Abstract:

Objective To investigate the best evidence application of exercise prescription in patients with chronic heart failure in clinical practice and evaluate its effectiveness. Methods The best evidence of exercise prescription for patients with chronic heart failure was summarized，and the evidence-based practice plan was developed，and it was implemented in the cardiology department of a tertiary hospital in Zhejiang Province from August to October，2022. Nurses’ exercise prescription knowledge-attitude-practice level，implementation rate of review indicators，the length of hospital stay，exercise endurance，daily living ability and grip strength of both groups before and after the intervention were compared. Results After the application of the best evidence，the score of knowledge dimension was（9.34±0.98） points；the score of attitude dimension was（63.29±1.37） points；the score of practice dimension was（25.49±1.51） points，which were statistically significant compared with the scores before the application of evidence（P<0.05）. After the application of the best evidence，the implementation rate of 16 review indicators was higher than that before the application of evidence（P<0.001）. The length of hospital stay in the evidence application group was shorter than that in the baseline examination group（Z=-2.610，P<0.001）. After intervention，the exercise endurance，daily living ability and grip strength of patients in the evidence application group were improved compared with the baseline review group，and the difference was statistically significant（P<0.05）. Conclusion After the application of the best evidence of exercise prescription in patients with chronic heart failure，it can improve the level of knowledge，attitude and practice of nurses on exercise prescription，standardize the compliance of nurses’ exercise prescription，reduce the number of days in the hospital，and improve patients’ exercise endurance，daily living ability and grip strength.

Key words: Chronic Heart Failure, Exercise Prescription, Evidence-Based Nursing, Best Evidence

摘要：

目的 将慢性心力衰竭患者运动处方的最佳证据应用于临床实践并评价其效果。方法 总结慢性心力衰竭患者运动处方最佳证据，制订循证实践方案，于2022年8月—10月，在浙江省某三级甲等综合医院心内科开展循证实践，比较最佳证据应用前后，护士运动处方知信行水平，审查指标执行率以及患者住院天数、运动耐力、日常生活能力和握力的差异。结果 最佳证据应用后，护士运动处方知信行调查问卷知识、态度、行为维度得分分别为（9.34±0.98）、（63.29±1.37）、（25.49±1.51）分，与证据应用前比较，差异具有统计学意义（P<0.05）；最佳证据应用后，16个审查指标执行率较证据应用前提升（P<0.001）；证据应用组患者住院天数较基线审查组缩短（Z=-2.610，P<0.001）；干预后，证据应用组患者运动耐力、日常生活能力和握力与基线审查组比较，差异具有统计学意义（P<0.05）。结论 慢性心力衰竭患者运动处方最佳证据的应用，可提高护士运动处方知信行水平，规范护士运动处方执行依从性，减少患者住院天数，提高患者运动耐力、日常生活能力和握力。

关键词: 慢性心力衰竭, 运动处方, 循证护理学, 最佳证据