基于问题导向的护理干预对冠心病PCI术后患者自我管理能力及康复效果的影响  

Influence of problem-oriented nursing intervention on self-management ability and rehabilitation effect of patients with coronary heart disease after PCI

作　　者：郑梅[1] 邹芸[1] 严雪娇 庄英[1] Zheng Mei;Zou Yun;Yan Xuejiao;Zhuang Ying(Department of Cardiovascular Medicine,Changzhou Second People′s Hospital,Changzhou 213003,China)

机构地区：[1]常州市第二人民医院心血管内科,常州213003

出　　处：《中国实用护理杂志》2022年第18期1361-1367,共7页Chinese Journal of Practical Nursing

基　　金：国家自然科学基金(81900453)。

摘　　要：目的探讨基于问题导向的护理干预在冠心病PCI术后患者自我管理与康复中的应用效果。方法选取常州市第二人民医院2019年1月至2021年1月冠心病PCI患者128例,采用随机数字表法分为观察组、对照组各64例。对照组采用常规自我管理干预,观察组采用基于问题导向的自我管理干预。干预6个月,比较2组自我管理能力、心功能、生命质量等指标。结果干预后6个月,观察组实际完成58例,对照组实际完成62例。干预前2组冠心病自我管理能力量表评分、心功能指标及西雅图心绞痛问卷各项评分比较差异均无统计学意义(P>0.05)。干预后6个月观察组疾病知识管理、症状管理、急救管理、日常生活管理、不良嗜好管理、治疗依从性及自我管理能力评分分别为(16.34±2.36)、(13.36±2.42)、(12.26±2.23)、(17.45±2.74)、(16.52±2.45)、(12.16±2.15)、(103.54±14.32)分,显著高于对照组的(14.32±2.45)、(12.45±2.23)、(10.75±2.32)、(16.05±2.45)、(15.24±2.53)、(10.36±2.24)、(94.09±13.36)分,差异有统计学意义(t值为2.14~4.59,均P<0.05)。干预6个月后观察组左心室收缩末期内径、左心室舒张末期内径分别为(34.39±6.75)、(52.60±6.31)mm,显著低于对照组的(38.56±6.52)、(55.79±5.74)mm,差异有统计学意义(t=3.52、2.90,均P<0.05)。干预后6个月观察组左心室射血分数、左心室短轴缩短率分别为(44.25±3.65)%、(23.86±2.41)%,显著高于对照组的(39.24±3.52)%、(22.26±2.51)%,差异有统计学意义(t=7.65、3.56,均P<0.05)。干预后6个月观察组躯体受限程度、心绞痛稳定性、心绞痛发作程度、治疗满意度、疾病认知程度、生命质量评分分别为(73.09±8.13)、(68.21±10.15)、(74.10±4.45)、(79.36±8.21)、(76.53±9.43)、(72.26±9.12)分,显著高于对照组的(64.15±8.11)、(59.38±10.23)、(63.51±5.23)、(62.45±8.16)、(67.68±9.20)、(63.44±8.65)分,差异有统计学意义(t值为4.74~11.91,均P<0.05)。结论基�Objective To investigate the effect of problem-oriented nursing intervention in the self-management rehabilitation of patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 128 patients with coronary heart disease undergoing PCI operation in Changzhou Second People′s Hospital from January 2019 to January 2021 were selected and randomly divided into the observation group and the control group with 64 cases in each group.The control group was given routine self-management intervention,and the observation group was given problem-oriented self-management intervention.After 6 months of intervention,the indicators of self-management ability,cardiac function,and quality of life were compared between the two groups.Results After 6 months of intervention,the observation group actually completed 58 cases,and the control group actually completed 62 cases.Before the intervention,there were no significant differences between the two groups in the scores of coronary self-management ability scale,cardiac function index and Seattle Angina Questionnaire(P>0.05).Six months after intervention,the scores of disease knowledge management,symptom management,first aid management,daily life management,bad addiction management,treatment compliance,and self-management ability in the observation group were 16.34±2.36,13.36±2.42,12.26±2.23,17.45±2.74,16.52±2.45,12.16±2.15,103.54±14.32,which were significant higher than those of in the control group,14.32±2.45,12.45±2.23,10.75±2.32,16.05±2.45,15.24±2.53,10.36±2.24,94.09±13.36(t=2.14-4.59,all P<0.05).After six months of intervention,the left ventricular end-systolic diameter(LVESD)and the left ventricular end-diastolic diameter(LVEDD)were(34.39±6.75)mm and(52.60±6.31)mm,which were significant lower than those of the control group,(38.56±6.52)mm and(55.79±5.74)mm(t=3.52 and 2.90,both P<0.05).Left ventricular ejection fraction(LVEF)and left ventricular short-axis shortening rate(FS)in the observation group after 6 months interven

关 键 词：冠心病 经皮冠状动脉介入术 问题导向 自我管理能力 康复效果 

分 类 号：R473.5[医药卫生—护理学]