基于保护动机理论的护理干预对冠脉支架植入术后患者的影响  

Effect of nursing intervention based on protective motivation theory on physiological index and self-management behavior after coronary stent implantation

作　　者：张蕾[1] 翟颖[1] 陆剑嵘[1] 毛莉娟[1] 刘琪[1] 王昆[1] ZHANG Lei;ZHAI Ying;LU Jianrong;MAO Lijuan;LIU Qi;WANG Kun(Department of Cardiology,Affiliated Drum Tower Hospital,Medical College of Nanfing University,Nanfing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院心脏科,江苏南京210008

出　　处：《安徽医药》2018年第7期1408-1412,共5页Anhui Medical and Pharmaceutical Journal

基　　金：北京力生心血管健康基金会领航基金课题(LHJJ201611424)

摘　　要：目的探讨保护动机理论运用于冠脉支架植入术后对患者生理指标和自我管理行为的影响。方法选择2015年1月至2016年6月行冠脉支架植入术患者94例,按照随机数字表法分为两组,每组47例。对照组行常规护理干预,观察组在常规护理基础上行基于保护动机理论的护理干预,主要为建立保护动机干预小组、集中健康教育、组织病友交流会、个性化干预和建立网络交流平台。对比分析两组护理前、护理6个月后各项生理指标变化及自我管理行为,并统计两组用药依从性情况。结果观察组护理6个月后SBP、DBP、FBG、Hb A1C、LDL-C、TC和TG水平分别为(128.25±6.24)mm Hg、(74.22±4.51)mmHg、(6.23±1.32)mmol·L^(-1)、(5.47±1.24)%、(3.02±0.44)mmol·L^(-1)、(4.62±0.57)mmol·L^(-1)、(1.85±0.36)mmol·L^(-1),均低于对照组,观察组HDL-C水平为(1.62±0.45)mmol·L^(-1),高于对照组,差异有统计学意义(P<0.05);观察组护理6个月后日常生活管理、疾病医学管理、情绪管理和自我管理行为总分分别为(32.16±2.74)分、(42.25±3.55)分、(15.39±1.39)分及(85.44±5.47)分,均高于对照组,差异有统计学意义(P<0.05);观察组护理6个月后用药依从性为97.87%,高于对照组的78.72%,差异有统计学意义(P<0.05)。结论基于保护动机理论的护理干预应用于冠脉支架植入术后患者可有效降低其血压、血糖和血脂水平,增强自我管理行为,提高用药依从性。Objective To study the effect of nursing intervention based on protective motivation on the physiological indexes and self-management behavior of patients after coronary stent implantation. Methods From January 2015 to June 2016,94 patients with coronary stent implantation were divided into two groups according to the random number method. In the control group,routine nursing intervention was conducted. The observation group was based on the nursing intervention based on protective motivation theory. The observation group was mainly engaged in the establishment of protection motive intervention group,centralized health education,organization of patient exchange,personalized intervention and establishment of network communication platform. Comparison of the two groups before the care,nursing 6 months after the changes in physiological indicators,self-management behavior,and statistics of the two groups of drug compliance. Results The value of SBP,DBP,FBG,Hb A1 C,LDL-C,TC,and TG after 6 months of care in the observation group were（ 128. 25 ± 6. 24） mm Hg,（ 74. 22 ± 4. 51） mm Hg,（ 6. 23 ± 1. 32） mmol·L^-1,（ 5. 47 ± 1. 24） %,（ 3. 02 ±0. 44） mmol·L^-1,（ 4. 62 ± 0. 57） mmol·L^-1,（ 1. 85 ± 0. 36） mmol·L^-1,all low in the control group,the HDL-C level in the observation group was（ 1. 62 ± 0. 45） mmol·L^-1,which was higher than that of the control group,and the difference was statistically significant（ P〈0. 05）. After 6 months of nursing,the total scores of daily life management,disease medicine management,emotion management and self management were（ 32. 16 ± 2. 74） points,（ 42. 25 ± 3. 55） points,（ 15. 39 ± 1. 39） points and（ 85. 44 ± 5. 47）points,which were higher than those in the control group,the difference was statistically significant.（ P〈0. 05）. In the observation group,medication adherence was 97. 87% after 6 months of care,which was higher than 78. 72% of the control group. The difference was statistically significant（ P〈0. 05）. C

关 键 词：冠心病 血管成形术 气囊 冠状动脉 动机 支架 自我护理 服药依从性 

分 类 号：R473.6[医药卫生—护理学]