基于认知-信念-行为的导向性干预在急性心肌梗死伴瓣膜反流患者中的应用价值  

Application value of oriented intervention based on cognitive,belief,and behavioral in patients with acute myocardial infarction and valve regurgitation

作　　者：王秀丽 陈光付 程慧超 WANG Xiuli;CHEN Guangfu;CHENG Huichao(Cardiac Intensive Care Unit,Puyang Anyang District Hospital,Anyang455000,China)

机构地区：[1]濮阳市安阳地区医院心脏重症监护室,河南安阳455000

出　　处：《社区医学杂志》2023年第15期790-795,共6页Journal Of Community Medicine

摘　　要：目的探讨基于认知-信念-行为的导向性干预对急性心肌梗死(AMI)伴瓣膜反流患者康复进程、心理应激、健康行为的影响,为制定AMI伴瓣膜反流患者的护理干预方案提供依据。方法回顾性选取2020-03-01-2022-07-31濮阳市安阳地区医院就诊的AMI伴瓣膜反流患者114例,均行经皮冠状动脉介入(PCI)术,采用随机数字表法分为导向性干预组(n=57)和常规干预组(n=57)。常规干预组给予常规护理干预,导向性干预组在常规干预组基础上进行基于认知-信念-行为的导向性干预。比较2组康复进程指标、乐观倾向〔生活定向测验修订版(LOT-R)〕、心理应激〔焦虑自评量表(SAS)、抑郁自评量表(SDS)〕、健康行为、并发症。结果导向性干预组首次排气、首次进食、首次下床活动和住院时间分别为(12.36±1.14)h、(15.29±1.05)h、(1.27±0.45)d、(6.21±0.47)d,短于常规干预组的(16.98±2.37)h、(20.46±1.34)h、(1.94±0.73)d、(8.63±0.62)d,差异有统计学意义,t值分别为13.263、22.928、5.899和23.484,均P<0.05;干预后,导向性干预组LOT-R评分为(21.67±1.09)分,高于常规干预组的(17.75±1.85)分,SAS和SDS评分分别为(47.61±2.34)分、(45.21±1.63)分,低于常规干预组的(53.65±3.42)分、(50.93±2.25)分,差异有统计学意义,F值分别为93.395、61.761和119.439,均P<0.05;导向性干预组健康行为优良率(94.74%)高于常规干预组(82.46%),并发症总发生率(5.26%)明显低于常规干预组(17.54%),差异有统计学意义,均P<0.05。结论基于认知-信念-行为的导向性干预可加快AMI伴瓣膜反流患者的康复进程,提升乐观倾向,减轻心理应激,改善健康行为,降低并发症发生风险,促进病情恢复。Objective To explore the effects of cognitive-belief-behavior oriented interventions on the rehabilitation process,psychological stress,and health behavior in patients with acute myocardial infarction(AMI)and valve regurgitation,in order to provide a basis for formulating nursing intervention plans for AMI patients with valve regurgitation.Methods One hundred and fourteen patients with AMI and valve regurgitation in Puyang Anyang District Hospital from March 1,2020 to July 31,2022were collected retrospectively and underwent percutaneous coronary intervention(PCI).All patients were divided into guided-intervention group(n=57)and routine intervention group(n=57)according to the random number table method.The routine intervention group received routine nursing intervention,while the guided intervention group received guided intervention based on cognition-belief-behavior on the basis of the routine intervention group.Rehabilitation progress indicators,optimistic tendencies[Revised Life Orientation Test(LOT-R)],psychological stress[Self-Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS)],health behaviors,and complications were compared between the two groups.Results The first time of exhaust,eating,getting out of bed activity,and hospitalization time in the guided intervention group were(12.36±1.14)hours,(15.29±1.05)hours,(1.27±0.45)days,and(6.21±0.47)days,respectively,which were shorter than those in the routine intervention group(16.98±2.37)hours,(20.46±1.34)hours,(1.94±0.73)days,and(8.63±0.62)days,with statistically significant difference(t=13.263,22.928,5.899,and 23.484,all P<0.05);after intervention,the LOT-R score in the guided intervention group was(21.67±1.09)points,which was higher than that in the routine intervention group(17.75±1.85)points,while the SAS and SDS scores were(47.61±2.34)points and(45.21±1.63)points,respectively,which were lower than those in the routine intervention group(53.65±3.42)points and(50.93±2.25)points,with statistically significant difference(F=93.395,61.761,

关 键 词：导向性干预 急性心肌梗死 瓣膜反流 乐观倾向 心理应激 

分 类 号：R542.22[医药卫生—心血管疾病]