervention effect.

Intervention measure

Intervention Group: A pioneering research intervention in which patients receive ongoing care, including regular psychological support, personalized development of rehabilitation training, and guidance on the patient's lifestyle.

Control group: Patients received conventional treatment for CHD, including drug therapy and regular follow-up.

Observation index

Anxiety and depression: The SAS and SDS were used to assess patients' anxiety and depression levels, respectively.

Treatment compliance: A self-made treatment compliance scale was used to evaluate patients' compliance during hospitalization and after discharge, which was divided into three levels: complete compliance, partial compliance and non-compliance.

Coping style: The MCMQ was used to assess the coping style of the patients, including three dimensions of facing, avoidance and submission.

Pelvic floor function status: The PFDI-20 was used to assess patients' pelvic floor function status, including bladder symptoms, intestinal symptoms, and pelvic symptoms.

Statistical analysis

SPSS statistical software was used for data analysis. For continuous variables, mean and standard deviation were used to describe them, and t-test was used for inter-group comparison. For categorical variables, frequency and percentage were used to describe them, and Chi-square test was used for inter-group comparison. In all analyses, a P value of less than 0.05 was considered statistically significant. In addition, in-depth interviews were used to conduct individual interviews with some patients to gain a more comprehensive understanding of their treatment experience and changes in mental state.

RESULTS

Comparison of anxiety and depression

After the pioneering intervention, SAS and SDS scores in the intervention group were significantly reduced (P < 0.05), from the mean before treatment (SAS: 57.33 ± 3.01; SDS: 41.33 ± 3.42)to the mean after treatment (SAS: 50.40 ± 1.45; SDS: 39.47 ± 1.57), respectively. The control group showed no significant changes on these two measures, suggesting that the pioneering study had a significant improvement in patients' anxiety and depression levels (Table 2).

Table 2 Comparison of anxiety and depression between the two groups before and after intervention.

Group	n	SAS		SDS
		Before intervention	After intervention	Before intervention	After intervention
Experimental group	30.00	57.33 ± 3.01	41.33 ± 3.42	50.40 ± 1.45	39.47 ± 1.57
Control group	30.00	56.27 ± 2.89	44.9 ± 3.1	52.77 ± 1.43	41.37 ± 1.35
t		-2.37	-1.90	1.07	-3.57
P value		0.37	P < 0.01	0.17	P < 0.01

SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

Comparison of treatment compliance

The evaluation results of treatment compliance showed that the proportion of complete and partial compliance patients in the intervention group was significantly increased, while the proportion of non-compliance patients was significantly decreased (P < 0.05). The change of treatment compliance in the control group was not significant. It shows that the intervention of the pioneering study has achieved significant effect in improving patients' treatment compliance (Table 3).

Table 3 Comparison of compliance patterns between the two groups before and after intervention.

Group	n	Face therapy		Avoidance therapy
		Before intervention	After intervention	Before intervention	After intervention
Experimental group	30.00	17.20 ± 1.75	13.13 ± 1.38	21.63 ± 1.54	13.70 ± 1.62
Control group	30.00	17.37 ± 0.96	15.67 ± 1.08	22.27 ± 1.29	15.13 ± 1.55
t		0.23	-3.54	-0.63	-1.43
P value		0.45	P < 0.01	0.09	P < 0.01

Comparison of coping styles

In the assessment of coping styles, the scores of facing dimension were significantly increased in the intervention group, while the scores of avoidance and submission dimension were significantly decreased (P < 0.05). The change in these three dimensions was not significant in the control group. This suggests that psychological support measures from pioneering research help patients face their illness more positively, with less avoidance and submissive coping styles (Table 4).

Table 4 Comparison of treatment compliance between the two groups after intervention.

