分阶段心理护理在慢性充血性心力衰竭患者中的应用研究

Application research of stage psychological nursing care in patients with chronic congestive heart failure

目的探讨分阶段心理护理在慢性充血性心力衰竭患者中的应用。方法选择2012年5月～2013年5月重庆市南川区人民医院治疗的充血性心力衰竭患者共156例，分为对照组72例及观察组84例。对照组给予充血性心力衰竭常规护理措施，观察3个月。对照组采取常规护理措施：观察组在常规护理基础上给予分阶段心理护理措施。观察患者的住院时间、3个月再住院率、6min步行距离等；采用汉密尔顿抑郁量表（HRSD）及健康状况调查问卷（SF-36）对两组日常生活品质进行评价。结果①观察组住院时间[（9．81±2．89）d]、3个月再住院率[32．1％（27／84）]均低于对照组[（11．45±3．30）d、54．2％（39／72）]，差异均有统计学意义（P〈0．05）。两组入院时6min步行距离比较，差异无统计学意义（P〉0．05）；出院时观察组6min步行距离[（432．70±60．74）m]长于对照组[（399．17±68．41）m]，差异有统计学意义（P〈0．05）。②两组入院时HRSD量表及SF-36量表评分比较，差异均无统计学意义（P〉0．05）。出院时观察组HRSD量表评分[（14．38±5．58）分]低于对照组[（16．33±5．01）分]，SF-36量表评分[（602．85±56．79）分]高于对照组[（540．36±66．51）分]，差异均有统计学意义（P〈0．05）。结论分阶段心理护理措施可明显改善患者的心理、精神状态及生活质量，其应用于充血性心力衰竭患者的临床疗效确切可靠。

Objective To investigate the application of stage psychological nursing care in patients with chronic con- gestive heart failure. Methods 156 cases of chronic congestive heart failure from May 2012 to May 2013 in the Peo- ple＇s Hospital of Nanchuan District were selected and divided into control group with 72 cases and observation group with 84 cases. The control group was treated with CHF conventional nursing measures, the observation group was treat- ed with stage psychological nursing care on the bases of chronic congestive heart failure conventional nursing measures, the course was 3 months. The hospital stays, 3 months rehospitalization rate, 6 min walking distance were observed; the Hamilton＇s depression scale （HRSD） and SF-36 scale were used to evaluate the daily life quality in the two groups. Results ①The hospital stays, 3 months rehospitalization rate in observation group [（9.81±2.89） d, 32.1% （27/84）] were all lower than those in control group [（11.45±3.30） d, 54.2% （39/72）], the differences were statistically significant （P 〈 0.05）. The difference of 6 rain walking distance before the hospital between the two groups was not statistically signifi- cant （P 〉 0.05）; the 6 min walking distance in observation group [（432.70±60.74） m] after the hospital was longer than that in control group [（399.17±68.41） m], the difference was statistically significant （P 〈 0.05）. ②The differences of HRSD scale scores and SF-36 scale scores before the hospital between the two groups were not statistically significant （P 〉 0.05）. The HRSD scale scores after the hospital in observation group [（14.38±5.58） points] was lower than that in control group [（16.33±5.01） points], the SF-36 scale scores after the hospital in observation group [（602.85±56.79） points] was higher than that in control group [（540.36±66.51） points], the differences were statistically significant （P 〈 0.05）. Conclusion Stage psychological nursing care can obviously improve the psychological, mental states and living quality, the clinical effects of application in patients with chronic congestive heart failure is exact and reliable.