健康行为互动模式在经皮冠状动脉介入治疗患者中的应用研究

doi:10.3761/j.issn.0254-1769.2023.14.001

摘要/Abstract

摘要：

目的探讨健康行为互动模式在经皮冠状动脉介入治疗患者心脏康复中的应用效果。方法采用便利抽样法，选择2022年4月—7月在武汉市某三级甲等医院心血管内科住院的40例冠心病行经皮冠状动脉介入治疗患者作为试验组，采用基于健康行为互动模式的心脏康复指导和护理干预；选择2021年12月—2022年3月住院的40例冠心病行经皮冠状动脉介入治疗患者作为对照组，采用常规心脏康复指导和护理。比较两组干预前后6 min步行距离、低密度脂蛋白水平、服药依从性、自我效能感和生活质量的差异。结果共75例患者完成研究，试验组38例，对照组37例。干预后，试验组6 min步行距离为（526.79±40.70） m，大于对照组的（469.41±55.82） m；试验组低密度脂蛋白水平为（1.49±0.39） mmol/L，低于对照组的（1.77±0.49） mmol/L，差异均具有统计学意义（均P<0.05）。试验组服药依从性得分为（7.29±0.35）分，高于对照组的（6.33±0.37）分；试验组自我效能感得分为（7.04±0.65）分，高于对照组的（5.98±0.74）分；试验组生活质量得分为（64.47±6.25）分，高于对照组的（55.43±5.94）分，两组比较，差异均具有统计学意义（均P<0.001）。结论基于健康行为互动模式的心脏康复指导和护理干预能够提高患者的主观能动性，使患者形成健康行为，从而提高患者的服药依从性、自我效能感和生活质量，促进患者的心脏康复。

关键词: 冠心病, 心脏康复, 健康行为互动模式, 康复护理

Abstract:

Objective To explore the effect of nursing interventions based on the Interaction Model of Client Health Behavior（IMCHB） in cardiac rehabilitation of patients with coronary heart disease after stent implantation. Methods The convenience sampling method was adopted to select 40 patients with coronary heart disease after stent implantation in the cardiovascular department of a tertiary A hospital in Wuhan from April to July 2022 as the experimental group，and this group received the cardiac rehabilitation guidance and nursing intervention based on the interactive model of health behavior. A total of 40 patients with coronary heart disease who were hospitalized from December 2021 to March 2022 after stent implantation were selected as the control group，and this group received the routine cardiac rehabilitation guidance and nursing. The 6-minute walking distance，low density lipoprotein levels，medication compliance scores，self-efficacy scores and quality of life scores before and after intervention were compared between the 2 groups. Results A total of 75 patients completed the study， with 38 in the experimental group and 37 in the control group. After the intervention，the 6 minutes walking distance of the experimental group was（526.79±40.70），which was higher than（469.41±55.82） in the control group. The level of low density lipoprotein was（1.49±0.39） in the experimental group，which was lower than （1.77±0.49） in the control group，and the differences were statistically significant（P<0.05）. The score of medication compliance in experimental group was（7.29±0.35） points，which was higher than（6.33±0.37） points in the control group. The score of self-efficacy was（7.04±0.65），which was higher than（5.98±0.74） in the control group. The quality of life score was （64.47±6.25），which was higher than（55.43±5.94） in the control group，and the differences were statistically significant（P<0.001）. Conclusion The cardiac rehabilitation guidance and nursing intervention based on the IMCHB can improve patients’ subjective initiative，so as to improve patients’ medication compliance，improve patients’ sense of self-efficacy and quality of life，promote patients’ cardiac rehabilitation.

Key words: Coronary Disease, Cardiac Rehabilitation, Interaction Model of Client Health Behavior, Rehabilitation Nursing

卢艺苇, 杨伟梅, 王敏, 范雪梅, 程捷, 陆丽娟, 王昭昭, 何细飞. 健康行为互动模式在经皮冠状动脉介入治疗患者中的应用研究[J]. 中华护理杂志, 2023, 58(14): 1669-1675.

LU Yiwei, YANG Weimei, WANG Min, FAN Xuemei, CHENG Jie, LU Lijuan, WANG Zhaozhao, HE Xifei. Application of Interaction Model of Client Health Behavior in patients with coronary heart disease after stent implantation[J]. Chinese Journal of Nursing, 2023, 58(14): 1669-1675.

图/表 4

表1 基于健康行为互动模式的心脏康复护理干预方案

Table 1 Specific contents of nursing intervention program of cardiac rehabilitation based on Interaction Model of Client Health Behavior

表2 两组一般资料比较[例（百分比，%）]

Table 2 Comparison of general data between 2 groups[case（percentage，%）]

表3 两组6 min步行距离、低密度脂蛋白水平比较（$\bar{x}±s$）

Table 3 Comparison of 6 minute walking distance，low density lipoprotein levels between 2 groups（$\bar{x}±s$）

表4 两组服药依从性、自我效能感、生活质量的比较（分，$\bar{x}±s$）

Table 4 Comparison of medication compliance scores, self-efficacy scores, quality of life scores between 2 groups（score，$\bar{x}±s$）

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