J Korean Acad Nurs.  2015 Aug;45(4):554-564. 10.4040/jkan.2015.45.4.554.

Development and Application of a Self-management Program based on Prothrombin INR Monitoring for Patients with Cardiac Valve Replacement

  • 1Dongsan Medical Center, Keimyung University, Daegu, Korea.
  • 2College of Nursing, Keimyung University, Daegu, Korea. jsp544@gw.kmu.ac.kr


The purpose of this study was to develop and evaluate a self-management program based on INR monitoring for patients with cardiac valve replacement.
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.
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 (chi2=4.80, p =.028).
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.


Self-management; Cardiac valve; Knowledge; Behavior; International Normalized Ratios
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