结构化教育自我管理对心力衰竭患者自我管理、生活质量及预后的影响  

The impact of structured education self-management on self-management,quality of life,and prognosis of heart failure patients

作　　者：徐倩 张伟[2] 唐建忠[1] 郑兵[2] Xu Qian;Zhang Wei;Tang Jianzhong;Zheng Bing(Department of General Medicine,Affiliated Hospital of Nantong University Jiangsu,Nantong 226000,China;不详)

机构地区：[1]南通大学附属医院全科医学科,南通226000 [2]南通市第一人民医院泌尿外科,南通226000

出　　处：《中国循证心血管医学杂志》2023年第7期827-830,834,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：江苏省卫生健康委科研课题(BJ21010);南通市卫健委课题(QA2021004)。

摘　　要：目的探究结构化教育自我管理对心力衰竭(HF)患者自我管理、生活质量及预后的影响。方法选取2020年1月~2021年12月于南通大学附属医院全科医学科治疗的120例HF患者展开研究,将其随机分为对照组(n=60)和研究组(n=60)。对照组给予自我管理标准教育,研究组在对照组的基础上给予结构化教育;经彩色多普勒超声诊断仪检测两组患者的心功能指标;对比两组患者干预前和1月后自我护理管理行为(SCHFI)评分、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及生活质量评分;对比两组6个月后MACCE和再入院累积发生率。结果干预1月后,两组SCHFI评分均得到提升,相较于对照组,研究组显著更高(P<0.05);干预1月后,两组患者LVEDD和LVESD均下降,LVEF升高,且研究组LVEDD和LVESD显著更低,LVEF显著更高(P<0.05);干预1月后,两组生活质量各项评分均有明显提升,相较对照组,研究组显著更高(P<0.05);随访6个月后,研究组MACCE发生率为8.33%显著低于对照组(30.00%),研究组再入院率为10.00%,显著低于对照组(43.33%),(P<0.05)。结论HF患者应用结构化教育自我管理,可有效改善患者自我管理和心功能指标,提升生活质量,降低MACCE和再入院发生率,值得在临床推广应用。Objective To investigate the impact of structured educational self-management on self-management,quality of life,and prognosis of patients with heart failure(HF).Methods A total of 120 HF patients treated in the Department of General Medicine at Nantong University Affiliated Hospital from January 2020 to December 2021 were randomly assigned to a control group(n=60)and a study group(n=60).The control group received standard self-management education,while the study group received structured education.Cardiac function indicators were measured using color Doppler ultrasonography.SCHFI score,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),quality of life score,and the cumulative incidence of major adverse cardiac and cerebrovascular events(MACCE)and readmission were compared between the two groups before and after 1 month of intervention,as well as after 6 months of follow-up.Results After 1 month of intervention,SCHFI scores in both groups improved,with the study group showing a significantly greater improvement than the control group(P<0.05).After 1 month of intervention,LVEDD and LVESD decreased in both groups,while LVEF increased.The study group had significantly lower LVEDD and LVESD and significantly higher LVEF than the control group(P<0.05).After 1 month of intervention,quality of life scores in both groups significantly improved,with the study group showing a significantly greater improvement than the control group(P<0.05).After 6 months of follow-up,the incidence of MACCE in the study group was 8.33%,significantly lower than that in the control group(30.00%),and the readmission rate in the study group was 10.00%,significantly lower than that in the control group(43.33%),(P<0.05).Conclusions The application of structured educational self-management can effectively improve self-management and cardiac function indicators,enhance the quality of life,and reduce the incidence of MACCE and readmission in HF patients,and is worthy

关 键 词：心力衰竭 结构化教育 心功能 MACCE 预后 

分 类 号：R541.61[医药卫生—心血管疾病]