医院到家庭连续护理模式对慢性心衰老年患者身心康复的影响

Impact of HtoH continuous nursing on medication compliance,readmission rates and cardiac function improvement in elderly patients with chronic heart failure

目的探讨医院到家庭(HtoH)的连续护理模式对慢性心衰老年患者用药依从性、再入院率及心脏功能改善的影响。方法选取新疆地区汉、维、哈萨克族慢性心力衰竭患者64例,将所有患者按年龄、性别、民族匹配分为2组,即护士随访组与非随访组。6个月后观察2组患者用药依从性、再入院率及心脏功能改善情况。结果在非随访组,β受体阻滞剂与氢氯噻嗪6个月后服用率显著低于出院时的服用率(P<0.05),其他药物服用率也有下降趋势,但差异无统计学意义(P>0.05);在随访组,出院时和随访6个月后的药物使用率差异无统计学意义(P>0.05)。相比于非随访组,随访组的左室射血分数、左室射血分数>0.40的人数有增加趋势,左室舒张末期容积则有下降趋势,但差异无统计学意义(P>0.05),而患者再入院次数则显著降低(P<0.01)。结论 HtoH的连续护理模式可以显著改善用药依从性、再入院率及心脏功能。

Objective To investigate HtoH continuous nursing on medication compliance、readmission rate、heart function improvement in elderly patients with old chronic heart failure. Methods 64 Han、Uygur and Kazak patients with chronic heart failure were divided into two groups according to the age、gender and ethnicity.The two groups were nurse follow-up group and non-nurse follow-up group.6 months later、the medication compliance、readmission rate、and heart function improvement were observed in these patients.Results In the non-nurse follow-up group、the utilization rates of β-blockers and hydrochlorothiazide in 6 months were significantly lower than the utilization rates when discharge 、P 〈 0.05 、、The utilization rates of other drugs showed the downward trend 、but the difference were not statistically significant 、P 〉0.05、.In the nursing follow-up group、the utilization rates after 6 months and when discharge showed no significant difference 、P 〉0.05、.Compared with the non-nurse follow-up group、left ventricular ejection fraction and the number of patients with left ventricular ejection fraction in nurse follow-up group showed an increasing trend、the left ventricular end-diastolic volume showed a downward trend、but the difference was not statistically significant 、P 〉0.05、.However、the number of readmission patients was significantly lower 、P 〈0.001、.Conclusion Nurse telephone follow-up can significantly improve medication compliance、readmission rate and heart function.