渥太华研究应用模式构建循证干预对中青年急性心肌梗死伴心律失常患者心境状态和Killip分级及预后复发率的影响  

The ottawa research application model construction of evidence-based interventions on the mood state,killip grade and prognostic recurrence rate of young and middle-aged patients with acute myocardial infarction and arrhythmia

作　　者：王晶晶 蔡丽丽[1] 丁海杰 周瑛君 任琳[2] WANG Jing-jing;CAI Li-li;DING Hai-jie;ZHOU Ying-jun;Ren Lin(Department of CCU,Qinhuangdao First Hospital,Qinhuangdao 066300,China;Department of cardiology,Qinhuangdao First Hospital,Qinhuangdao 066300,China)

机构地区：[1]秦皇岛市第一医院CCU二病区,河北省秦皇岛市066300 [2]秦皇岛市第一医院心内科,河北省秦皇岛市066300

出　　处：《中国心血管病研究》2021年第11期1022-1027,共6页Chinese Journal of Cardiovascular Research

基　　金：河北省医学课题项目(202004A028)。

摘　　要：目的探讨渥太华研究应用模式构建循证干预对中青年急性心肌梗死(AMI)伴心律失常患者心境状态、Killip分级及预后复发率的影响。方法选取2020年11月至2021年2月我院心内科收治的106例中青年AMI伴心律失常患者,根据建档顺序分为对照组和观察组,各53例。对照组给予传统护理,观察组在传统护理的基础上给予渥太华研究应用模式构建循证干预。统计两组Killip分级和心律失常复发率,对比干预前后两组的心境状态(POMS)、应对方式(TSCQ)、健康行为(HPLP-Ⅱ)及护理满意度。结果干预3个月后观察组Killip分级Ⅰ级高于对照组[60.38%比35.85%],Ⅲ级低于对照组[9.43%比33.96%],干预结束后观察组心律失常复发率低于对照组(3.77%比24.53%,P<0.05);干预3个月后观察组POMS量表中紧张-焦虑、迷惑-混乱、愤怒-敌意、抑郁-沮丧低于对照组[(9.85±2.10)分比(12.69±2.96)分,(5.56±1.25)分比(8.55±2.12)分,(4.56±1.02)分比(8.10±1.54)分,(12.25±3.22)分比(16.85±4.10)分,P<0.05];干预3个月后观察组TSCQ消极应对评分低于对照组[(15.32±3.25)分比(21.25±4.10)分],TSCQ积极应对评分高于对照组[(34.58±4.10)分比(29.36±3.85)分,P<0.05];干预3个月后观察组HPLP-Ⅱ评分等级高于对照组(优秀43.40%比28.30%,良好41.51%比28.30%,一般13.21%比30.19%,差1.89%比13.21%,P<0.05);观察组反应性、移情性、可靠性、有形性、保证性评分高于对照组[(4.81±0.11)分比(4.20±0.32)分,(4.82±0.10)分比(4.15±0.42)分,(4.72±0.20)分比(4.05±0.53)分,(4.83±0.12)分比(4.12±0.34)分,(4.85±0.13)分比(4.11±0.41)分,P<0.05]。结论中青年AMI伴心律失常患者管理工作中,渥太华研究应用模式构建循证干预有助于调节患者身心状态,改善预后效果,降低预后复发风险。Objective To explore the effect of evidence-based intervention constructed by the Ottawa study application model on the mood state, Killip grade and prognostic recurrence rate of young and middle-aged acute myocardial infarction(AMI) patients with arrhythmia. Methods 106 young and middle-aged AMI patients with arrhythmia treated in the Department of Cardiology of our hospital from November 2020 to February 2021 were divided into control group and observation group according to the filing order, with 53 cases in each group.The control group was given traditional nursing, and the observation group was given evidence based intervention on the base of Ottawa research application model. The Killip grade and arrhythmia recurrence rate of the two groups were counted and the mood state(POMS), coping style(tscq) and health behavior(hplp-Ⅱ) of the two groups were compared before and after the intervention. Results After 3 months of intervention, the Killip grade of the observation group was higher than that of the control group [60.38% vs. 35.85%] and grade Ⅲ was lower than that of the control group [9.43% vs. 33.96%];the recurrence rate of arrhythmia in the observation group was lower than that of the control group(3.77% vs. 24.53%, P<0.05);the levels of tension anxiety, muddled confusion,anger hostilityand depression dispirited in POMS in the observation group were lower than those in the control group[(9.85±2.10) vs.(12.69 ± 2.96),(5.56±1.25) vs.(8.55±2.12),(4.56±1.02) vs.(8.10±1.54),(12.25±3.22) vs.(16.85±4.10),P<0.05];the tscq negative coping score in the observation group was lower than that in the control group [(15.32±3.25) vs.(21.25±4.10)] and the tscq positive coping score was higher than that in the control group[(34.58 ± 4.10) vs.(29.36 ± 3.85),P<0.05];the score of Hplp-Ⅱ in the observation group(excellent 43.40% vs.28.30%, good 41.51% vs. 28.30%, general 13.21% vs. 30.19%, poor 1.89% vs. 13.21%,P<0.05) was higher than that in the control group. Conclusion In the management of young and middle

关 键 词：构建循证干预 中青年 急性心肌梗死 心律失常 心境状态 健康行为 

分 类 号：R542.22[医药卫生—心血管疾病]