Siebens领域管理模式对心房颤动患者临床结局和生命质量的影响  

Effects of Siebens domain management model on life quality and outcomes for patients with atrial fibrillation

作　　者：司小明[1] 陈慧玲[1] 张赟 陈同峰[1] 付海霞[1] Si Xiaoming;Chen Huiling;Zhang Bin;Chen Tongfeng;Fu Haixiao(Structural Heart Disease Division,Heart Center of Henan Provincial People's Hospital,Fuwai Central China Hospital,Fuwai Central China Hospital of Zhengzhou University,450000)

机构地区：[1]河南省人民医院心脏中心,华中阜外医院,郑州大学华中阜外医院结构性心脏病病区,河南郑州450000

出　　处：《护士进修杂志》2021年第6期486-491,共6页Journal of Nurses Training

基　　金：2020年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20200105)。

摘　　要：目的探讨Siebens领域管理模式对心房颤动患者临床结局和生命质量的影响。方法选取84例心房颤动者,按照入院时间分为对照组和观察组,每组42例。对照组(2017年5月-2018年5月)给予常规护理,观察组(2018年6月-2019年6月)实施Siebens领域管理模式。入院时和出院6个月时,采用Morisky服药依从性量表(Morisky medication adherence scale,MMA)和SF-36健康调查量表评价患者用药依从性和生命质量,采用Kaplan-Meier法比较两组因心血管事件再入院率。结果出院6个月,观察组MMAS-8得分为(7.18±0.71)分,明显高于对照组的(6.52±1.07)分;观察组SF-36健康调查量表中生理功能、生理职能、躯体疼痛、总体健康、精神健康维度得分及总分分别为(80.34±3.59)分、(46.18±14.66)分、(90.84±5.94)分、(70.13±10.19)分、(83.87±8.80)分和(585.24±26.59)分,明显高于对照组的(69.69±11.08)分、(36.80±10.33)分、(82.91±6.81)分、(60.40±8.36)分、(78.34±9.73)分和(535.69±33.78)分,差异有统计学意义(P<0.05)。随访6个月,观察组因心血管事件再入院5例(13.2%),对照组10例(28.6%),观察组心血管事件再入院风险明显低于对照组(Log-rank χ^(2)=3.918,P=0.048)。结论Siebens领域管理模式能有效提升心房颤动患者生命质量,降低心血管事件再入院率。Objective To investigate the effects of Siebens domain management model on life quality and outcomes of patients with atrial fibrillation.Methods A total of 84 atrial fibrillation patients were assigned to control group and experimental group according to the enrolled time,with 42 cases in each group.The patients in the control group received routine nursing,the experimental group carried out Siebens domain management model nursing.At admission and 6 months after discharge,the medication compliance and life quality was assessed by Morisky medication adherence scale(MMA)and Mos-36-item short form health survey respectively.The re-admission of cardiovascular events were compared by Kaplan-Meier method.Results At 6 months after discharge.The MMAS-8 scores were(7.18±0.71)point in the experimental group,It's significantly higher than that in the control group(6.52±1.07)points;the physical function,role-physical,pain,general health,mental health as well as total SF-36 scores were(80.34±3.59)points,(46.18±14.66)points,(90.84±5.94)points,(70.13±10.19)points,(83.87±8.80)points and(585.24±26.59)points in the experimental group.It's significantly higher than that of the control group(69.69±11.08)points,(36.80±10.33)points,(82.91±6.81)points,(60.40±8.36)points(78.34±9.73)points and(535.69±33.78)points.The difference was statistically significant(P<0.05).At 6 months after discharge,the re-admission of cardiovascular events were 5 cases(13.2%)in the experimental group and 10 cases(28.6%)in the control group,the difference was statistically significant(Log-rank χ^(2)=3.918,P=0.048).Conclusion Siebens domain management model can improve the quality of life and decrease re-admission of cardiovascular events of patients with atrial fibrillation.

关 键 词：Siebens领域管理模式 心房颤动 生命质量 再入院 护理 

分 类 号：R47-05[医药卫生—护理学] R473.54[医药卫生—临床医学]