老年综合评估护理干预在提高老年冠心病患者生活质量中的应用

Application of comprehensive geriatric assessment nursing model on the quality of life in elderly patients with coronary heart disease

目的：探讨临床护理中引用老年综合评估（ CGA）对老年冠心病（ CHD）患者生活质量的影响。方法纳入2012年1月-2013年6月心内科住院老年CHD患者143例，按照随机数字表法分为对照组69例和CGA组74例。对照组实施心内科专科护理，CGA组实施基于心内科专科护理的CGA护理模式。于入院及出院后6个月采用中国心血管病人生活质量评定问卷（ CQQC ）对两组患者的体力、病情、医疗状况、一般生活、社会心理、工作人际关系等方面进行评分比较。结果 CGA 组患者中有75．7％的患者具有两种或两种以上老年综合征或老年问题，其中抑郁占67．6％，睡眠障碍占66．2％，听力障碍占62．2％，视力障碍占60．8％。干预前，两组患者的生活质量评分差异无统计学意义（ P ＞0．05），干预后CGA组CQQC在体力、病情、医疗状况、一般生活、社会心理、工作人际关系等维度评分及总分分别为（10．86±5．06），（8．75±4．54），（5．90±0．40），（5．22±1．95），（8．41±3．22），（0．97±0．66），（40．11±9．05）分，明显高于对照组的（7．35±4．12），（4．57±0．85），（4．72±0．82），（3．85±1．45），（3．67±1．52），（0．70±0．64），（24．86±4．43）分，差异有统计学意义（t值分别为4．541，7．545，11．137，4．720，11．095，2．470，12．653；P＜0．05）。结论基于老年综合评估的护理干预能够在老年CHD的临床护理中起到积极作用，并能提高老年CHD患者的生活质量。

Objective To explore the effects of the comprehensive geriatric assessment （ CGA） nursing model on the quality of life in elderly patients with coronary heart disease （ CHD ） .Methods A total of 143 cases of hospitalized elderly patients with CHD were randomly divided into two groups , from January 2012 to June 2013 .The control group （ 69 cases ） was given the cardiovascular specialty nursing and the CGA group （74 cases） was given the cardiovascular nursing based on the CGA nursing model .The scores of patients ’ physical strength, illness, medical condition, general life, social psychology, working and interpersonal relationship were surveyed using the questionnaire of quality of life in patients with cardiovascular diseases （ CQQC） when patients first admitted to the hospital and 6 months after discharge .Results In the CGA group , 75.7%patients had two or more kinds of elder problems , within which 67.6% was depression, 66.2% was sleep disorder, 62.2% were hearing disability and 60.8% was visual disability.Before the intervention, the scores of quality of life between groups had no significant differences （P 〉0.05）.After the nursing intervention, the scores of physical strength , illness, medical condition, general life, social psychology, working and interpersonal condition in the CGA group were （10.86 ±5.06）, （8.75 ±4.54）, （5.90 ±0.40）, （5.22 ±1.95）, （8.41 ±3.22）, （0.97 ±0.66） and （40.11 ±9.05）.Those scores in the control group were （7.35 ±4.12）, （4.57 ±0.85）, （4.72 ±0.82）, （3.85 ±1.45）, （3.67 ±1.52）, （0.70 ±0.64） and （24.86 ±4.43）.The differences of scores between groups were significant （ t =4.541, 7.545, 11.137, 4.720, 11.095, 2.470, 12.653, respectively;P 〈0.05 ）.Conclusions Based on the comprehensive evaluation, the CGA nursing model can play a positive role in clinical nursing of elderly CHD patients , and it also can improve the quality of life in elderly patients with CHD .