P5434Evaluation of the determinant factors on the capacity for self-care in patients with acute myocardial infarction

Abstract

Background: In patients suffered from Acute Myocardial Infarction, Self-care ca-pacity after their discharge including ability to recover fully from an illness, to regain as optimal a level of function as possible, and to maintain a healthy state, depends on numerous interrelated factors. The objective of this study was to in-vestigate the factors associated with self-care in patients having history of percu-taneous coronary intervention for acute myocardial infarction. Methods: Between September 2017 and October 2017, 106 patients with history of PCI for acute myocardial infarction were enrolled in the study during their visit to the outpatient department. The capacity of Self-Care was assessed with the Self Care Agency Questionnaire (SCAQ) which consists of the scale of 29 items in-cluding 4 subscales: 1) ability to perform self-care operations, 2) ability to adjust one's own physical condition based on personal weaknesses, 3) ability to con-centrate one's attention on self-care, and 4) ability to receive valid support. Each subscale score was calculated by summing the item scores, and score range is 29-145. We divided these patients into two groups according to the SCAQ score, namely high SCAQ group (n=58) or low SCAQ group (n=48), and evaluated its correlation with patient characteristics and social background including age, gender, number of PCI procedure after index procedure, income, education, smoking, job status, social activity, co-living families, support from others, and status of life worth living (ikigai). The concept of "life worth living (ikigai)" is as reported elsewhere, a proxy of quality of life (QOL), and was measured by the Ikigai-9 Questionnaire, which comprises 9 questions and score range is 9-45. Results: Low SCAQ group was older than high SCAQ group (66.6 v.s. 72.9 years old, p<0.001). Low SCAQ group was more likely to be male, current smoker, no social activity, no support from other in daily life than high SCAQ group (91.7 v.s. 75.9%, p<0.05; 85.4 v.s. 63.8%, p<0.05, 14.6 v.s. 39.7%, p<0.01; 40.4 v.s. 53.8%, p<0.01, respectively). Conversely, high SCAQ group was more likely to be jobless than low SCAQ group (69.0 v.s. 39.6%, p<0.01). Ikigai-9 score was significant lower in low SCAQ group than high SCAQ group (24.7 v.s. 29.9, p<0.001). SCAQ score has strong correlation with Ikigai-9 score (r=0.52, p<0.001). Conclusions: In patients with older age, male, smoking, current worker, no so-cial support and no social activity were more likely to be low self-care capacity. Self-care capacity has significant correlation with the score of the Ikigai-9 Questionnaire. The issue for the self-care in patient with AMI is multifactorial. A com-prehensive approach from medical professional, families, and local community are needed.