出院康复指导联合积极心理干预对老年冠心病心绞痛患者遵循医嘱及康复效果的影响  

Effects of discharge rehabilitation guidance combined with positive psychological intervention on compliance with medical orders and rehabilitation effect in elderly patients with angina pectoris of coronary heart disease

作　　者：郑鸿露 刘雪慧 赵政霆 Zheng Honglu;Liu Xuehui;Zhao Zhengting(Department of Cardiology,West China Hospital,Sichuan University/West China College of Nursing,Sichuan University,Chengdu,Sichuan,610000,P.R.China;Third Ward,Department of Cardiology,Ruijin Hospital,Medical College of Shanghai Jiaotong University,Shanghai,200025,P.R.China)

机构地区：[1]四川大学华西医院心脏内科/四川大学华西护理学院,四川成都610000 [2]上海交通大学医学院附属瑞金医院心脏内科三病区,上海200025

出　　处：《老年医学与保健》2023年第3期506-510,共5页Geriatrics & Health Care

基　　金：国家自然科学基金(81600299)。

摘　　要：目的观察出院康复指导联合积极心理干预对老年冠心病心绞痛患者遵循医嘱及康复效果的影响,为其治疗提供方法。方法招募2019年7月—2022年7月四川大学华西医院收治的老年冠心病心绞痛患者140例,按数字表法随机分为观察组(70例)和对照组(70例)。2组均遵医嘱进行相同的治疗及随访管理,对照组给予出院康复指导,观察组在与对照组相同处理的基础上联合积极心理干预,2组干预均从出院前1 d至出院后3个月。观察并比较2组不良情绪[采取简版老年抑郁量表(GDS-15)和广泛性焦虑障碍量表(GAD-7)评估]、遵医嘱情况[采取Morisky用药依从性问卷(MMAS-8)和健康促进生活方式量表(HPLP-Ⅱ)评估]、康复效果[采取西雅图心绞痛量表(SAQ)评估]。结果观察组出院后干预3个月时GDS-15、GAD-7得分均低于对照组,差异均有统计学意义(P<0.05);观察组出院后干预3个月时MMAS-8、HPLP-Ⅱ得分、SAQ各维度得分均高于对照组,差异均有统计学意义(P<0.05)。结论出院康复指导联合积极心理干预可缓解老年冠心病心绞痛患者的负性情绪,提高其用药依从性,改善其健康行为,提高其康复效果。Objective To observe the effects of discharge rehabilitation guidance combined with positive psychological intervention on the compliance with medical orders and rehabilitation effect in elderly patients with angina pectoris of coronary heart disease,and provide a treatment method for this disease.Methods 140 elderly patients with angina pectoris of coronary heart disease admitted to West China Hospital,Sichuan University from July 2019 to July 2022 were recruited and divided into observation group(70 cases)and control group(70 cases)according to the random number table method.Both groups received the same treatment and follow-up management according to the doctor s advice.The control group was given discharge rehabilitation guidance,and the observation group was given positive psychological intervention on the basis of the same treatment as the control group.The intervention in both groups lasted from 1 day before discharge to 3 months after discharge.The negative emotions[Simplified 15-item Geriatric Depression Scale(GDS-15),Generalized Anxiety Disorder Scale-7(GDS-7)],compliance with medical orders[Morisky Medication Adherence Scale-8(MMAS-8),Health Promotion Lifestyle Profile-Ⅱ(HPLP-Ⅱ)]and rehabilitation effect[Seattle Angina Questionnaire(SAQ)]were compared between the two groups.Results At 3 months of intervention after discharge,GDS-15 score and GDAD-7 score of the observation group were lower than those of the control group,while MMAS-8 score,HPLP-Ⅱscore and SAQ scores in all dimensions were higher than those of the control group,with statistical significance(all P<0.05).Conclusion The combination of discharge rehabilitation guidance and positive psychological intervention can relieve the negative emotions of elderly patients with angina pectoris of coronary heart disease,improve their medication compliance and health behavior,and enhance their rehabilitation effect.

关 键 词：老年 冠心病心绞痛 出院康复指导 积极心理干预 遵医嘱情况 康复效果 

分 类 号：R473.5[医药卫生—护理学]