延续性护理干预对急性心肌梗死患者PCI术后心理状态及服药依从性的影响

Continuous nursing intervention on acute myocardial infarction patients after PCI to improve their psychological status and medication compliance

目的:探讨延续性护理干预对急性心肌梗死患者经皮冠状动脉介入术(PCI)后心理状态及服药依从性的影响。方法:选取2010年10月至2012年4月在本院心血管内科住院的急性心肌梗死患者84例,入院后行急诊PCI,简单随机分为观察组与对照组,观察组43例,对照组41例,观察组出院后采用定期家访、电话回访、来院复诊等方式进行持续护理干预跟踪随访,对照组采取常规门诊随访和复查。通过问卷调查的方式比较两组患者出院后1个月、3个月、6个月、12个月心理状态及服药依从性的差异。结果:两组患者与自身基线相比,焦虑、抑郁评分均有下降,两组不同时间段各评价指标之间差异均有统计学意义(P<0.05),变化趋势存在不同。通过护理干预在1个月时没有明显差异,在3个月时开始出现差异,6个月、12个月时均值差异最明显,焦虑、抑郁情绪减轻最明显,服药依从性佳。结论:出院后持续护理干预能有效减轻急性心肌梗死PCI术后患者焦虑和抑郁情绪,提高患者服药依从性、遵医行为,提高疗效,减少心血管事件再发情况。

Objective： To explore the effects of nursing intervention on mental Staius and medication compliance of patients with acute myocardial infarction after percutaneous coronary intervention （PCI）. Methods： The authors selected 84 acute myocardial infarction patients from October, 2010 to April, 2012. All of them got emergency PCI after admitted. Then they were simply randomized into experimental group （43 cases） and control group （41 cases）. Experimental group accepted continuous nursing intervention after discharged, including regular home visits, telephone feedback and clinical visits. Control group got a regular clinical follow-up. Their mental status and medication compliance were investigated after 1 month, 3 months, 6 months, and 12 months from discharged, respectively. Results： Compared with baseline, anxiety and depression scores decreased in both groups （P〈0.05）. But the trends were different. There was no difference between two groups at 1 month in terms of anxiety, depression score and medication compliance. But difference appeared at 3 months, and became more obvious at 6 and 12 months after discharged. The anxiety and depression improved significantly, and medication compliance increased also. Conclusion： Nursing interventions could effectively reduce acute myocardial infarction patients＇ anxiety and depression after percutaneous coronary intervention, improve their compliance, and prevent recurrent cardiovascular events.