PRECEDE护理模式对风心病患者术后生活质量、服药依从性及焦虑抑郁状况的影响  

Effect of predisposing,reinforcing,enabling constructs in educational diagnosis and evaluation nursing model on postoperative quality of life,medication compliance,and anxiety and depression in patients with rheumatic heart disease

作　　者：张红[1] 邬海燕 岳朝换 ZHANG Hong;WU Hai-yan;YUE Chao-huan(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Admission Office,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450000 [2]郑州大学第一附属医院入院接诊处,河南郑州450000

出　　处：《海南医学》2023年第23期3478-3481,共4页Hainan Medical Journal

基　　金：2021年河南省自然科学基金(编号:212300410257)。

摘　　要：目的探究倾向、强化及促成因素(PRECEDE)护理模式对风心病患者术后生活质量(QOL)、服药依从性及焦虑抑郁状况的影响。方法选择2019年5月至2022年6月郑州大学第一附属医院心内科收治的90例风湿性心脏病患者为研究对象,根据随机数表法分为观察组和对照组各45例。两组患者均行心脏瓣膜置换术,对照组患者接受常规的治疗性护理,观察组患者接受PRECEDE护理,比较两组患者心功能改善情况、护理前和护理1个月后的QOL评分、日常生活能力评分(ADL)、Morisky用药依从性问卷评分、Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果观察组患者的心功能改善率为93.33%,明显高于对照组的75.56%,差异有统计学意义(P<0.05);护理前,两组患者的QOL评分和ADL评分比较差异均无统计学意义(P>0.05),护理1个月后,两组患者的QOL评分和ADL评分明显高于治疗前,且观察组的QOL评分和ADL评分分别为(20.97±2.50)分、(81.53±4.12)分,明显高于对照组的(15.75±2.47)分、(71.53±4.31)分,差异均有统计学意义(P<0.05);护理前,两组患者的Morisky评分比较差异无统计学意义(P>0.05),护理1个月后,对照组患者的Morisky评分与治疗前比较差异无统计学意义(P>0.05),但观察组患者的Morisky评分明显高于护理前,且明显高于对照组,差异均有统计学意义(P<0.05);护理前,两组患者的SAS和SDS评分比较差异均无统计学意义(P>0.05),护理1个月后,两组患者的SAS和SDS评分明显低于治疗前,且观察组患者的SAS和SDS评分分别为(45.54±4.54)分、(46.32±5.04)分,明显低于对照组的(50.32±4.75)分、(52.25±4.89)分,差异均有统计学意义(P<0.05)。结论PRECEDE护理应用于心脏瓣膜置换术的风湿性心脏病患者,不仅可提高治疗效果和生活质量,而且还可以改善患者的服药依从性和焦虑抑郁心理。Objective To explore the effect of PRECEDE(predisposing,reinforcing,enabling constructs in educational diagnosis and evaluation)nursing model on postoperative quality of life(QOL),medication compliance,and anxiety and depression in patients with rheumatic heart disease.Methods Ninety patients with rheumatic heart disease admitted to the Department of Cardiology,the First Affiliated Hospital of Zhengzhou University from May 2019 to June 2022 were selected as the research objects.According to the random number table method,they were divided into an observation group and a control group,with 45 patients in each group.All patients underwent cardiac valve replacement.The patients in the control group were given conventional nursing,while the patients in the observation group adopted PRECEDE nursing model.The improvement of cardiac function,QOL score,activities of daily living(ADL)score,Morisky medication compliance scale score,Zung Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)score were compared between the two groups before and at one month after nursing.Results The improvement rate of cardiac function was 93.33%in the observation group,which was significantly higher than 75.56%in the control group(P<0.05).Before nursing,there was no significant difference in QOL score and ADL score between the two groups(P>0.05).After one month of nursing,the QOL and ADL scores showed an increase in two groups,and the QOL and ADL scores in the observation group were(20.97±2.50)points and(81.53±4.12)points,which were significantly higher than(15.75±2.47)points and(71.53±4.31)points in the control group(P<0.05).Before nursing,there was no significant difference in Morisky score between the two groups(P>0.05).After 1 month of nursing,Morisky score of the control group showed no significant difference with that before treatment(P>0.05);however,the Morisky score of the observation group was significantly higher than that before nursing,and also significantly higher than that of the control group(P<0.05).Before n

关 键 词：风湿性心脏病 倾向、强化及促成因素护理模式 生活质量 焦虑抑郁 服药依从性 

分 类 号：R473.5[医药卫生—护理学]