基于移动医疗的症状群管理在慢性心力衰竭患者中的应用研究

doi:10.3761/j.issn.0254-1769.2024.11.002

摘要/Abstract

摘要：

目的探讨基于移动医疗的症状群管理在慢性心力衰竭（chronic heart failure，CHF）患者延续性护理中的应用效果。方法组建研究团队，基于院内移动医疗平台设计CHF患者症状群管理模块，选取青岛市某三级甲等医院2022年6月—12月心血管内科收治的CHF患者作为研究对象，其中A病区的235例作为试验组，B病区的235例作为对照组。试验组在常规延续护理的基础上实施基于移动医疗的症状群管理，对照组采用常规延续护理。比较两组出院时、出院6个月的心功能状态、自我护理水平和生活质量的差异。结果试验组最终纳入232例，对照组纳入225例。出院6个月后，两组心功能状态、自我护理水平及生活质量均较干预前改善（P<0.05）；出院6个月后，试验组心功能状态、自我护理水平及生活质量均优于对照组（P<0.05）。结论基于移动医疗平台对CHF患者进行症状群管理，能提高疾病管理效率，并为患者提供整体的自我管理计划，提高患者的自我管理能力，改善患者结局。

关键词: 症状群, 心力衰竭, 移动医疗, 延续性护理

Abstract:

Objective This study aims to investigate the application of symptom group management using a mobile health platform in managing heart failure patients during convalescence. Methods The research involved patients with chronic heart failure who were treated at a tertiary A hospital in Qingdao from June 2022 to December 2022. The experimental group consisted of 235 patients who were discharged after treatment in ward A，while the control group consisted of 235 patients who were discharged during the same period in ward B. The experimental group received an mHealth-based symptom clusters management program following routine continuous nursing and the control group was given routine continuous nursing after discharge. 6 months after the intervention，the heart function status，self-care level，and quality of life were compared between 2 groups. Results The experimental group ultimately included 232 cases，while the control group ultimately included 225 cases. Furthermore，the cardiac functional status，level of self-care，and quality of life of both the experimental group and the control group showed improvement compared to the pre-intervention period（P<0.05）. The experimental group exhibited significantly better cardiac function status compared to the control group，and the experimental group demonstrated higher levels of self-care confidence，and quality of life relative to the control group（P<0.05）. Conclusion The utilization of a mobile medical platform can enhance the management of heart failure patients’ symptom groups，resulting in improved disease management efficiency. This platform provides patients with a comprehensive self-management plan，ultimately enhancing their self-management abilities and overall outcomes.

Key words: Symptom Cluster, Heart Failure, Mobile Health, Continuing Care

赵梦璐, 卢晓虹, 曹丽华, 李福海, 韩静, 姜欣, 崔伟宁, 赵倩, 张文忠. 基于移动医疗的症状群管理在慢性心力衰竭患者中的应用研究[J]. 中华护理杂志, 2024, 59(11): 1294-1300.

ZHAO Menglu, LU Xiaohong, CAO Lihua, LI Fuhai, HAN Jing, JIANG Xin, CUI Weining, ZHAO Qian, ZHANG Wenzhong. Application research of an mHealth-based symptom clusters management program in the nursing of chronic heart failure patients[J]. Chinese Journal of Nursing, 2024, 59(11): 1294-1300.

图/表 5

表1 两组一般资料的比较[例（百分比，%）]

Table 1 Comparison of general data between the 2 groups[case（percentage，%）]

表2 两组干预前后左室射血分数、B型尿钠肽的比较（$\bar{x}±s$）

Table 2 Comparison of left ventricular ejection fraction and B-type brain natriuretic peptide before and after interventions of 2 groups（$\bar{x}±s$）

表3 两组出院6个月后6 min步行试验的比较[例（百分比，%）]

Table 3 Comparison of 6MWT between the 2 groups after 6 months of discharge[case（percentage，%）]

表4 Comparison of the scores of MLHFQ before and after interventions of 2 groups（分，$\bar{x}±s$）

Table 4

表5 Comparison of the scores of SCHFI before and after interventions of 2 groups（分，$\bar{x}±s$）

Table 5

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