心理复原模型框架下的动机性访谈对冠心病老年患者健康管理的影响  

Impact of motivational interviewing under the framework of psychological resilience model on the health management of elderly patients with coronary heart disease

作　　者：郭燕[1] 蔡丹霞[1] 赵毅[1] 陈士芳[1] 车慧文 GUO Yan;CAI Dan-xia;ZHAO Yi;CHEN Shi-fang;CHE Hui-wen(Department of Cardiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA;Department of Psychology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA)

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471003 [2]河南科技大学第一附属医院心理科,河南洛阳471003

出　　处：《海南医学》2024年第12期1814-1819,共6页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20230463)。

摘　　要：目的探讨心理复原模型框架下的动机性访谈对冠心病老年患者健康管理的影响。方法选取2023年1~4月于河南科技大学第一附属医院就诊的164例老年冠心病患者纳入研究,按随机数表法分为研究组和常规组各82例。常规组患者采用常规护理,研究组患者在常规组护理的基础上联合心理复原模型框架下的动机性访谈,两组均干预3个月。干预前后比较两组患者的心功能[左心室收缩末期内径(LVESD)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、6 min步行试验结果、生活质量[西雅图心绞痛调查问卷(SAQ)]、自我管理行为[冠心病自我管理行为量表(CSMS)]、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)],同时比较两组患者的不良事件发生率和干预后3个月的复发率。结果干预后,研究组患者的LVESD、LVEDD分别为(46.25±3.25)mm、(45.39±1.17)mm,明显低于常规组的(50.14±4.19)mm、(49.87±1.39)mm,LVEF和6 min步行试验结果分别为(44.25±2.59)%、(362.27±12.35)m,明显高(长)于常规组的(39.98±2.21)%、(258.54±7.86)m,差异均有统计学意义(P<0.05);干预后,研究组患者的CSMS、SAQ评分分别为(68.50±1.20)分、(242.21±7.85)分,明显高于常规组的(54.68±2.38)分、(222.05±6.52)分,SAS、SDS评分分别为(38.52±2.14)分、(35.97±1.14)分,明显低于常规组的(44.14±3.58)分、(40.49±2.59)分,差异均有统计学意义(P<0.05);研究组患者的不良事件总发生率为3.66%,明显低于常规组的12.20%,差异有统计学意义(P<0.05);干预后3个月,研究组患者的复发率为5.00%,明显低于常规组的15.19%,差异有统计学意义(P<0.05)。结论心理复原模型框架下的动机性访谈应用于老年冠心病健康管理中可缓解患者负性情绪,改善患者自我管理行为,提升患者心功能及生活质量,降低不良事件发生风险,预防疾病复发。Objective To explore the impact of motivational interviewing under the framework of psychological resilience model on the health management of elderly patients with coronary heart disease.Methods A total of 164 elderly patients with coronary heart disease who were treated at the First Affiliated Hospital of Henan University of Science and Technology from January 2023 to April 2023 were selected and randomly divided into a study group and a conventional group,each with 82 cases.The patients in the conventional group received conventional care,while the patients in the study group received motivational interviewing under the framework of psychological resilience model in addition to conventional care,both for 3 months.Before and after intervention,the cardiac function[left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],6-minute walk test results,quality of life[Seattle Angina Questionnaire(SAQ)],self-management behavior[Coronary Artery Disease Self-management Scale(CSMS)],psychological status[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)]of the two groups were compared.The incidence of adverse events and the recurrence rate at 3 months after intervention were also compared between the two groups.Results After intervention,the LVESD and LVEDD in the study group were(46.25±3.25)mm and(45.39±1.17)mm,respectively,which were significantly lower than(50.14±4.19)mm and(49.87±1.39)mm in the conventional group,and the LVEF and 6-minute walk test results were(44.25±2.59)%and(362.27±12.35)m,respectively,which were significantly higher than(39.98±2.21)%and(258.54±7.86)m in the conventional group,with statistically significant differences(P<0.05).After intervention,the CSMS and SAQ scores in the study group were(68.50±1.20)points and(242.21±7.85)points,respectively,which were significantly higher than(54.68±2.38)points and(222.05±6.52)points in the conventional group;the SAS and SDS scores were(38.52±2.14)points an

关 键 词：心理复原模型 动机性访谈 冠心病 健康管理 心功能 

分 类 号：R473.5[医药卫生—护理学]