Orem自理理论模式对慢性心力衰竭患者心理健康及认知功能的影响  

Effect of Orem's self-care theory model on mental health and cognitive function in patients with chronic heart failure

作　　者：张慧娜[1] 丁雪茹[1] 董霞[1] ZHANG Hui-na;DING Xue-ru;DONG Xia(ICU,Cardiovascular Disease Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)

机构地区：[1]新疆医科大学第一附属医院心血管病中心重症监护室,新疆乌鲁木齐830054

出　　处：《心血管康复医学杂志》2025年第1期46-50,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：新疆医科大学第一附属医院2022年度“青年科研起航”专项基金护理人才专项13。

摘　　要：目的:探讨奥瑞姆(Orem)自理理论对慢性心力衰竭(CHF)患者心理健康及认知功能的影响。方法:回顾性收集2019年2月至2022年8月在新疆医科大学第一附属医院进行治疗的97例CHF患者的临床资料,按照干预方式不同分为对照组(n=45,采取常规干预措施)及干预组(n=52,采用Orem自理理论模式干预),均进行6个月的干预。比较两组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、简易精神状态量表(MMSE)量表评分、左室射血分数(LVEF)、静息心率(HR)、健康状况调查简表(SF-36)、巴塞尔(Barthel)指数评分。采用Kaplan-Meier生存曲线比较两组患者不良预后的发生率。结果:干预6个月后,与对照组比较,干预组患者的HAMA[(12.50±4.89)分比(19.09±5.80)分]、HAMD评分[(12.31±4.28)分比(19.56±5.79)分]、HR[(87.33±7.42)次/min比(100.11±7.89)次/min]均显著降低,MMSE评分[(21.90±3.37)分比(18.27±3.50)分]、LVEF[(50.25±5.24)%比(42.11±4.51)%]、SF-36[(63.65±10.43)分比(51.71±6.83)分]、Barthel指数[(60.67±8.43)分比(45.00±9.56)分]显著提高(P均<0.001)。Kaplan-Meier曲线结果显示干预组不良预后发生率显著低于对照组(5.77%比24.44%,P=0.035)。结论:对CHF患者采用Orem理论干预能够显著改善负性情绪和认知能力,恢复患者心功能,提高生活质量及自理能力,降低预后不良风险。Objective:To investigate the effect of Orem's self-care theory on mental health and cognitive function in patients with chronic heart failure(CHF).Methods:We retrospectively collected clinical data of 97 CHF patients treated in the First Affiliated Hospital of Xinjiang Medical University between February 2019 and August 2022.According to intervention way,they were divided into control group(n=45,routine intervention)and intervention group(n=52,Orem's self-care theory model intervention).Both groups were intervened for 6 months.Scores of Hamilton Anxiety scale(HAMA),Hamilton Depression scale(HAMD),Mini-Mental State Examination(MMSE),left ventricular ejection fraction(LVEF),resting heart rate(HR),scores of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)and Barthel index were compared between two groups.Kaplan-Meier survival curve was used to compare incidence of unfavorable outcome between two groups.Results:After 6-month intervention,compared with patients in control group,those in intervention group had significant lower scores of HAMA[(12.50±4.89)points vs.(19.09±5.80)points],HAMD[(12.31±4.28)points vs.(19.56±5.79)points]and HR[(87.33±7.42)beats/min vs.(100.11±7.89)beats/min],and significant higher LVEF[(50.25±5.24)%vs.(42.11±4.51)%],scores of MMSE[(21.90±3.37)points vs.(18.27±3.50)points],SF-36[(63.65±10.43)points vs.(51.71±6.83)points]and Barthel index[(60.67±8.43)points vs.(45.00±9.56)points](P<0.001 all).Kaplan-Meier survival analysis indicated that incidence of unfavorable outcome in intervention group was significantly lower than that of control group(5.77%vs.24.44%,P=0.035).Conclusion:Orem's self-care theory intervention could significantly improve negative emotions and cognitive ability,restore patients'cardiac function,improve the quality of life and self-care capacity,and reduce risk of unfavorable outcome in CHF patients.

关 键 词：心力衰竭 护理 认知 

分 类 号：R541.61[医药卫生—心血管疾病]