多学科团队延续性护理模式在心房颤动患者中的应用研究

doi:10.3761/j.issn.0254-1769.2020.07.002

摘要/Abstract

摘要：

目的探索护士主导的多学科团队延续性护理模式在心房颤动患者中的应用效果。方法 2017年10月—2018年10月,选取北京市某三级甲等医院心脏中心住院治疗的心房颤动患者为研究对象,按病区分为试验组和对照组。试验组在常规护理与健康教育的基础上给予护士主导的多学科团队延续性护理,对照组接受心内科常规护理与健康教育。比较两组入组时及出院后6个月时的服药依从性和生活质量,比较出院后1个月、3个月、6个月因心血管事件再入院情况,采用Cox比例风险模型比较两组因心血管事件再入院情况。结果共纳入148例心房颤动患者,试验组80例,对照组68例,两组一般资料的比较,差异无统计学意义（P>0.05）。试验组出院后6个月时中文版服药依从性量表得分、中文版生活质量简表总分及其生理职能、躯体疼痛和精神健康维度得分均高于对照组,差异具有统计学意义（P<0.05）。虽然两组出院后因心血管事件再入院率的比较,差异无统计学意义（P>0.05）,但Cox比例风险模型显示,试验组的再入院风险相对较低（HR=0.633,95%CI=0.322~1.245）。结论护士主导的多学科团队延续性护理可以提高患者的服药依从性,提升其生活质量,改善患者健康结局。

关键词: 心房颤动, 延续性护理, 多学科, 生活质量, 服药依从性

Abstract:

Objective To evaluate the effects of continuity nursing care in the management of patients with atrial fibrillation by a nurse-led multidisciplinary team. Methods From October 2017 to October 2018,atrial fibrillation patients who were hospitalized were selected into an experimental group and a control group according to the inpatient wards. Patients in the control group received routine care and follow-up in the department of cardiology. Patients in the experimental group received a continuous care by a nurse-led multidisciplinary team. The medication compliance and quality of life were compared between 2 groups at admission and 6 months after discharge. The re-admissions of cardiovascular events were compared at 1 month,3 months,and 6 months after discharge. Survival analysis was used to compare the re-admission of cardiovascular events between 2 groups of patients with time after discharge. Results Totally 148 patients with atrial fibrillation were included in this study with 80 cases in the experimental group and 68 cases in the control group. There was no statistical difference between 2 groups in terms of gender,age,and clinical status（P>0.05）. The score of medication compliance in the experimental group was higher than that in the control group at 6 months after discharge. The difference was statistically significant（P<0.05）. The total score of quality of life and the scores of its 3 dimensions（role-physical,bodily pain and mental health）in the experimental group were higher than those in the control group at 6 months after discharge. The difference was statistically significant（P<0.05）. There was no significant difference in the re-admission incidences of cardiovascular events between 2 groups at 1 month,3 months,and 6 months after discharge（P>0.05）. Although Log-rank test showed that there was no statistically significant difference in the re-admission incidences of cardiovascular events between 2 groups with time after discharge（Log-rank P>0.05）,Cox regression analysis showed the risk of re-admission in the experimental group was lower than it in the control group,HR=0.633（95%CI：0.322~1.245）. Conclusion The continuity care of nurse-led multidisciplinary team can improve medication compliance of patients and quality of life and patient-related health outcomes.

Key words: Atrial Fibrillation, Continuity of Care, Multidisciplinary, Quality of Life, Medication Compliance

杜宜修, 吴芳琴, 卢晓英, 陈汝明, 张宇. 多学科团队延续性护理模式在心房颤动患者中的应用研究[J]. 中华护理杂志, 2020, 55(7): 969-974.

DU Yixiu, WU Fangqin, LU Xiaoying, CHEN Ruming, ZHANG Yu. The application effects of continuous nursing care in management of patients with atrial fibrillation by a nurse-led multidisciplinary team[J]. Chinese Journal of Nursing, 2020, 55(7): 969-974.

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