以ITHBC理论为基础的延续护理应用于心房颤动患者的效果观察

王萍萍; 宁彬; 张雪瑞; 闫树艳

doi:10.16766/j.cnki.issn.1674-4152.004191

以ITHBC理论为基础的延续护理应用于心房颤动患者的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.004191

阜南县人民医院心血管内科，安徽阜阳 236300

基金项目:

安徽省卫生健康科研项目 AHWJ2023A20336

详细信息

通讯作者:
王萍萍，E-mail：18712673313@163.com

中图分类号: R473.55 R541.75
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出版历程
- 收稿日期: 2025-02-21
- 网络出版日期: 2025-11-17

The effect of continuous nursing based on ITHBC theory in patients with atrial fibrillation

Department of Cardiovascular Medicine, Funan County People' s Hospital, Fuyang, Anhui 236300, China

摘要

摘要: 目的以健康行为改变整合理论(ITHBC)框架实施延续护理干预，分析其对改善心房颤动患者抗凝知识掌握程度、抗凝依从性及自我管理能力的效果，为优化心房颤动患者的长期管理提供循证依据。方法选取2022年3月—2024年7月阜南县人民医院收治的182例心房颤动患者为研究对象，采用随机数字表法将其分为对照组(91例)和观察组(91例)。对照组患者应用常规延续护理，观察组在对照组基础上应用以ITHBC理论为基础的延续护理。比较2组患者抗凝知识掌握程度、抗凝依从性及自我管理能力。结果干预6个月后，观察组患者抗凝知识掌握程度及抗凝依从性分别为(9.02±0.85)分、(25.07±3.09)分，均高于对照组[(7.19±1.03)分、(22.17±4.04)分]，差异均有统计学意义(P＜0.05)。干预后，观察组患者心房颤动自我管理能力量表各维度得分及总分均有所提高，且观察组量表总分高于对照组[(50.32±6.74)分vs. (44.19±8.59)分, F=4.869, P < 0.001]。结论以ITHBC理论为基础的延续护理能够提高心房颤动患者疾病相关知识及抗凝依从性，提高患者自我管理能力，改善临床结局。
- 心房颤动 /
- 抗凝依从性 /
- ITHBC理论 /
- 延续护理 /
- 自我管理能力 /
- 临床结局
Abstract: Objective The implementing of continuity of care interventions is to be executed using the integrated theory of health behavior change (ITHBC) framework. The effectiveness of this implementation will be analyzed in terms of its impact on improving anticoagulant knowledge, compliance, and self-management abilities in patients with atrial fibrillation. The objective is to provide evidence-based support for optimizing the long-term management of patients with atrial fibrillation. Methods A total of 182 patients diagnosed with atrial fibrillation were selected as research subjects from March 2022 to July 2024, admitted to Funan County People' s Hospital. These subjects were method ically divided into two groups: a control group and an observation group, with 91 cases in each group. The control group patients received routine continuing care, while the observation group received continuing care based on ITHBC theory in addition to the care received by the control group. The level of anticoagulant knowledge mastery, anticoagulant compliance, and self-management ability between two groups of patients were compared. Results Following a six-month intervention period the observation group demonstrated a higher level of knowledge and compliance with anticoagulation therapy, with mean scores of 9.02±0.85 and 25.07±3.09, respectively. These scores were significantly higher than those observed in the control group, which averaged (7.19±1.03) points and (22.17±4.04) points, yielding a statistically significant difference (P < 0.05). Following the implementation of the intervention, there was an enhancement in the scores of each dimension and the total score of the atrial fibrillation self-management scale for patients in the observation group. The total score of the observation group scale exceeded that of the control group [(50.32±6.74) points vs. (44.19±8.59) points, F=4.869, P < 0.001]. Conclusion Continuing nursing based on the ITHBC theory can improve disease-related knowledge and anticoagulant compliance in patients with atrial fibrillation, enhance patients'self-management abilities and improve clinical outcomes.
- Atrial fibrillation /
- Anticoagulation compliance /
- ITHBC theory /
- Continuing care /
- Self-management ability /
- Clinical outcome

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表 1 2组房颤患者一般资料比较

Table 1. Comparison of general characteristics between the two groups of atrial fibrillation patients

项目	对照组(n=91)	观察组(n=91)	统计量	P值
性别(例)			0.089^a	0.765
男性	50	52
女性	41	39
年龄(x±s，岁)	59.17±4.34	58.46±5.12	1.009^b	0.314
房颤类型(例)			0.698^a	0.403
持续性房颤	64	69
阵发性房颤	27	22
BMI(x±s)	22.03±2.59	21.76±2.64	0.696^b	0.487
受教育程度(例)			1.157^c	0.561
初中及以下	33	30
中专/高中	41	38
大专及以上	17	23
稳态时华法林剂量(x±s，mg)	2.50±0.47	2.46±0.53	0.539^b	0.591
合并症(例)
高血压	46	50	0.353^a	0.553
糖尿病	40	35	0.567^a	0.451
高血脂	58	61	0.218^a	0.640
病程时间(x±s，月)	7.35±1.73	7.41±2.08	0.212^b	0.833
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组房颤患者干预前后抗凝知识掌握程度及抗凝依从性比较(x±s，分)

Table 2. Comparison of anticoagulation knowledge mastery and adherence between two groups of atrial fibrillation patients before and after the intervention(x±s, points)

组别	例数	抗凝知识掌握程度		抗凝依从性
组别	例数	干预前	干预后	干预前	干预后
对照组	91	5.13±1.42	7.19±1.03	21.89±3.16	22.17±4.04
观察组	91	5.20±1.66	9.02±0.85	22.43±3.50	25.07±3.09^c
统计量		0.306^a	11.068^b	1.092^a	5.326^b
P值		0.760	＜0.001	0.276	＜0.001
注：^a为t值，^b为F值；与同组干预前比较，^cP < 0.05。

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表 3 2组房颤患者干预前后自我管理能力比较(x±s，分)

Table 3. Comparison of self-management abilities between two groups of atrial fibrillation patients before and after the intervention(x±s, points)

组别	例数	房颤特异性征象监测			影响INR因素管理			遵医行为		服用华法林管理
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
对照组	91	2.95±0.86	3.27±1.05		3.15±0.94	3.71±1.12		7.93±2.00	9.19±1.87^b	8.30±2.25	9.74±1.64^b
观察组	91	3.03±0.95	4.18±1.23^b		3.20±0.99	4.33±0.49^b		8.04±2.16	10.62±2.33^b	8.24±2.19	10.73±2.14^b
统计量		0.596^a	5.019^c		0.349^a	4.628^c		0.356^a	4.371^c	0.182^a	3.054^c
P值		0.552	＜0.001		0.727	＜0.001		0.722	＜0.001	0.856	0.001

组别	例数	生活方式管理					不良嗜好管理			总分
组别	例数	干预前		干预后			干预前		干预后	干预前	干预后
对照组	91	8.09±2.01		10.13±2.16^b			7.19±1.85		8.05±1.82	38.77±7.13	44.19±8.59^b
观察组	91	8.14±2.15		11.59±1.82^b			7.03±1.77		9.06±1.63^b	39.12±8.06	50.32±6.74^b
统计量		0.162^a		4.805^c			0.596^a		3.943^c	0.310^a	4.869^c
P值		0.871		＜0.001			0.552		＜0.001	0.757	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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