Normal information
The clinical data of 50 children with simple CHD who were treated in our hospital from January 2020 to December 2020 were collected, and the sleep quality and medication compliance after transcatheter intervention were retrospectively analyzed. The children were randomly divided into the study group (n = 25) and the control group (n = 25) using the random number table method. The inclusion criteria were as follow: 1.simple CHD was diagnosed and received transcatheter interventional; 2. postoperative echocardiography showed satisfactory correction of cardiac malformations; 3. there were no serious complications during the perioperative period; 4. patients with normal mental state, no intellectual disability or severe developmental stunting; 5. children and their parents agreed to participate in this study and signed an informed consent form. The exclusion criteria were as follows: 1. the patients combined with severe pulmonary hypertension and other diseases; 2. severe complications occurred during the perioperative period; 3. the children and their parents refused to participate in this study.
Methods
This was a retrospective study. Children in the control group were given routine care during the perioperative period. On the basis of routine care, the children in the study group implemented the family-centered care: 1. Health education: The researchers provided health education guidance for patients and their families, such as issuing health education manuals, group lectures, etc., so that the children and parents could understand the etiology, treatment process and prognosis of CHD. 2. The researchers introduced the effects of aspirin, dosage, method and time, and possible side effects to the family members of the children in detail, and allowed the parents to supervise the children's medication. 3. The researchers encouraged parents to actively participate in the psychological care of children. They could distract the children by allowing them to watch TV, listen to music, etc., to reduce irritability and anxiety. The researchers created a family-style ward environment to relax the children's psychology and ensure that they could have enough sleep. 4. The researchers established a good communication channel between medical staff and parents, kept abreast of changes in the children’s condition every day, and provided parents with consultation and feedback. They also paid attention to the emotional changes of children, communicated more with them, actively persuaded and guided, gave care, consideration and comfort, and helped children build confidence in overcoming the disease. 5. The researchers instructed the parents of children to continue home care after they were discharged from the hospital.
The two groups of nursing measures were implemented by trained senior nurses. One month later, the researchers conducted a questionnaire survey on sleep quality and medication compliance of the two groups of children. The questionnaire was distributed and recycled on the spot. A total of 50 questionnaires were issued, and 50 were actually recovered, with a recovery rate of 100%. After checking the validity and completeness of the questionnaire, it was found that the efficiency and completeness of the questionnaire were both 100%.
Observation index
The Pittsburgh sleep quality index (PSQI) was compiled in 1989 by Dr. Buysse,5 a psychiatrist at the University of Pittsburgh, USA. This scale was suitable for evaluating sleep quality of patients with sleep disorders and mental disorders, and it was also suitable for evaluating sleep quality of ordinary people. The scale consisted of 9 questions, the first 4 questions were fill-in-the-blank questions, the last 5 questions were multiple-choice questions, and the fifth question contained 10 small questions. The 18 self-assessment items consisted of 7 components, and each component was scored on a scale of 0 to 3. The cumulative score of each component was the total PSQI score. The total score ranged from 0 to 21 points. The higher the score, the worse the quality of sleep.
The Chinese revised version of the Morisky Medication Adherence Scale with 8 items (Morisky Medication Adherence Scale, MMAS-8) was proposed by Morisky and his colleagues in 2008.6 It was developed on the basis of MMAS-4,7 and it was used to assess the patient’s medication compliance. There were 8 questions in the scale. The alternative answers to questions 1 to 7 were "Yes" and "No". The answer to "No" was 1 point, and the answer to "Yes" was 0. The fifth question was scored in reverse. The candidate answers to the eighth question were "never", "occasionally", "sometimes", "often", and "all the time", which were 1.00, 0.75, 0.50, 0.25 and 0 points respectively. The full score of the scale was 8 points, a score below 6 was considered low compliance, a score of 6 to 7 was considered moderate compliance, and a score of 8 was considered high compliance.
Sample size
The sample size was determined with SPSS 22. 0. Alpha value was set at 0.05 and a power of 0.90. Based on the calculation, the resulting minimum sample size was 44 patients. Considering a 15% drop rate, we included 50 samples for the research.
Data collection
The researchers screened 50 eligible children for the study, and recorded their sleep quality and medication compliance scores one month after transcatheter intervention.
Statistical Analysis
SPSS 22.0 was used for statistical analysis in the study. The qualitative data were compared between groups by the chi-square test. The quantitative data were expressed as the mean±standard deviation, and the t-test was used to compare the differences in sleep quality and medication compliance scores between groups. P<0.05 was indicated that the difference was significant.