延续性自我管理干预对PCI患者自我管理行为的影响

Effects of transitional self-management intervention on patients after percutaneous coronary intervention

目的：探讨延续性自我管理干预对经皮冠状动脉介入治疗（ PCI ）患者自我管理行为的影响。方法将100例PCI患者按照抽签法分为试验组和对照组各50例，对照组给予心内科常规健康教育，试验组给予以延续护理理念及自我管理理论为基础制订的延续性自我管理干预方案。应用自我管理知识问卷及冠心病自我管理行为量表（ CSMS）分别于干预前，干预后1个月和干预后6个月对两组患者进行测评，比较两组患者的差异。结果干预前，两组患者的自我管理知识问卷和CSMS各维度得分差异无统计学意义（ P＞0．05）。干预后1个月，试验组患者的CSMS日常生活管理、疾病医学管理、情绪认知管理评分分别为（48．17±7．20），（46．43±5．66），（47．96±9．69）分，优于对照组的（30．68±8．51），（33．40±4．86），（22．44±8．56）分，差异有统计学意义（t值分别为10．539，10．767，13．221；P＜0．01）；干预后6个月，试验组患者CSMS日常生活管理、疾病医学管理、情绪认知管理评分分别为（58．83±6．16），（65．30±5．28），（61．55±8．23）分，高于对照组的（30．47±8．37），（28．45±5．07），（24．00±7．25）分，差异有统计学意义（t值分别为18．373，33．822，22．929；P＜0．01）。试验组干预后6个月与干预后1个月相比，自我管理知识及冠心病自我管理行为量表各维度得分明显提高，差异均有统计学意义（P＜0．05）。对照组患者干预后1个月时日常生活管理知识及行为、疾病医学管理知识及行为得分均有提高，差异均有统计学意义（P＜0．05），但6个月时与1个月相比，疾病医学管理行为得分显著降低，差异均有统计学意义（P＜0．05）。结论与常规心内科的健康教育相比，延续性自我管理干预能显著改善PCI患者的自我管理知识及行为，可以在临床上广泛推广应用。

Objective To evaluate the effects of transitional self-management intervention on patients after percutaneous coronary intervention （ PCI ） .Methods One hundred PCI patients were assigned into the control group （50 cases） and the intervention group （50 cases） according to draw method.The control group was treated with the cardiology conventional health education .The intervention group was treated with the self-management model and the transitional nursing model .The coronary artery self-management scale （ CSMS） was used to compare between the groups at one month and six month after PCI .Results There was no significant difference in the score of CSMS before the investigation （P＆gt;0.05）.After one month of intervention, the score of daily management , disease management and emotional cognition of the intervention group were （ 48 .17 ± 7.20）, （46.43 ±5.66） and （47.96 ±9.69）, respectively, which were significantly higher than （30.68 ± 8.51）, （33.40 ±4.86） and （22.44 ±8.56） in the control group, the difference was statistically significant （t=10.539, 10.767, 13.221, respectively;P 〈0.01）.After six month of intervention, the score of daily management, disease management and emotional cognition of the intervention group were （58.83 ±6.16）, （65.30 ±5.28） and （61.55 ±8.23）, respectively, which were significantly higher than （30.68 ±8.51）, （28.45 ±5.07） and （24.00 ±7.25） in the control group, the difference was statistically significant （t =18.373, 33.822, 22.929, respectively;P 〈0.01）.After one month of intervention, the self-management knowledge and behavior of the intervention group were significantly better than the control group , the difference was statistically significant （P 〈0.05）.At one month, the daily management, disease management and behavior of the control group was significantly improved , the difference was statistically significant （P〈0.05）.However , the score of disease management at six month after the intervention was significantly decreased compared with that at month, the difference was statistically significant （P〈0.05）.Conclusions Comparing with the conventional health education , the transitional self-management intervention is effective , and it is worthy of getting widely extension in hospital .