Factors Associated With Behavior Modification for Cardiovascular Risk Factors in Patients with Coronary Artery Disease in Northern Taiwan

北台灣地區冠狀動脈疾病患者的心血管危險因子修正行為之相關因素

邱愛富(Ai-Fu Chiou)；汪慧鈴(Huey-Ling Wang)；陳保羅(Paul Chan)；丁予安(Yu-An Ding)；許寬立(Kwan-Lih Hsu)；高憲立(Hsien-Li Kao)

冠狀動脈疾病 ； 危險因子 ； 修正行為 ； 自我效能 ； 健康信念 ； coronary artery disease ； risk factor ； modifying behavior ； self-efficacy ； health belief

The Journal of Nursing Research

17卷3期（2009 / 09 / 01）

221 - 230

英文

背景　研究顯示降低心血管危險因子可以降低冠狀動脈疾病的罹病率和死亡率、改善患者預後及降低醫療成本。 目的　了解北台灣地區冠狀動脈疾病患者的心血管危險因子、認知、及其修正行為的情形，並探討影響心血管危險因子修正行為的相關因素。 方法　採橫斷式設計，以立意取樣，針對北部三家醫學中心的心臟內科門診冠狀動脈疾病患者為收案對象，共有156位冠狀動脈疾病患者接受訪談完成結構式問卷。資料以SPSS 14.0進行分析，統計方法包括平均數、標準差、百分比等描述性統計，Pearson相關係數，卡方檢定和複迴歸。 結果　自我效能、實際危險因子數、工作狀態、以及健康信念等變項可用來解釋38%的危險因子修正行為的變異量。其中以自我效能最具有預測力。年齡和A型人格是冠狀動脈疾病患者最常見的心血管危險因子。大多數的患者能夠做到按時服藥、規律飲食及生活作息，但是對於定期量血壓、規律運動、和控制體重則有較低的遵從性。 結論　建議護理人員應該評估冠狀動脈疾病患者的心血管危險因子、自我效能、和健康信念情形，並提供患者個別化的整體性照護。

Background: Studies have demonstrated that improvement in cardiovascular risk factors may contribute to reduced coronary artery disease (CAD) morbidity and mortality, improved patient outcomes, and lower medical costs associated with treating heart disease. Purpose: The purpose of this study was to understand the coronary risk factor profile, to have the knowledge of risk factors, to understand the modifying behaviors, and to understand the factors associated with modifying behaviors of cardiovascular risk factors among patients with CAD in northern Taiwan. Methods: A cross-sectional design was used in this study. Using nonprobability sampling, 156 patients diagnosed with CAD were interviewed and asked to complete a structural questionnaire in cardiovascular clinics at three medical centers in northern Taiwan. Data were analyzed by descriptive analysis, Pearson's correlation, chi-square tests, and stepwise multiple regression. Results: A total of 38% of variance of modifying behaviors was explained by self-efficacy, actual risk factors, work status, and health beliefs. Self-efficacy was the strongest predictor of behavior to modify cardiovascular risk factors. Age and type ”A” personality were the two leading cardiovascular risk factors for the participants. Most participants could perform modifying behaviors such as taking medications, eating an appropriate diet, and following specific lifestyle recommendations. However, participants had relatively lower adherence to monitoring blood pressure, exercising regularly, and controlling weight. Conclusions/Implications for Practice: Nurses should assess patient cardiovascular risk factors, health beliefs, and self-efficacy and then provide comprehensive and adequate instruction to each based on his or her specific risk factors.

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