家属参与式个案管理在老年慢性心力衰竭容量管理中的作用  

Role of family-participated case management in capacity management of elderly chronic heart failure

作　　者：钱晶 吕颖[1] 韩芳 时华[2] 戴琴[2] 高月琴[2] 唐冬霞[2] QIAN Jing;L Ying;HAN Fang;SHI Hua;DAI Qin;GAO Yue-qin;TANG Dong-xia(Jiangsu Vocational College of Medicine,Yancheng,Jiangsu,224005,China)

机构地区：[1]江苏医药职业学院,江苏盐城224005 [2]泰州市第二人民医院

出　　处：《心血管康复医学杂志》2024年第2期222-226,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2022年度江苏医药职业学院临床教学基地科研发展专项课题立项项目(20229102);泰州市姜堰区2022年科技专项扶持项目(社会事业)(2022304)。

摘　　要：目的:探究家属参与式个案管理在老年慢性心力衰竭(CHF)容量管理中的作用。方法:收集泰州市第二人民医院心内科在2022年5月至11月收治的符合纳排标准的104例老年CHF患者为研究对象。采用整群同期抽样法分为对照组(n=52,常规护理)和观察组(n=52,常规护理的基础上采用家属参与式个案管理模式进行干预护理),两组均干预3个月。比较两组患者干预前后左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)、左室射血分数(LVEF)、心力衰竭自我护理指数(SCHFI),明尼苏达心力衰竭患者生活质量问卷(MLHFQ)评分。结果:与对照组比较,观察组干预后LVEF[(50.67±2.41)%比(54.62±2.42)%]、SCHFI的自我护理维持[(45.75±13.10)分比(59.82±13.86)分]、自我护理管理[(46.72±17.92)分比(63.18±15.04)分]、自我护理信心[(52.61±12.59)分比(63.07±17.21)分]评分显著升高,MLHFQ的身体领域[(23.54±4.56)分比(20.35±3.01)分]和情绪领域[(21.87±4.05)分比(19.72±3.23)分]评分、LVEDd[(52.73±2.38)mm比(50.42±2.43)mm]、LVESd[(36.48±1.67)mm比(34.06±1.49)mm]显著降低,P均<0.01。结论:家属参与式个案管理可以显著提高老年慢性心力衰竭患者心功能、自我护理能力、生活质量,在临床治疗和护理中具有良好的应用前景。Objective:To explore the role of family-participated case management in the capacity management of elderly chronic heart failure(CHF).Methods:A total of 104 eligible aged CHF patients who were admitted to the Department of Cardiology in Taizhou Second People's Hospital from May to November 2022 were collected.According to cluster simultaneous sampling method,they were divided into control group(n=52,routine nursing)and observation group(n=52,received family-participated case management mode based on routine nursing),both groups were intervened for three months.Left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF),scores of self-care of heart failure index(SCHFI)and Minnesota living with heart failure questionnaire(MLHFQ)were compared between two groups before and after intervention.Results:Compared with control group after intervention,there were significant rise in LVEF[(50.67±2.41)%vs.(54.62±2.42)%],self-care maintenance[(45.75±13.10)points vs.(59.82±13.86)points],self-care management[(46.72±17.92)points vs.(63.18±15.04)points],self-care confidence[(52.61±12.59)points vs.(63.07±17.21)points]scores of SCHFI,and significant reductions in physical domain[(23.54±4.56)points vs.(20.35±3.01)points],emotional domain[(21.87±4.05)points vs.(19.72±3.23)points]scores of MLHFQ,LVEDd[(52.73±2.38)mm vs.(50.42±2.43)mm]and LVESd[(36.48±1.67)mm vs.(34.06±1.49)mm]in observation group,P<0.01 all.Conclusion:Family-participated case management can significantly improve cardiac function,self-care ability and quality of life in elderly patients with chronic heart failure,and has good application prospects in clinical treatment and nursing.

关 键 词：心力衰竭 护理 心室功能 左 生活质量 

分 类 号：R541.6[医药卫生—心血管疾病]