协同康复护理干预对慢性心力衰竭患者自护能力和生活质量的影响

祖东亮; 张双; 王楠

doi:10.16766/j.cnki.issn.1674-4152.002304

协同康复护理干预对慢性心力衰竭患者自护能力和生活质量的影响

doi: 10.16766/j.cnki.issn.1674-4152.002304

秦皇岛市第一医院心血管内科，河北秦皇岛 066000

基金项目:

河北省卫生健康委科研基金项目 20201315

详细信息

通讯作者:
张双, E-mail: huohuotai@163.com

中图分类号: R192 R541.6
计量
- 文章访问数: 172
- HTML全文浏览量: 69
- PDF下载量: 15
- 被引次数: 0
出版历程
- 收稿日期: 2021-05-08
- 网络出版日期: 2022-03-03

Effect of collaborative rehabilitation nursing intervention on self-care ability and quality of life of patients with chronic heart failure

Department of Cardiology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei 066000, China

摘要

摘要: 目的协同康复护理干预模式用于慢性心力衰竭(简称“心衰”)患者后对其自我护理能力和生活质量的影响分析。方法将秦皇岛市第一医院2018年11月—2020年7月期间收治的120例慢性心衰患者纳入研究，按随机数字表法分为观察组和对照组，每组60例。对照组患者实施心内科常规护理措施，观察组患者在对照组基础上行协同康复护理干预模式，干预周期12周，应用自我护理指数量表(SCHFI)及明尼苏达心衰患者生活质量量表(MLHFQ)对2组患者干预前后自护能力和生活质量进行评定，随访半年，对再入院率进行比较。结果干预结束后，干预组患者自我护理能力各维度得分显著高于对照组(t_维持=9.363，P < 0.001；t_管理=11.896，P < 0.001；t_信心=7.453，P < 0.001；)，生活质量总分及各维度得分显著低于对照组(t_总分=-4.152，P < 0.001；t_躯体=-4.025，P < 0.001；t_情绪=-2.929，P=0.004；t_其他=-2.680，P=0.009)，差异有统计学意义(均P < 0.05)；随访半年，观察组患者再入院率为8.33%(5/60)，对照组为31.67%(19/60)，观察组显著低于对照组，差异有统计学意义(χ²=10.208，P=0.001)。结论协同康复护理干预模式应用于慢性心衰患者，可有效改善患者自我护理能力和生活质量，降低再入院率，具有较好的临床推广应用前景。
- 协同康复护理 /
- 慢性心衰 /
- 自护能力 /
- 生活质量
Abstract: Objective To analyse the influence of collaborative rehabilitation nursing intervention model on the self-care ability and quality of life of patients with chronic heart failure. Methods A total of 120 patients with chronic heart failure admitted to the Qinhuangdao First Hospital from November 2018 to July 2020 were included in the study. The patients were divided into the observation group and control group using the random number table method, with 60 cases in each group. The patients in the control group received routine cardiology nursing measures, and the patients in the observation group performed a collaborative rehabilitation nursing intervention model based on the control group. The intervention period was 12 weeks. The self-care index scale and the Minnesota heart failure patient quality of life scale were applied. The self-care ability and quality of life of the two groups of patients before and after intervention were assessed and followed up for half a year, and the readmission rate was compared. Results After the intervention, all dimensions of the self-care ability of the intervention group were significantly higher than those of the control group (t_maintenance=9.363, P < 0.001; t_management=11.896, P < 0.001; t_maintenance=7.453, P < 0.001), whereas the quality of life and total score of each dimension were significantly lower than those in the control group (t_{total score}=-4.152, P < 0.001; t_body=-4.025, P < 0.001; t_emotion=-2.929, P=0.004; t_other=-2.680, P=0.009), and the difference was statistically significant (P < 0.05). After follow-up for half a year, the re-admission rate of patients in the observation group was 8.33% (5/60), and the control group was 31.67% (19/60). The observation group was significantly lower than the control group, and the difference was statistically significant (χ²=10.208, P=0.001). Conclusion The model of collaborative rehabilitation nursing intervention applied to patients with chronic heart failure can improve the self-care ability and quality of life of patients and reduce the readmission rate, and this model has a good clinical application potential.
- Collaborative rehabilitation nursing /
- Chronic heart failure /
- Self-care ability /
- Quality of life

HTML全文

表 1 2组慢性心衰患者干预前后自我护理能力得分比较(x ±s，分)

组别	例数	自我护理维持		自我护理管理		自护信心
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	60	30.52±2.63	46.43±4.31^a	25.25±3.25	47.24±7.52^a	22.15±6.25	48.63±12.45^a
对照组	60	31.12±3.54	36.76±6.74^a	24.99±3.01	31.43±7.03^a	21.95±4.01	33.42±9.74^a
t值		-1.054	9.363	0.455	11.896	0.209	7.453
P值		0.294	< 0.001	0.650	< 0.001	0.835	< 0.001
注：与同组干预前比较，^aP < 0.05。

下载: 导出CSV

表 2 2组慢性心衰患者生活质量得分比较(x ±s，分)

组别	例数	生活质量总分		躯体领域		情绪领域		其他领域
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	60	48.52±6.63	35.43±7.31^a	22.25±3.25	13.24±3.52^a	10.15±2.25	8.03±2.45^a	16.15±4.22	12.34±3.10^a
对照组	60	48.12±7.54	40.76±6.74^a	21.99±3.01	16.43±5.03^a	10.95±3.01	9.42±2.74^a	16.02±3.05	14.34±4.88^a
t值		0.309	-4.152	0.455	-4.025	-1.649	-2.929	0.193	-2.680
P值		0.758	< 0.001	0.650	< 0.001	0.102	0.004	0.847	0.009
注：与同组干预前比较，^aP < 0.05。

