经皮冠状动脉介入治疗患者心脏康复信息需求和自我管理的研究

doi:10.3761/j.issn.0254-1769.2023.04.002

摘要/Abstract

摘要：

目的描绘经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）患者在不同时间点心脏康复信息需求、自我管理行为的变化轨迹，并探讨两者的相关性。方法采用纵向研究的方法，于2021年6月—2022年1月在江西省某三级甲等医院的心内科病区和心血管门诊，纳入符合标准的186例PCI患者作为调查对象，采用一般资料调查表、中文版心脏康复信息需求量表和冠心病自我管理行为评定量表分别在术前1 d、术后3 d及出院后1、3、6个月共5个时间点进行跟踪随访，评估患者的心脏康复信息需求和自我管理行为。结果最终纳入165例，围手术期PCI患者的心脏康复信息需求总分及各维度得分总体呈上升趋势，但诊断与治疗维度得分在术前和出院后1个月内达到高峰，总体呈动态变化；出院后6个月内，PCI患者的心脏康复信息需求总分、自我管理行为总分及各维度得分呈下降趋势，但风险因素管理维度得分在出院后3个月内呈上升趋势；在出院后6个月内，PCI患者的自我管理行为总分及日常生活管理维度、疾病医学管理维度得分均呈下降趋势，情绪认知管理维度得分呈上升趋势。在出院后1个月，心脏康复信息需求与自我管理行为呈正相关（r=0.185，P<0.05）；在出院后6个月，两者呈负相关（r=-0.174，P<0.05）。结论 PCI患者的心脏康复信息需求、自我管理行为总分及各个维度得分在围手术期和出院后6个月内呈动态变化；PCI患者的心脏康复信息需求与自我管理行为在出院后1个月呈正相关，在出院后6个月呈负相关。提示医护人员应加强患者的随访管理，满足其疾病康复信息需求，进一步提高患者自我管理水平，以减少心血管事件和降低再入院率。

关键词: 心血管疾病, 经皮冠状动脉介入治疗, 心脏康复信息需求, 自我管理, 康复护理

Abstract:

Objective To describe the change trajectory of cardiac rehabilitation information needs and self-management in patients undergoing percutaneous coronary intervention （PCI） at different time points，and to explore the correlation between them. Methods A longitudinal study was conducted. From June 2021 to January 2022，186 PCI patients who met the criteria were enrolled in the cardiology ward and cardiovascular clinic of a tertiary A hospital in Jiangxi Province. General information questionnaire，the Cardiac Rehabilitation Information Needs Scale and Coronary Heart Disease Self-Management Behavior Rating Scale were employed for follow-up at 1 day before surgery，3 days after surgery，and 1，3，and 6 months after discharge to evaluate the patients’ cardiac rehabilitation information needs and self-management behavior. Results 165 cases were finally included. The total demand for cardiac rehabilitation information and the scores of each dimension in perioperative PCI patients showed an overall upward trend，but the demand for diagnosis and treatment reached the peak before surgery and within 1 month after discharge，showing a dynamic change overall. Within 6 months after discharge，the total demand for cardiac rehabilitation information，self-management and scores of each dimension of PCI patients showed an overall downward trend，but the demand for risk factor management showed an upward trend within 3 months after discharge. Within 6 months after discharge，self-management，daily life management and medical disease management of PCI patients showed a downward trend，while emotional cognitive management showed an upward trend. There was a positive correlation between them at 1 month after discharge（r=0.185，P<0.05），and a negative correlation between them at 6 months after discharge（r=-0.174，P<0.05）. Conclusion The information needs，self-management and dimensions of cardiac rehabilitation in patients with PCI change dynamically during perioperative period and within 6 months after discharge. The self-management of PCI patients was positively correlated with the total demand for cardiac rehabilitation information at 1 month after discharge，and negatively correlated at 6 months after discharge. It is suggested that medical staff should strengthen the follow-up management of patients and meet the needs of patients in all aspects of disease rehabilitation，which can further improve the self-management ability of patients and help to reduce the rate of cardiovascular events and readmission.

Key words: Cardiovascular Diseases, Percutaneous Coronary Intervention, Information Needs for Cardiac Rehabilitation, Self-Management, Rehabilitation Nursing

夏瑶瑶, 李颐, 熊晓云, 周亮, 王艳慧, 马兰英. 经皮冠状动脉介入治疗患者心脏康复信息需求和自我管理的研究[J]. 中华护理杂志, 2023, 58(4): 398-405.

XIA Yaoyao, LI Yi, XIONG Xiaoyun, ZHOU Liang, WANG Yanhui, MA Lanying. Study on information needs and self-management of cardiac rehabilitation in patients undergoing percutaneous coronary intervention[J]. Chinese Journal of Nursing, 2023, 58(4): 398-405.

图/表 4

表1 调查对象的一般资料（n=165）

Table 1 General information of respondents（n=165）

表2 不同时间点经皮冠状动脉介入治疗患者中文版心脏康复信息需求总分及各维度得分的比较 [n=165，分，M（P25，P75）]

Table 2 Comparison of cardiac rehabilitation information needs and scores of different dimensions in patients with PCI at different time points[n=165，scores，M（P25，P75）]

表3 出院后不同时间点经皮冠状动脉介入治疗患者冠心病自我管理行为评定量表总分及各维度得分的比较[n=165，分，M（P25，P75）]

Table 3 Self-management of PCI patients at different time points after discharge and comparison of scores of various dimensions[n=165，scores，M（P25，P75）]

表4 出院后不同时间点经皮冠状动脉介入治疗患者心脏康复信息需求与自我管理的相关性

Table 4 Correlation between cardiac rehabilitation information needs and self-management in patients with PCI at different time points after discharge

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