以健康行为改变整合理论为基础的健康教育联合多种肺部康复训练对心脏瓣膜置换术后患者的效果  

Effect of integrated theory of health behavior change-based health education combined with pulmonary rehabilitation training on patients after heart valve replacement

作　　者：马晓红 冯亚[2] 何微丽 张蕾[4] Ma Xiaohong;Feng Ya;He Weili;Zhang Lei(Skill Training Center,Luoyang Central Hospital,Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳市中心医院技能培训中心,洛阳471000 [2]郑州大学附属洛阳市中心医院心外手术室,洛阳471000 [3]郑州大学附属洛阳市中心医院心外监护室,洛阳471000 [4]郑州大学附属洛阳市中心医院先心病瓣膜外科,洛阳471000

出　　处：《国际移植与血液净化杂志》2023年第6期13-16,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的:探讨以健康行为改变整合理论(the integrated theory of health behavior change,ITHBC)为基础的健康教育联合多种肺部康复训练在心脏瓣膜置换术后患者中的应用效果。方法:选取2020年3月至2023年4月在郑州大学附属洛阳中心医院先天性心脏病瓣膜外科接受心脏瓣膜置换术治疗的99例患者,根据数字表法将其随机分为对照组和观察组,对照组49例患者给予常规健康教育和常规肺康复训练,观察组50患者给予以ITHBC为基础的健康教育联合多种肺部康复训练。比较两组患者的肺功能、围手术期指标、抗凝治疗效果和自我效能。结果:干预3个月后,两组患者的最大通气量、第1秒用力呼气容积和呼气流量峰值占预计值百分比水平均升高,且观察组均显著高于对照组(P<0.05),观察组患者的术后进食时间、下床活动时间和总住院时间均显著短于对照组(P<0.05)。干预3个月后,两组患者的一般自我效能感量表(general self-efficacy scale,GSS)评分和治疗范围内的时间百分比(time in therapeu-tic range,TTR)水平均升高,且观察组显著高于对照组(P<0.05)。结论:以ITHBC为基础的健康教育联合多种肺部康复训练可促进心脏瓣膜置换术后患者的肺功能改善,缩短术后进食时间、下床活动时间和住院时间,有利于自我效能和抗凝效果的提升。Objective To investigate the effect of health education combined with pulmonary rehabilitation training based on the integrated theory of health behavior change(ITHBC)in patients after heart valve replacement.Methods Ninety-nine patients who received heart valve replacement treatment in Skill Training Center,Luoyang Central Hospital,Zhengzhou University from March 2020 to April 2023 were selected and divided into the control group and the observation group according to random number table method.The Patients in the control group(n=49)were given routine health education and routine pulmonary rehabilitation training,and the patients in the observation group(n=50)were given ITHBC-based health education combined with various pulmonary rehabilitation training.The pulmonary function,perioperative indexes,anticoagulant efficacy and self-efficacy were compared between the two groups.Results After 3 months of intervention,the maximum volume of gas,forced expiratory volume in the first second and the percentage of peak expiratory flow to the predicted value were increased in both groups,and those in the observation group were significantly higher than those in the control group(P<0.05).The time to eat,time to get out of bed and total hospital stay in the observation group were lower than those in the control group(P<0.05).After 3 months of intervention,the general self-efficacy scale(GSS)score and the time in therapeutic range(TTR)level were increased in both groups,and those in the observation groups were significantly higher than those in the control group(P<0.05).Conclusion ITHBC-based health education combined with various pulmonary rehabilitation training can promote the improvement of lung function in patients after heart valve replacement,thus reducing the time to eat,get out of bed and stay in hospital,and improving self-efficacy and anticoagulation effect.

关 键 词：健康行为改变理论 肺康复 缩唇呼吸 呼吸功能训练 心脏瓣膜置换术 

分 类 号：R473.6[医药卫生—护理学]