基于FOCUS-PDCA程序的集束化干预对慢性心力衰竭伴水肿患者心功能、睡眠质量及自我效能水平的影响  

Effects of clustering interventions based on FOCUS-PDCA procedures on cardiac function, sleep quality, and self-efficacy in patients with chronic heart failure and edema

作　　者：韩凌颖 刘倩 李娜娜 HAN Ling-ying;Liu Qian;LI Nana(Zhengzhou Seventh People’s Hospital(Zhengzhou Cardiovascular Disease Hospital,Henan Cardiovascular Disease Hospital Affiliated to Southern Medical University),Zhengzhou 450016,Henan,China)

机构地区：[1]郑州市第七人民医院(郑州市心血管病医院,南方医科大学附属河南心血管病医院),河南郑州450016

出　　处：《中国校医》2023年第6期460-462,475,共4页Chinese Journal of School Doctor

摘　　要：目的 研究基于发现-组织-澄清-理解-选择-计划-实施-检查-处理(FOCUS-PDCA)程序护理管理的集束化干预对慢性心力衰竭伴水肿患者自我效能、睡眠质量及心功能的影响。方法 选取本院2021年1月—2022年6月期间105例慢性心力衰竭伴水肿患者随机分组,对照组52例给予常规干预,观察组53例联合基于FOCUS-PDCA程序的集束化干预,对比2组患者心功能指标、睡眠质量和自我效能。结果 观察组干预后,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)水平分别为(56.55±1.08)mm、(46.86±1.24)mm,均低于对照组的(58.47±1.17)mm、(48.42±1.13)mm,左心室射血分数(LVEF)为(53.42±2.58)%高于对照组的(50.35±2.86)%(F=8.740、6.734、5.778,P均<0.01);观察组干预后,匹兹堡睡眠质量指数(PSQI)中入睡时间、睡眠质量、睡眠效率、睡眠时间评分分别为(1.25±0.56)分、(1.50±0.52)分、(1.61±0.53)分、(1.41±0.53)分,均低于对照组的(1.65±0.51)分、(1.89±0.54)分、(1.83±0.55)分、(1.81±0.57)分(F=3.825、3.770、2.087、3.725,P均<0.05);观察组干预后,自我效能感评分(GSES)及生活自理能力评分(ADL)分别为(31.42±2.79)分、(69.56±4.66)分,均高于对照组的(28.59±2.68)分、(63.88±4.89)分(F=5.299、6.094,P均<0.01)。结论 基于FOCUS-PDCA程序的集束化干预能够有效提高慢性心力衰竭伴水肿患者睡眠质量,增强自我效能,避免心功能持续降低。Objective To study the effects of cluster intervention based on discovery-organization-clarification-understanding-select-plan-implement-check-process-process nursing management(FOCUS-PDCA)on self-efficacy,sleep quality,and cardiac function in patients with chronic heart failure and edema.Methods A total of 105 patients with chronic heart failure and edema in the hospital from January 2021 to June 2022 were randomly divided into a control group(n=52)and an observation group(n=53),.The control group received the conventional intervention,and the observation group received the conventional intervention combined with cluster intervention based on the FOCUS-PDCA program.Cardiac function indicators,sleep quality,and self-efficacy were observed and compared between the two groups.Results After the intervention,the left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)of the observation group were(56.55±1.08)mm and(46.86±1.24)mm,respectively,which were lower than those of the control group:(58.47±1.17)mm and(48.42±1.13)mm,respectively.The left ventricular ejection fraction(LVEF)was(53.42±2.58)%,higher than that of the control group:(50.35±2.86)%(F=8.740,6.734,5.778,all P<0.01).After the intervention,in the observation group,the Pittsburgh Sleep Quality Index(PSQI)scores of sleep time,sleep quality,sleep efficiency,and sleep time were(1.25±0.56)points,(1.50±0.52)points,(1.61±0.53)points and(1.41±0.53)points,respectively,which were lower than those in the control group:(1.65±0.51)points,(1.89±0.54)points,(1.83±0.55)points,and(1.81±0.57)points(F=3.825,3.770,2.087,3.725,all P<0.05),respectively.After the intervention,the scores of self-efficacy(GSES)and self-care ability(ADL)in the observation group were(31.42±2.79)points and(69.56±4.66)points,respectively,which were higher than those in the control group:(28.59±2.68)points and(63.88±4.89)points(F=5.299,6.094;both P<0.01).Conclusions Clustering intervention based on the FOCUS-PDCA program can effectively improve sle

关 键 词：睡眠质量 慢性心力衰竭 集束化干预 心功能 FOCUS-PDCA程序 

分 类 号：R541.61[医药卫生—心血管疾病]