延续护理对提高心脏瓣膜置换术出院患者抗凝治疗依从性的研究  

The effect of transitional care on the anticoagulant therapy compliance among discharged patients undergoing cardiac valve replacement surgery

作　　者：李彬[1] 多伶俐[1] 于游游 王金星[3] 刘静[3] 

机构地区：[1]哈励逊国际和平医院护理部,河北省衡水市053000 [2]哈励逊国际和平医院检验科,河北省衡水市053000 [3]哈励逊国际和平医院胸心外科,河北省衡水市053000

出　　处：《中国护理管理》2014年第12期1278-1281,共4页Chinese Nursing Management

基　　金：衡水市科学技术研究与发展计划课题

摘　　要：目的 :探讨延续护理对心脏瓣膜置换术出院患者抗凝治疗依从性的影响。方法 :选取2010年5月至2013年5月在我院胸心外科行心脏瓣膜置换手术的患者121例,按患者出院先后顺序分为对照组60例与实验组61例,两组患者出院前均进行心脏瓣膜置换术后常规出院指导,出院后对照组采取常规门诊随访和复查,实验组由专职护士实施系统的电话专病随访和健康教育,同时利用短信平台向患者发送疾病知识、服药复诊提醒等手机短信。通过问卷调查的方式比较两组患者出院后3个月、6个月、12个月对心脏瓣膜置换术后抗凝知识掌握情况、抗凝治疗依从性、抗凝不当引起的并发症发生情况的差异。结果 :出院后3个月、6个月、12个月,两组患者不同时段各评价指标之间差异均有统计学意义(P<0.05)。结论 :对心脏瓣膜置换术出院患者实施延续护理干预可以满足患者的健康需求,提高其抗凝治疗的依从性,减少抗凝不当引起的并发症。Objective： To explore the effect of transitional care on the anticoagulant therapy compliance among discharged patients undergoing valve replacement surgery. Methods： We recruited 121 patients undergoing cardiac valve replacement surgery in the cardiothoracic surgery department of our hospital from May 2010 to May 2013, and divided them into control group（n=61） and experimental group（n=60）, respectively, according to their discharge order. All of the patients received routine discharge guidance. The control group adopted routine outpatient follow-up and recheck, and the experimental group received a telephone follow-up of specific disease and related health education, and received short messages about disease knowledge and medication reminders through short message platform provided by full-time nurse. We compared the anticoagulation knowledge, the anticoagulant therapy compliance, and the complications caused by improper anticoagulation between the two groups 3 months, 6 months, and 12 months after discharge by questionnaire. Results： There were significant differences in each of the evaluation index between the two groups 3 months, 6 months, and 12 months after discharge（P〈0.05）. Conclusions： Transitional care interventions among discharged patients with cardiac valve replacement surgery could meet their health needs, improve the anticoagulant therapy compliance, and reduce the incidence of complications caused by improper anticoagulation.

关 键 词：延续护理 心脏瓣膜置换 专病随访 手机短信 抗凝治疗 依从性 

分 类 号：R47[医药卫生—护理学]