심장판막수술 후 프로트롬빈 INR 모니터링형 자가관리프로그램 개발 및 적용

Abstract

Purpose: The purpose of this study was to develop and evaluate a self-management program based on INR monitoring for patients with cardiac valve replacement. Methods: This program was comprised of five weekly sessions based on Sousa’s Enhance-Behavior Performance Model. The first session included individual teaching, and the other four sessions included Prothrombin Time International Normalized Ratios (PT INR) self-monitoring, telephone counseling and self-management checklist recording. Participants were patients who had cardiac valve replacement. They were randomly assigned to the experimental or control group. Sixteen in the experimental group participated in the self-management program and seventeen in the control group participated in general care. Selfmanagement knowledge, self-efficacy, self-management behavior and PT INR were measured as dependent variables. Data were analyzed using Mann Whitney U-test, t-test and ANCOVA. Results: The experimental group showed significantly higher post-test scores in self-management knowledge (t=5.86, p <.001), self-efficacy (F=18.32, p <.001), and self-management behavior (t=3.44, p =.002) compared to the control group. Also, the experimental group showed significantly higher frequency in maintaining the treatment range of PT INR compared to the control group (χ 2=4.80, p =.028). Conclusion: The results of the research on the self-management program based on PT INR monitoring showed that it is effective in improving self-management knowledge, self-efficacy, and selfmanagement behavior as well as maintaining treatment range of PT INR of patients with cardiac valve replacement.