1240: Does the Time of Mechanical Reperfusion by Coronary Angioplasty in the Setting of the Acute Phase of Myocardial Infarction be Improved by Optimization of The Logistics?

Abstract

Method:A database search using the MeSH search terms: hypertension, risk factors, nurses, nurse-patient relations, health behaviour, patient compliance, lifestyle, patient education, health promotion, self-care, attitude, motivation, adaptation, models, social support, communication and ambulatory care facilities. Results: Factors related to the patients' predispositions and abilities to change lifestyle and adhere to treatment were attitudes and beliefs, view of health, personality and traits, need for autonomy, and level of perceived vulnerability, hardiness, self-efficacy, control, sense of coherence, and social support and network. Values can be considered the basis for decision-making and the concept of health is tied into one's belief systems. Traits are factors that persistently determine our conduct in many different situations.Patients' need for autonomy should be respected through informed consent to help patients making own decisions. The degree of vulnerability changes with the degree of environmental support and personal resources. Scoring high on locus of control, hardiness and sense of coherence buffer the impact of stressful life-events. Self-efficacy is a belief in oneself to use and implement available skills. Social support is a feeling of belonging and being valued. Having social networks is crucial for psychological health. In the counselling session it is essential to obtain a shared decision-making made in concordance between patient and nurse. The outcome of the counselling should be behavioural change with the goal of adherence to treatment and maintenance of new behaviours. To achieve this the patient has to develop self-care agencies through coping resources by means of nursing agencies, i.e. interventions. A model, according to Orem's self-care deficit theory of nursing, was constructed to describe factors influencing patients in the communication with the nurse in counselling sessions. The organising nursing system facilitating patients' self-care resources in hypertension care should be added. Conclusion: To have knowledge of patients' predispositions to change behaviour and to adhere with medication are prerequisites for successful nursing in hypertension care.