居家自我管理的干预模式对经皮冠状动脉介入治疗术后患者的影响
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摘要
【目的】探讨居家自我管理的护理干预方法对经皮冠状动脉介入(PCI)术后患者疗效的影响。【方法】随机抽取符合入选标准的40例PCI术后患者,护理团队采用集中健康指导、电话随访等方式对研究对象进行为期6个月定期用药、饮食、运动、生活行为及危险因素控制等居家自我管理干预,通过患者自身前后对照研究,比较患者饮食、用药、健康行为等方面的康复知识知晓率、遵医行为满意率及并发症发生率的差异。【结果】干预前后调查问卷的回收率均为100%,40例研究对象干预前患者PCI康复知识的知晓率为65%,干预后为100%,差异有统计学意义(P<0.05);干预后遵医行为满意率明显提高,差异有统计学意义(P<0.05);干预组较同期未干预组并发症的发生率明显下降,差异有统计学意义(P<0.05)。【结论】居家自我管理的干预模式对提高患者康复知识知晓率、遵医行为及降低并发症的发生效果明显。
[Objective] To explore the effect of home self-management nursing model on patients after percutaneous coronary intervention(PCI). [Methods] A total of 40 PCI postoperative patients who met the inclusion criteria were randomly selected.And during the six months of home self-management intervention by means of centralized health guidance and telephone follow-ups,the nursing team did interventions on the subjects in relation to medications,diet,exercise,and control of risk factors.Then the patients were compared before and after the intervention in their awareness rate of rehabilitation knowledge in diet,drug use and health activities,and in satisfaction rate of compliance with doctor′s orders and the incidence of complications. [Results] We issued questionnaires about the awareness rate of PCI rehabilitation knowledge among those 40 patients before and after the intervention,and the recovery rates of the questionnaires were both 100%.Before the intervention the awareness rate of patients′ rehabilitation knowledge was 65% according to the questionnaires and increased to 100% after the intervention,the difference being statistically significant(P<0.05).The satisfaction rate of compliance was significantly increased after the intervention and the difference was statistically significant(P<0.05).The incidence of complications of the intervention group was significantly lower than that of the non-intervention group during the same period and the difference was statistically significant(P<0.05). [Conclusion] The intervention model of self-management at home has obvious effects in improving patients′ awareness rate of rehabilitation knowledge and compliance with doctor′s orders,thus reducing the incidence of complications.
[Objective] To explore the effect of home self-management nursing model on patients after percutaneous coronary intervention(PCI). [Methods] A total of 40 PCI postoperative patients who met the inclusion criteria were randomly selected.And during the six months of home self-management intervention by means of centralized health guidance and telephone follow-ups,the nursing team did interventions on the subjects in relation to medications,diet,exercise,and control of risk factors.Then the patients were compared before and after the intervention in their awareness rate of rehabilitation knowledge in diet,drug use and health activities,and in satisfaction rate of compliance with doctor′s orders and the incidence of complications. [Results] We issued questionnaires about the awareness rate of PCI rehabilitation knowledge among those 40 patients before and after the intervention,and the recovery rates of the questionnaires were both 100%.Before the intervention the awareness rate of patients′ rehabilitation knowledge was 65% according to the questionnaires and increased to 100% after the intervention,the difference being statistically significant(P<0.05).The satisfaction rate of compliance was significantly increased after the intervention and the difference was statistically significant(P<0.05).The incidence of complications of the intervention group was significantly lower than that of the non-intervention group during the same period and the difference was statistically significant(P<0.05). [Conclusion] The intervention model of self-management at home has obvious effects in improving patients′ awareness rate of rehabilitation knowledge and compliance with doctor′s orders,thus reducing the incidence of complications.
引文
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[8]DAWKES S,SMITH G D,ELLIOTT L,et al.Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty[J].J Geriatr Cardiol,2016,13(5):393-400.
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[10]MOHR F W,MORICE M C,KAPPETEIN A P,et al.Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease:5-year follow-up of the randomised,clinical SYNTAX trial[J].Lancet,2013,381(9867):629-638.
[2]胡亚妮,林平,张金丽,等.经皮冠状动脉支架植入术后患者自我管理行为及其影响因素[J].中华护理杂志,2012,47(2):167-169.
[3]谢博钦,徐丽华.冠心病患者自我管理行为现况及其预测因子分析[J].解放军护理杂志,2011,28(3B):3-7.
[4]郑淑梅,杨秀兰,吕烨辉,等.延续性自我管理教育在冠心病介入治疗患者心脏康复中的应用[J].中华护理杂志,2012,47(4):297-300.
[5]杨丽娟,隋捷,刘晓波,等.急性冠脉综合征患者的护理干预及健康管理[J].护理实践与研究,2013,10(12):39-41.
[6]姜明霞,裴道灵,刘建平.健康管理对社区居民认知冠心病相关因素的影响[J].上海预防医学,2010,22(4):178-180.
[7]姚立群,庞书勤,郑丽维,等.连续性护理的概念内涵及测量工具的研究进展[J].中华护理杂志,2013,48(11):1026-1029.
[8]DAWKES S,SMITH G D,ELLIOTT L,et al.Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty[J].J Geriatr Cardiol,2016,13(5):393-400.
[9]DE MELO GHISI G L,GRACE S L,THOMAS S,et al.Healthcare providers′ awareness of the information needs of their cardiac rehabilitation patients throughout the program continuum[J].Patient Educ Couns,2014,95(1):143-150.
[10]MOHR F W,MORICE M C,KAPPETEIN A P,et al.Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease:5-year follow-up of the randomised,clinical SYNTAX trial[J].Lancet,2013,381(9867):629-638.