对急性心肌梗死PCI术后患者自我管理能力的纵向研究  

A longitudinal study of self-management ability in acute myocardial infarction patients after percutaneous coronary intervention

作　　者：韩颖[1] 和霞[1] 林梅[1] Han Ying;He Xia;Lin Mei(Cardiac Care Unit,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院心脏重症监护室,天津300052

出　　处：《中华现代护理杂志》2020年第9期1213-1217,共5页Chinese Journal of Modern Nursing

摘　　要：目的了解急性心肌梗死(AMI)患者PCI术后自我管理能力的发展轨迹,探讨感知控制力、出院准备度的预测作用,旨在为制订阶段性、个性化自我管理方案提供理论依据。方法于2018年5—9月便利抽取天津市某三甲综合医院心内CCU住院的168例行PCI的AMI患者作为研究对象,采用冠脉支架植入患者自我管理能力自评量表、修订版控制态度量表、出院准备度量表对其进行调查。分别于患者出院时(Time 1,T1)、出院后3个月(Time 2,T2)、出院后6个月(Time 3,T3)、出院后9个月(Time 4,T4)、出院后12个月(Time 5,T5)进行资料收集。结果168例AMI患者T1、T2、T3、T4、T5自我管理能力得分分别为(34.91±5.03)、(38.89±7.22)、(43.78±9.32)、(47.76±10.33)、(53.29±11.48)分;T1感知控制力得分为(20.63±6.70),T1出院准备度得分为(59.85±21.42)分。条件模型拟合指数均达标,自我管理能力的发展轨迹呈线性形式,且呈显著上升趋势,初始水平和发展速度均存在显著的个体差异。感知控制力、出院准备度均能正向预测自我管理能力的初始水平;感知控制力能正向预测自我管理能力的发展速度。结论AMI患者PCI术后自我管理能力呈持续性发展,但仍有待提升空间,可通过提高感知控制力及出院准备度来实现。Objective To understand the development trajectory of self-management ability of acute myocardial infarction(AMI)patients after percutaneous coronary intervention(PCI),to explore the predictive roles of perceived control force and hospital discharge readiness so as to provide a theoretical basis for working out the phased and personalized self-management plan.Methods From May to September 2018,this study selected 168 AMI inpatients with PCI of Cardiac Care Unit at a ClassⅢGrade A general hospital in Tianjin as subjects by convenience sampling.All patients were investigated with the Self-management Scale for Patients Undergone Coronary Artery Stent Implantation,the Chinese Version of Control Attitudes Scale-revised and the Readiness for Hospital Discharge Scale.Data were collected at discharge(Time 1,T1),3 months(Time 2,T2),6 months(Time 3,T3),9 months(Time 4,T4),12 months(Time 5,T5)after discharge.Results Among 168 AMI patients,the scores of self-management ability in T1,T2,T3,T4 and T5 were(34.91±5.03),(38.89±7.22),(43.78±9.32),(47.76±10.33)and(53.29±11.48)respectively.The scores of perceived control force and hospital discharge readiness in T1 were(20.63±6.70)and(59.85±21.42)respectively.Conditional model fit indexes all reached the standard.The development trajectory of self-management ability was a linear form and a significant rise.There were individual differences in the initial levels and development speeds.Perceived control force and hospital discharge readiness could positively predict the initial level of self-management ability.Perceived control force could positively predict the development speed of self-management ability.Conclusions Self-management ability of AMI inpatients after PCI shows a sustainable development which can be promoted by improving the perceived control force and hospital discharge readiness.

关 键 词：急性心肌梗死 自我管理 感知控制力 出院准备度 潜变量增长曲线模型 

分 类 号：R473[医药卫生—护理学]