下载: 导出CSV

参考文献(20)

[1]	罗宗婷, 胡慧, 庞书勤, 等. 中医院校护理学硕士研究生科研能力与护理研究自我效能的相关性研究[J]. 护理管理杂志, 2020, 20(7): 476-480. doi: 10.3969/j.issn.1671-315x.2020.07.005
[2]	张婷, 王庆, 王莹. 护理延伸服务对慢性心衰合并心律失常患者健康行为和心功能的影响[J]. 中国循证心血管医学杂志, 2019, 11(12): 1524-1526. doi: 10.3969/j.issn.1674-4055.2019.12.28
[3]	潘媛媛, 彭羽, 陈萍, 等. 多元化护理模式对老年慢性心衰伴营养不良患者的干预效果研究[J]. 成都医学院学报, 2019, 14(1): 118-122. doi: 10.3969/j.issn.1674-2257.2019.01.028
[4]	常兴. 自制膳食营养处方护理对老年慢性心衰病情恢复及营养状态的影响[J]. 食品安全质量检测学报, 2019, 10(5): 1209-1213. https://www.cnki.com.cn/Article/CJFDTOTAL-SPAJ201905025.htm
[5]	陈杰, 张海燕. 美国重症护理学会护患协同模式简介及启示[J]. 中国护理管理, 2020, 20(1): 1-6. doi: 10.3969/j.issn.1672-1756.2020.01.001
[6]	莫月英, 徐皓芝, 郭献密. 双环节协同护理模式在乳腺癌根治术患者中的应用[J]. 齐鲁护理杂志, 2020, 26(14): 62-64. doi: 10.3969/j.issn.1006-7256.2020.14.021
[7]	田小娜. 协同护理模式对老年糖尿病合并慢阻肺患者疗效及心理状态的影响[J]. 河北医药, 2020, 42(14): 2215-2218. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ202014034.htm
[8]	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 慢性心力衰竭基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2019, 18(10): 936-947. doi: 10.3760/cma.j.issn.1671-7368.2019.10.008
[9]	郑喜灿, 赵丽, 潘文文, 等. 一院多区护理区域协同与同质化管理模式[J]. 解放军医院管理杂志, 2020, 27(4): 389-391. https://www.cnki.com.cn/Article/CJFDTOTAL-JFYG202004029.htm
[10]	袁丹, 龙春梅, 陈嘉妍. 协同护理模式对慢性心力衰竭病人自我护理能力的影响[J]. 全科护理, 2016, 14(11): 1083-1085. doi: 10.3969/j.issn.1674-4748.2016.11.002
[11]	郎倩, 冯芳, 李庆, 等. 基于自我效能理论的健康教育对慢性心力衰竭患者生活质量的影响[J]. 现代预防医学, 2018, 45(8): 1441-1444. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201808027.htm
[12]	张越, 郭晓琴, 章娟, 等. 基于德尔菲法构建育龄期女性生殖健康自我护理能力量表[J]. 护理研究, 2020, 34(14): 2468-2472. doi: 10.12102/j.issn.1009-6493.2020.14.007
[13]	贲倩莹, 朱凌燕, 黄晓莉, 等. 慢性心力衰竭患者自我管理现状及其影响因素[J]. 华南预防医学, 2021, 47(1): 109-112. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202101029.htm
[14]	王俊兰. 协同护理干预对乳腺癌改良根治术后病人性康复效果和负性情绪的影响[J]. 护理研究, 2020, 34(19): 3523-3526. doi: 10.12102/j.issn.1009-6493.2020.19.034
[15]	袁春艳, 杨华, 罗莉, 等. 协同护理模式对结直肠癌患者结肠造口后护理效果及自我护理能力的效果观察[J]. 中华肿瘤防治杂志, 2018, 25(S2): 213, 215. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL2018S2137.htm
[16]	李瑞. 利用协同康复护理模式提高帕金森病患者自护能力生存质量[J]. 山西医药杂志, 2020, 49(16): 2209-2211. doi: 10.3969/j.issn.0253-9926.2020.16.050
[17]	晏婷, 温雅, 徐英, 等. 医护心衰门诊对心力衰竭患者住院-家庭自我护理行为延续性的应用效果[J]. 实用医院临床杂志, 2020, 17(4): 66-68. doi: 10.3969/j.issn.1672-6170.2020.04.020
[18]	高敏, 孙国珍, 邢双双, 等. 高强度间歇有氧运动对心力衰竭患者运动耐力及生活质量影响的Meta分析[J]. 中国循证医学杂志, 2020, 20(1): 53-62. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ202001010.htm
[19]	龚凤翔, 邓莉莹, 唐朝. 家庭访视护理对社区老年慢性病患者自我护理能力及生活质量的影响[J]. 齐鲁护理杂志, 2020, 26(15): 42-44. doi: 10.3969/j.issn.1006-7256.2020.15.011
[20]	陈子文, 岳明, 沈娟. 反馈式护理对溃疡性结肠炎患者心境状态及自我管理能力的影响[J]. 护理实践与研究, 2020, 17(15): 73-75. doi: 10.3969/j.issn.1672-9676.2020.15.027