预见性风险干预联合LEARNS模式下的健康教育在老年慢性心力衰竭患者中的应用效果  

Application effect of anticipatory risk intervention combined with health education under LEARNS mode in elderly patients with chronic heart failure

作　　者：王艳川 许艳 舒媛媛[1] 曾莹[1] 杨长林 刘继东[3] WANG Yan-chuan;XU Yan;SHU Yuan-yuan;ZENG Ying;YANG Chang-lin;LIU Ji-dong(Department of General Practice,Panzhihua Central Hospital,Panzhihua,Sichuan,617000,China)

机构地区：[1]攀枝花市中心医院全科医学科,四川攀枝花617000 [2]攀枝花市中心医院老年科,四川攀枝花617000 [3]攀枝花市中心医院呼吸与危重症医学科,四川攀枝花617000

出　　处：《心血管康复医学杂志》2025年第1期36-41,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨预见性风险干预联合LEARNS模式下的健康教育在老年慢性心力衰竭(CHF)患者中的应用效果。方法:选择2022年1月-2023年2月攀枝花市中心医院收治的老年CHF患者126例,根据随机数字表法,将患者分为对照组和干预组,各63例。两组患者均采用常规护理,对照组患者在此基础上联合LEARNS模式下的健康教育,干预组患者在对照组基础上联合预见性风险干预,两组均干预2个月。对比两组患者的生理指标、不良情绪、生活质量、睡眠质量、疾病感知控制和自我效能,以及不良事件发生情况。结果:与对照组比较,干预后干预组收缩压(SBP)[(119.84±8.60)mmHg比(129.49±9.24)mmHg]、舒张压(DBP)[(81.59±5.08)mmHg比(88.51±6.36)mmHg]、N末端B型利钠肽原(NT-proBNP)[(2604.46±204.80)ng/L比(3024.87±212.27)ng/L]、焦虑自评量表(SAS)[(55.90±2.43)分比(60.11±2.62)分]、抑郁自评量表(SDS)[(57.03±2.56)分比(61.54±2.66)分]、明尼苏达心力衰竭患者生活质量问卷(MLHFQ)[(52.05±6.32)分比(60.46±7.10)分]和匹兹堡睡眠质量指数(PSQI)[(9.00±1.65)分比(11.05±1.96)分]均显著下降,而左心室射血分数(LVEF)[(51.83±7.28)%比(47.57±5.98)%]、修订版控制态度量表(CAS-R)[(35.59±2.97)分比(30.60±3.52)分]和一般自我效能感量表(GSES)[(36.98±4.21)分比(30.52±4.14)分]评分均显著升高(P均<0.001)。干预组患者不良事件发生率显著低于对照组(3.17%比12.70%,P=0.048)。结论:预见性风险干预联合LEARNS模式下的健康教育能够有效改善老年CHF患者的生理指标,提高生活和睡眠质量,增强疾病的感知和自我效能,减少不良情绪,降低不良事件发生率。Objective:This study aims to explore the application effect of anticipatory risk intervention combined with health education under LEARNS mode in elderly patients with chronic heart failure(CHF).Methods:This randomized controlled enrolled 126 elderly CHF patients admitted in Panzhihua Central Hospital between January 2022 and February 2023.They were divided into control group(n=63)and intervention group(n=63).All patients received routine nursing care,patients in control group received additional health education under LEARNS mode,compared to those in intervention group receiving additional anticipatory risk intervention based on control group,both groups were intervened for 2 months.Physiological indexes,negative emotion,quality of life,sleep quality,disease perception&control and self-efficacy,as well as incidence of adverse events,were compared between two groups.Results:Compared with patients in control group after intervention,those in intervention group had significant lower systolic blood pressure(SBP)[(119.84±8.60)mmHg vs.(129.49±9.24)mmHg],diastolic blood pressure(DBP)[(81.59±5.08)mmHg vs.(88.51±6.36)mmHg],N terminal pro brain natriuretic peptide(NT-proBNP)[(2604.46±204.80)ng/L vs.(3024.87±212.27)ng/L],scores of Self-Rating Anxiety Scale(SAS)[(55.90±2.43)points vs.(60.11±2.62)points],Self-Rating Depression Scale(SDS)[(57.03±2.56)points vs.(61.54±2.66)points],Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(52.05±6.32)points vs.(60.46±7.10)points]and Pittsburgh Sleep Quality Index(PSQI)[(9.00±1.65)points vs.(11.05±1.96)points],and significant higher left ventricular ejection fraction(LVEF)[(51.83±7.28)%vs.(47.57±5.98)%],scores of Control Attitude Scale-Revised(CAS-R)[(35.59±2.97)points vs.(30.60±3.52)points]and General Self-Efficacy Scale(GSES)[(36.98±4.21)points vs.(30.52±4.14)points](P<0.001 all).Incidence of adverse events in intervention group was significantly lower than that of control group(3.17%vs.12.70%,P=0.048).Conclusion:Anticipatory risk intervention combined with

关 键 词：心力衰竭 护理 LEARNS模式 

分 类 号：R541.61[医药卫生—心血管疾病]