行为转变理论在冠脉介入术后患者心脏康复干预中的效果研究  

Effect of transtheoretical model of behavior in cardiac rehabilitation nursing intervention in patients undergone percutaneous coronary intervention

作　　者：周莹莹[1] 鞠桂萍[2] 丰小星[1] 顾岩[1] 

机构地区：[1]吉林大学第一医院心内科,长春130021 [2]吉林大学第一医院感染科,长春130021

出　　处：《中国循证心血管医学杂志》2016年第3期293-296,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：吉林省省级经济结构战略调整引导资金专项项目(高技术产业和信息化推进;2015Y037-3)

摘　　要：目的 探讨以行为转变理论为依据制定的心脏康复护理干预措施在经皮冠脉介入治疗术后患者中的应用效果。方法 连续入选2014年10月~2015年10月在吉林大学第一医院心内科经皮冠脉介入治疗患者107例,随机分为干预组（52例）,对照组（55例）。对照组接受常规护理。干预组给予常规护理并实施以行为转变理论为基础架构的心脏康复行为干预策略。比较两组患者的一般临床资料（包括年龄、性别、文化程度、心功能分级、支架个数）,干预前及干预3个月后行为变化阶段、心血管危险因素水平、生命质量评分。结果 干预后干预组和对照组各行为变化阶段的人数差异有显著性意义（χ2=38.272,P〈0.001）,干预组收缩压、总胆固醇、三酰甘油较对照组降低（t=-2.078,P=0.040;t=-3.716,P〈0.001;t=-3.745,P〈0.001）,两组间生存质量中生理机能、一般健康状况、精神健康3个维度方面比较差异有显著意义（t=2.358,P=0.020;t=2.695,P=0.008;t=2.612,P=0.010）。结论 以行为转变理论为依据建立的心脏康复干预策略能够促进经皮冠脉介入术后患者的行为转变,降低冠状动脉粥样硬化性心脏病（冠心病）危险因素,提高患者一般自我效能,改善冠脉介入术后患者生活质量,促进健康。Objective To investigate the application effect of cardiac rehabilitation nursing intervention based on transtheoretical model of behavior （TTM） in patients undergone percutaneous coronary intervention （PCI）. Methods The patients （n=107） were continuously chosen from Oct. 2014 to Oct. 2015, and randomly divided into intervention group （n=52） and control group （n=55）. The control group was given routine nursing, and intervention group was given cardiac rehabilitation behavior interventional strategies based on TTM besides of routine nursing. The clinical general material （including age, sex, educational background, NYHA grades and stent numbers）, stages of behavior change before and 3 m after intervention, risk factors of cardiovascular diseases and quality of life （QOL） scores were compared in 2 groups. Results After intervention, the difference in case numbers at all stages of behavior change had statistical significance between 2 groups （χ2=38-272, P〈0.001）. The levels of systolic blood pressure, total cholesterol and triglyceride decreased in intervention group compared with control group （t=-2.078, P=0.040; t=-3.716, P〈0.001; t=-3.745, P〈0.001）. The difference in 3 dimensions-physical function of QOL, general health status and psychological health, had statistical significance between 2 groups （t=2.358, P=0.020; t=2.695, P=0.008; t=2.612, P=0.010）. Conclusion The cardiac rehabilitation behavior interventional strategies based on TTM can improve behavior change, reduce risk factor of coronary heart disease, increase self-efficacy and improve QOL and health status in patients after PCI.

关 键 词：行为转变理论 经皮冠脉介入 心脏康复 一般自我效能 生存质量 

分 类 号：R816.2[医药卫生—放射医学]