预立医疗照护计划在慢性心力衰竭患者中的应用研究  

Application of advance care planning in patients with chronic heart failure

作　　者：张慧[1] 万琼[1] 叶燕[1] 赵燕丽 罗曼[1] 张忠明 张静 ZHANG Hui;WAN Qiong;YE Yan;ZHAO Yanli;LUO Man;ZHANG Zhongming;ZHANG Jing(Department of Cardiovascular Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Gastroenterology,Huangshi Yangxin People's Hospital,Huangshi 435200,China)

机构地区：[1]华中科技大学同济医学院附属同济医院心血管内科,武汉市430000 [2]阳新县人民医院消化内科,黄石市435200

出　　处：《护理管理杂志》2022年第11期800-804,共5页Journal of Nursing Administration

摘　　要：目的探讨预立医疗照护计划对慢性心力衰竭患者的干预效果。方法选择2020年11月至2022年6月在湖北省某三级甲等医院接受治疗的209例慢性心力衰竭患者为干预对象,将其随机分为对照组(104例)和实验组(105例),对照组实施常规照护,实验组在对照组的基础上实施预立医疗照护计划访谈结合微视频教育,比较干预前后患者预立医疗照护计划接受度、延续治疗护理接受比例及焦虑抑郁的变化。结果干预后实验组患者预立医疗照护计划接受度得分高于对照组(P<0.01),实验组患者对心肺复苏、人工辅助呼吸、尽可能延续生命的接受比例较对照组有显著差异(P<0.01),实验组患者焦虑抑郁得分高于对照组(P<0.01)。结论实施预立医疗照护计划访谈结合微视频教育可提高慢性心力衰竭患者预立医疗照护计划接受度,心肺复苏、人工辅助呼吸、尽可能延续生命的接受比例降低,但提高了焦虑抑郁水平,临床预立医疗照护计划实践中应关注慢性心力衰竭患者焦虑抑郁水平变化,并采取心理疏导措施。Objective To explore the effect of advance care planning(ACP)intervention in patients with chronic heart failure(CHF).Methods A total of 209 patients with CHF who were treated in a 3A Grade hospital in Hubei Province from November 2020 to June 2022 were randomly divided into the control group(n=104)and the experimental group(n=105).The control group was given routine care,and the experimental group was given ACP interview combined with micro video education intervention based on the control group.The changes in ACP acceptance,continuous treatment care acceptance rate,anxiety and depression before and after the intervention were compared.Results The score of acceptance of ACP after intervention in the experimental group was higher than that of the control group(P<0.01),the proportion of receiving cardiopulmonary resuscitation,artificial assisted breathing and extending life as far as possible in the experimental group were significantly different from those of the control group(P<0.01),and the score of anxiety and depression in the experimental group were higher than those of the control group(P<0.01).Conclusion The application of ACP interview combined with micro video education intervention can improve the acceptance of ACP,reduce the acceptance rate of continuous treatment care,but improve the level of anxiety and depression in patients with CHF.Health staff should pay attention to the changes in anxiety and depression in patients with CHF and take psychological counseling measures.

关 键 词：预立医疗照护计划 微视频教育 患者 慢性心力衰竭 

分 类 号：R48[医药卫生—临床医学]