Effects of case management-based psychological outpatient service combined with health education on disease knowledge mastery and self-efficacy in elderly outpatients with coronary heart disease

Jiang Fuling; Chen Yue; Chen Ping; Sun Wei; Tang Yu; Chen Jing; Huang Mingjin; Luo Hong

doi:10.11986/j.issn.1673-873X.2025.12.02

Abstract：Objective To investigate the effects of a case management-based psychological outpatient service combined with health education on disease knowledge mastery and self-efficacy in elderly outpatients with coronary heart disease(CHD),providing references for outpatient management.Methods A total of 120 elderly CHD outpatients from Xichang People's Hospital(July 2022-December 2024)were enrolled.Based on the implementation timeline of the case management-based psychological service,60 patients receiving conventional health education(July 2022-September 2023)were assigned to the control group,while 60 patients receiving the combined intervention(October 2023-December 2024)formed the study group.The control group received routine outpatient health education;the study group received additional case management-based psychological intervention.Psychological status,disease knowledge mastery,self-efficacy,and degree of satisfaction with nursing were compared before and after the intervention.Results Before the intervention,no significant differences were noted between groups in scores for five disease knowledge subscales:dietary management,functional exercise,emo-tional management,medication adherence,and complication awareness(P>0.05).After the intervention,scores in all five subscales increased in both groups compared to pre-intervention levels,with the study group showing significantly higher scores than the control group(P<0.05).Pre-intervention scores for the five subscales of the Chinese General Self-Efficacy Scale(GSES)—negative affect,emotional agitation,physical activity,weather/environment,and safety behavior—showed no intergroup differences(P>0.05).Post-intervention scores for all five GSES subscales increased in both groups versus pre-intervention,with significantly higher scores in the study group(P<0.05).Pre-intervention scores for the three sub-cales of the Connor-Davidson Resilience Scale(CD-RISC)—tenacity,optimism,and strength—showed no intergroup differ-ences(P>0.05).Post-intervention,scores for all three CD-RISC subscales increased in both groups versus pre-interven-tion,with significantly higher scores in the study group(P<0.05).No significant intergroup differences were found in sat-isfaction scores for service environment and medical costs(P>0.05).However,the study group had significantly higher satisfaction scores for service efficiency,service attitude,and service technique than the control group(P<0.05).Conclu-sion The case management-based psychological outpatient service combined with health education helps improve disease knowledge,promote self-efficacy,ameliorate psychological status,and increase the degree of satisfaction with nursing in elderly CHD outpatients,warranting clinical promotion.