title: [Development and Application of a Self-management Program based on Prothrombin INR Monitoring for Patients with Cardiac Valve Replacement].
abstract: OBJECTIVE
  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. Self-management 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 (χ²=4.80, p=.028).
  
  
  CONCLUSIONS
  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 self-management behavior as well as maintaining treatment range of PT INR of patients with cardiac valve replacement.
authors.affiliation: Dongsan Medical Center, Keimyung University, Daegu, Korea.
authors.forename: Hyun Rye
authors.initials: HR
authors.lastname: Jeon
authors.affiliation: College of Nursing, Keimyung University, Daegu, Korea. jsp544@gw.kmu.ac.kr.
authors.forename: Jeong Sook
authors.initials: JS
authors.lastname: Park
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006349:Heart Valve Diseases / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D016730:Program Development; D015397:Program Evaluation; D011516:Prothrombin / Q000032:analysis*; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013689:Telephone
chemical_list: D000925:Anticoagulants; D011516:Prothrombin
keywords: Behavior; Cardiac valve; International Normalized Ratios; Knowledge; Self-management