慢性心力衰竭患者照顾者家庭护理准备方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2025.16.001

摘要/Abstract

摘要：

目的构建基于McMaster家庭功能模式的慢性心力衰竭患者照顾者家庭护理准备方案并探讨其应用效果。方法通过文献分析、专家函询、预试验等形成该方案。2023年12月至2024年4月，便利抽取蚌埠市某三级甲等医院心内科住院的86对慢性心力衰竭患者及其照顾者作为研究对象。采用抛硬币法，以病区为单位随机分为试验组43对和对照组43对。试验组在常规护理的基础上实施该方案，对照组给予常规护理。于入院时、出院时以及出院后1、3个月，比较两组照顾者家庭护理准备、照顾者照护能力、患者生活质量的差异。结果共81对患者及其照顾者完成干预，试验组41对，对照组40对。重复测量方差分析显示，两组照顾者家庭护理准备、照顾者照护能力、患者生活质量均存在时间与组间的交互效应（F_交互=320.995，P_交互<0.001；F_交互=83.303，P_交互<0.001；F_交互=113.283，P_交互<0.001）。简单效应分析显示，出院时以及出院后1、3个月，试验组照顾者家庭护理准备、照顾者照护能力得分高于对照组（P<0.001）；出院后1、3个月，试验组患者生活质量得分低于对照组（P<0.001）。结论该方案的实施可有效提高慢性心力衰竭患者照顾者的家庭护理准备和照护能力，改善患者的生活质量。

关键词: 心力衰竭, 照顾者, 家庭护理准备, 照护能力, 生活质量, 护理

Abstract:

Objective To construct a home care readiness program for caregivers of patients with chronic heart failure based on the McMaster Family Functioning Model and explore its application effects. Methods The program was developed through literature analysis，expert correspondence and pre-testing. 86 pairs of patients with chronic heart failure and their caregivers who were admitted to the Department of Cardiology of a tertiary-level hospital in Bengbu City were conveniently selected from December 2023 to April 2024 as the study subjects. Using the coin-flip method，the patients were randomly divided into 43 pairs in an experimental group and 43 pairs in a control group on a ward-by-ward basis. The experimental group implemented the program on the basis of routine care，and the control group was given routine care. Differences in caregiver home care readiness，caregiver caregiving ability and patients’ quality of life were compared between the 2 groups at the time of admission，at the time of discharge，and 1 and 3 months after discharge. Results A total of 81 pairs of patients and their caregivers completed the intervention，with 41 in the experimental group and 40 in the control group. Repeated-measures ANOVA showed that there was an interaction effect between time and group for caregiver home care readiness，caregiver caregiving ability，and patient quality of life in both groups（F=320.995，P<0.001；F=83.303，P<0.001；F=113.283，P<0.001）. Simple effect analyses showed that caregiver home care readiness and caregiver caregiving competence scores were higher in the experimental group than those in the control group at the time of discharge and at 1 and 3 months post-discharge（P<0.001）；quality of life scores of patients in the experimental group were lower than it in the control group at 1 and 3 months post-discharge（P<0.001）. Conclusion The implementation of the program can effectively improve the home care readiness and caregiving ability of caregivers of patients with chronic heart failure，and improve the quality of life of patients.

Key words: Heart Failure, Caregiver, Home Care Readiness, Caregiving Ability, Quality of Life, Nursing Care

王宇, 何梦雨, 祁明昊, 雷梦玲, 陈振月, 王峰, 周静. 慢性心力衰竭患者照顾者家庭护理准备方案的构建及应用研究[J]. 中华护理杂志, 2025, 60(16): 1925-1932.

WANG Yu, HE Mengyu, QI Minghao, LEI Mengling, CHEN Zhenyue, WANG Feng, ZHOU Jing. Construction and application of a home care readiness program for caregivers of patients with chronic heart failure[J]. Chinese Journal of Nursing, 2025, 60(16): 1925-1932.

图/表 6

表1 慢性心力衰竭患者照顾者家庭护理准备方案

Table 1 Home care readiness program for caregivers of chronic heart failure patients

表2 两组患者一般资料的比较[例（百分比，%）]

Table 2 Comparison of general information of patients in 2 groups[cases（percentage，%）]

表3 两组照顾者一般资料的比较[名（百分比，%）]

Table 3 Comparison of general information of caregivers in 2 groups[cases（percentage，%）]

表4 两组照顾者家庭护理准备量表得分的比较（分，$\bar{x}\pm s$）

Table 4 Comparison of Home Care Readiness scale scores of caregivers between 2 groups（score，$\bar{x}\pm s$）

表5 两组照顾者照护能力问卷得分的比较（分，$\bar{x}\pm s$）

Table 5 Comparison of caring ability questionnaire scores of caregivers between 2 groups（score，$\bar{x}\pm s$）

表6 两组明尼苏达心力衰竭患者生活质量问卷得分的比较（分，$\bar{x}\pm s$）

Table 6 Comparison of MLHFQ scores of patients between 2 groups（score，$\bar{x}\pm s$）

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