循证的自我管理结合心理引导对冠心病合并高血压患者疾病认知、心功能及自护水平的影响  

Impact of evidence-based self-management combined with psychological guidance on disease awareness,cardiac function,and self-care levels in patients with coronary heart disease and hypertension

作　　者：王夏楠 唐荣欣 张丽婷[1] 任蕾元 韩萌 WANG Xia'nan;TANG Rongxin;ZHANG Liting;REN Leiyuan;HAN Meng(Cardiac Center,The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第一附属医院心脏中心,郑州450003

出　　处：《中国健康心理学杂志》2025年第5期742-747,共6页China Journal of Health Psychology

基　　金：河南省中医药科学研究专项课题(编号:2023ZY2013)。

摘　　要：目的:研究基于循证的自我管理结合心理引导对冠心病合并高血压患者的护理效果。方法:选取2022年3月-2024年1月某院收治的98例冠心病合并高血压患者,回顾性收集其临床资料,根据护理方法不同分为两组,对照组49例接受常规护理,观察组49例在对照组的基础上接受基于循证的自我管理结合心理引导,对两组疾病认知、心功能[心排血量(CO)、心脏指数(CI)、每搏输出量(SV)、每搏输出量指数(SI)、左室每搏做功指数(LVSWI)及左室做功(LCW)]、血压[收缩压(SBP)、舒张压(DBP)]、自护水平[采用冠心病自我管理行为量表(CSMS)]及护理效果进行评估。结果:干预后观察组疾病认知总评分明显高于对照组(t=12.667,P<0.05);干预后观察组CO、CI、SV、SI、LVSWI及LCW显著高于对照组,SBP及DBP水平低于对照组(t=3.750,3.577,2.939,3.469,2.678,3.079,3.640,4.035;P<0.05);干预后观察组CSMS评分显著高于对照组(t=2.746,6.681,6.652;P<0.05);观察组患者总有效率为95.92%,显著高于对照组81.63%(χ^(2)=5.018,P<0.05)。结论:循证的自我管理与心理引导相结合,在冠心病合并高血压患者的临床护理中效果显著,有效优化心功能指标,稳定了血压水平,并且显著提高患者对疾病的认知程度及自护水平。Objective:To investigate the nursing outcomes of evidence-based self-management combined with psychological guidance for patients with coronary heart disease and hypertension.Methods:We selected 98 patients with coronary heart disease and hypertension treated in our hospital from March 2022 to January 2024.Retrospectively collected their clinical data.According to different nursing methods,they were divided into two groups:The control group(49 cases)received routine care,while the observation group(49 cases)received evidence-based self-management combined with psychological guidance on top of what the control group receives.Evaluated both groups in terms of disease awareness,cardiac function[Cardiac Output(CO),Cardiac Index(CI),Stroke Volume(SV),Stroke Volume Index(SI),Left Ventricular Stroke Work Index(LVSWI),and Left Ventricular Work(LCW)],blood pressure[Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)],self-care level[using the Coronary Artery Disease Self-Management Scale(CSMS)],and nursing outcomes.Results:The total score for disease cognition in the observation group after the intervention was significantly higher than that in the control group(t=12.667,P<0.05).After the intervention,the observation group showed significantly higher levels of CO(Cardiac Output),CI(Cardiac Index),SV(Stroke Volume),SI(Stroke Index),LVSWI(Left Ventricular Stroke Work Index),and LCW(Left Cardiac Work)compared to the control group,while the SBP(Systolic Blood Pressure)and DBP(Diastolic Blood Pressure)levels were lower(t=3.750,3.577,2.939,3.469,2.678,3.079,3.640,4.035;P<0.05).The CSMS(Chronic Heart Failure Self-Management Scale)scores in the observation group were significantly higher than those in the control group after the intervention(t=2.746,6.681,6.652;P<0.05).The total effective rate in the observation group was 95.92%,significantly higher than the 81.63%in the control group(χ^(2)=5.018,P<0.05).Conclusion:The combination of evidence-based self-management and psychological guidance has shown significant effects i

关 键 词：循证 自我管理 心理引导 冠心病 高血压 疾病认知 心功能 

分 类 号：R395.5[哲学宗教—心理学] R749.92[医药卫生—医学心理学]