关键词: 急性心肌梗死；经皮冠状动脉介入术；心脏康复；渥太华决策支持框架；决策辅助；共享决策三步模式

Abstract: Objective: To develop a decision-making assistant program for cardiac rehabilitation exercise in patients after Percut-aneous Coronary Intervention for Acute Myocardial Infarction (AMI) who are affected by kinesiophobia and to evaluate the effects of this program, in order to provide a reference for improving patients' compliance with cardiac rehabilitation exercise. Methods: Based on the Ottawa Decision Support Framework and the shared Decision Making Three-talk Model, a decision-making assistant program for cardiac rehabilitation exercise was developed. By convenience sampling, 70 AMI patients with Percutaneous Coronary Intervention (PCI) and kinesiophobia in the cardiology department of a tertiary grade A hospital in Guizhou province were recruited from December 2023 to September 2024. Participants were randomly assigned to the control group or the intervention group through the random number table. Patients in the control group received routine care, while patients in the intervention group received the cardiac rehabilitation exercise decision-making assistant program. Changes in kinesiophobia level, exercise compliance, and left ventricular ejection fraction of patients at admission, discharge, one month post-discharge, and three months post-discharge were compared. Results: There were significant differences in the temporal changes of kinesiophobia level and exercise compliance between the two groups. At discharge, 1 month and 3 months after discharge, the kinesiophobia level in the intervention group was lower than that in the control group, and the exercise compliance was higher than that in the control group, with statistically significant differences (all P<0.05). At 3 months after discharge, the left ventricular ejection fraction was 60.89±5.44 percent in the intervention group, which was higher than 56.23±8.67 percent in the control group, and the difference was statistically significant (P<0.05). Conclusion: The application of the decision-making assistant program for the cardiac rehabilitation exercise can reduce AMI-PCI patients' exercise phobia, improve exercise compliance, and enhance cardiac function.

Key words: Acute Myocardial Infarction; Percutaneous Coronary Intervention; cardiac rehabilitation; Ottawa Decision Support Framework; decision aids; shared Decision Making Three-talk Model