终末期心力衰竭患者预立医疗照护计划干预方案的构建及应用研究  

Construction of advance care planning intervention program and its application in patients with end-stage heart failure

作　　者：徐榆林 郝献芳[1] 陈倩[2] 李豪 白井双 芦雨 王晓东[5] XU Yulin;HAO Xianfang;CHEN Qian;LI Hao;BAI Jingshuang;LU Yu;WANG Xiaodong

机构地区：[1]郑州大学第一附属医院河医院区心血管内科二病区,郑州市450000 [2]郑州大学第一附属医院河医院区心血管内科医学部,郑州市450000 [3]郑州大学第一附属医院河医院区心血管内科八病区,郑州市450000 [4]郑州大学第一附属医院河医院区骨科三病区(2),郑州市450000 [5]郑州大学第一附属医院河医院区呼吸内科,郑州市450000 [6]河南省人民医院/郑州大学人民医院重症医学科

出　　处：《中华护理教育》2024年第10期1247-1254,共8页Chinese Journal of Nursing Education

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102090);郑州大学第一附属医院护理科研专项青年项目(HLKY2023020)。

摘　　要：目的构建预立医疗照护计划干预方案,并探讨其在终末期心力衰竭患者中的应用效果。方法引入心力衰竭特定问题提示列表手册,结合其制订预立医疗照护计划干预方案。2022年1月—2023年6月,选取某三级甲等医院收治的80例终末期心力衰竭患者为研究对象,按入住病区将其分为试验组(n=40)和对照组(n=40)。对照组接受常规护理,试验组在对照组基础上接受基于预立医疗照护计划干预方案的干预。比较两组干预前后死亡焦虑、生命意义感和优逝期望量表得分。结果共74例患者完成本研究(试验组35例、对照组39例)。干预前,两组死亡焦虑、生命意义感和优逝期望量表得分比较,差异无统计学意义(P>0.05);干预后,试验组死亡焦虑量表得分低于对照组,患者生命意义感、优逝期望量表得分高于对照组(均P<0.05)。结论预立医疗照护计划干预方案的运用有助于降低终末期心力衰竭患者死亡焦虑水平,增强其生命意义感,提高其优逝期望值。Objective To construct an advance care planning(ACP)intervention program and explore its effectiveness in patients with end-stage heart failure(ESHF).Methods Based on the heart-failure-specific question prompt list,the ACP intervention program was developed.From January 2022 to June 2023,80 patients with ESHF admitted to a tertiary hospital were recruited and divided into an experimental group(n=40)and a control group(n=40)based on their ward assignments.The control group received routine care,while the experimental group received the ACP intervention program in addition to routine care.Before and after the intervention,scores on the Templer’s Death Anxiety Scale(T-DAS),Meaning in Life Questionnaire(MLQ),Good Death Inventory(GDI)were compared between the two groups.Results A total of 74 patients completed the study(35 from the experimental group and 39 from the control group).Before the intervention,there were no statistically significant differences in the scores of the T-DAS,MLQ,and GDI between the two groups(P>0.05).After the intervention,the experimental group had lower T-DAS scores and higher MLQ and GDI scores compared to those in the control group(all P<0.05).Conclusion The application of the ACP intervention program can help reduce death anxiety,enhance feelings of meaning in life,and improve expectations for a good death among patients with ESHF.

关 键 词：心力衰竭 预立医疗照护计划 问题提示列表 终末期 

分 类 号：R473.5[医药卫生—护理学]