Group	n	Complete compliance	Partial compliance	Noncompliance
Experimental group	30	18	8	4
Control group	30	10	12	8
χ2 value	3.96
P value	0.047

Comparison of pelvic floor function status

In the assessment of pelvic floor functional status, PFDI-20 scores decreased significantly in the intervention group, from the mean before treatment (16.83 ± 1.72) to the mean after treatment (10.47 ± 1.3) (P < 0.05). There was no significant change in this index in the control group. It indicates that the intervention of the pioneering study has a significant effect on improving the functional status of the pelvic floor of patients (Table 5).

Table 5 Comparison of pelvic floor function between the two groups before and after intervention.

Group	n	Bladder function		Gastrointestinal function
		Before intervention	After intervention	Before intervention	After intervention
Experimental group	30	16.83 ± 1.72	10.47 ± 1.3	23.27 ± 3.37	13.60 ± 1.30
Control group	30	15.9 ± 1.16	10.2 ± 1.22	24.67 ± 2.92	14.77 ± 1.48
t		0.27	0.93	-1.40	-1.17
P value		0.42	0.02	0.09	P < 0.01

DISCUSSION

The findings show that pioneering research in continuing care of CHD significantly improves anxiety and depression levels in patients[24-25]. In the intervention group, the mean scores of both SAS and SDS decreased significantly, while the control group did not change significantly on either measure. This suggests that the psychological support measures of the pioneering study had a positive impact on patients' mental health. Anxiety and depression are often comorbidities in patients with heart disease and are closely related to the prognosis of cardiovascular events and patients' quality of life. Groundbreaking research has reduced levels of anxiety and depression by providing personalized psychological support to help patients cope better with their illness and treatment. This is essential for the patient's overall recovery and is in line with the concept of integrated care.

The results showed that patients' treatment adherence improved significantly with the intervention of the groundbreaking study. The proportion of patients with full compliance and partial compliance increased significantly, while the proportion of patients with non-compliance decreased significantly. In contrast, there was no significant change in treatment compliance in the control group. The improvement in treatment adherence may be related to the personalized rehabilitation training and lifestyle guidance used in the pioneering study. After receiving a specially customized rehabilitation plan, patients are more likely to actively participate in rehabilitation training, which improves the execution of treatment. It also highlights the importance of personalized care in chronic disease management to meet the specific needs and expectations of patients. Positive changes in patients' coping styles were observed with the intervention of the groundbreaking study. There was a significant increase in the dimension of facing illness, while there was a significant decrease in the dimension of avoidance and submission. In contrast, in the control group, these changes were not significant. This suggests that the psychological support of pioneering research helps patients face the challenges of the disease more positively. By helping patients establish a positive mindset in the face of rehabilitation and lifestyle changes, pioneering research has played an important role in improving the way patients cope. This positive coping style may have a positive impact on a patient's long-term prognosis.

The study found that with the intervention of the pioneering study, patients' pelvic floor functional state scores were significantly reduced, while the control group showed no significant change on this measure. This suggests that pioneering research may have a positive impact on improving the physiological function of patients. The improvement in the functional state of the pelvic floor may be related to rehabilitation training and personalized guidance in the pioneering study. These measures help patients better understand and strengthen the pelvic floor muscles and improve the stability and function of the pelvic floor. This is especially important for patients with CHD because some treatments and medications can negatively affect pelvic floor function. The findings of quantitative data were further supported by the results of in-depth interviews. Patients who receive pioneering research interventions are more aware of their disease, more confident in treatment options, less psychologically burdened, and have a smoother recovery process. These individual interview results provide a more nuanced interpretation and support for quantitative data, highlighting the combined effect of pioneering research in improving patients' overall quality of life.

CONCLUSION

Combined with these results, pioneering research in continuing care for CHD has had a positive impact on patients' psychological status, treatment compliance, and physiological function. This study provides useful enlightenment for improving the comprehensive nursing plan of patients with CHD, and emphasizes the importance of personalized and comprehensive nursing for patients with chronic diseases. However, this study also has some limitations, such as a small sample size and a short study period. Future studies can further expand the sample size and extend the follow-up period to verify the persistence and universality of these findings.