Application of cognitive behavioral intervention based on IMB model in patients with chronic heart failure
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摘要: 目的 探索有效改善慢性心力衰竭患者生活质量、心功能、负性情绪及提升自护能力的科学方法,为临床护理提供依据。 方法 将2019年1月—2020年3月入住濉溪县医院心内科72例符合纳入标准的慢性心力衰竭患者按随机数字表随机分为对照组和观察组各36例,对照组实施常规护理,观察组在常规护理基础上实施以IBM模型基础的认知行为干预,采用ZUNG焦虑自评量表(SAS)、抑郁自评量表(SDS)、明尼苏达量表(MLWHFQ)、自护能力测定量表(ESCA)、6分钟步行试验对2组患者的焦虑抑郁程度、生活质量、自护能力、心功能进行测评。 结果 干预前2组患者焦虑抑郁评分、生活质量评分、自护能力评分、6分钟步行距离比较,差异无统计学意义(均P>0.05)。干预后观察组焦虑、抑郁评分[(36.84±6.57)分、(38.00±4.66)分]明显低于对照组[(43.66±7.93)分、(47.10±6.39)分];干预后观察组生活质量评分[(47.66±7.87)分]明显低于对照组[(59.39±7.63)分],差异有统计学意义(均P<0.05);干预后观察组自护能力评分[(109.53±12.29)分]高于对照组[(99.41±12.51)分],干预后观察组6分钟步行距离[(287.47±51.68)m]高于对照组[(235.78±49.54)m],差异有统计学意义(均P<0.05)。 结论 基于IMB模型的认知行为干预能明显改善慢性心力衰竭患者的心功能和负性情绪,提升自护能力及生活质量,值得临床应用和家庭护理推广。Abstract: Objective To explore the scientific methods to effectively improve the quality of life, cardiac function, negative emotions and self-care ability of patients with chronic heart failure, so as to provide basis for clinical nursing. Methods A total of 72 patients with chronic heart failure admitted to the Department of Cardiology of Suixi County Hospital, from January 2019 to March 2020, were randomly divided into control group and observation group, 36 cases in each group. The control group received routine nursing. The observation group received cognitive behavioral intervention based on information-motivation-behavioral skills(IMB) model on the basis of routine nursing. ZUNG self-rating anxiety scale(SAS), self-rating depression scale(SDS), minnesota living with heart failure questionnaire(MLWHFQ), exercise of self-care agency scale(ESCA), and 6-minute walking test were used to measure the levels of anxiety and depression, quality of life, self-care ability and heart function. Results Before the intervention, there were no significant difference in anxiety and depression score, quality of life score, self-care ability score and 6-minute walking distance between the two groups(all P>0.05). The scores of anxiety and depression in the intervention group,(36.84±6.57) and(38.00±4.66), were significantly lower than those in the control group,(43.65±7.93) and(47.10±6.39). The scores of quality of life in the intervention group(47.66±7.87)were significantly lower than those in the control group(59.39±7.63), with statistically significant significance(P<0.05). After intervention, the self-care ability score(109.53±12.29)of the observation group was higher than that of the control group( 99.41±12.51), and the 6-minute walking distance[(287.47±51.68) m] of the observation group was higher than that of the control group[(235.78±49.54)m], the difference was statistically significant(all P<0.05). Conclusion Using cognitive behavioral intervention based on IMP model can significantly improve the heart function and negative emotions of patients with chronic heart failure, improve self-care ability and quality of life, which is worthy of clinical application and family nursing promotion.
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