JCI标准下团队健康教育在心脏瓣膜置换术患者中的应用效果

Application of group health education under JCI criteria in patients with heart valve replacement

目的：探讨国际医疗卫生机构认证联合委员会（ JCI）标准下团队健康教育在心脏瓣膜置换术（ HVR）患者中的应用效果。方法选取2013年2月—2014年1月首次接受HVR的192例风湿性心脏病患者作为研究对象,根据随机数字表法将患者分为观察组和对照组,各96例。对照组患者给予常规健康教育,观察组患者给予JCI标准下的团队健康教育,由医生与护士为主的团队对患者的门诊、住院、围术期、出院及随诊各个阶段进行健康教育。在出院后6个月内,比较两组患者的随访结果,采用生活质量综合评定问卷（GQOLI-74）评价两组患者的生活质量。结果随访期间,观察组按时服药及定期复查的患者分别为96.9%,93.8%,高于对照组的86.5%,80.2%,差异有统计学意义（χ2值分别为6.818,7.772；P〈0.01）；观察组患者发生并发症发生率及再次入院率分别为9.4%,4.2%,均优于对照组的22.9%,12.5%,差异有统计学意义（χ2值分别为6.501,4.364；P〈0.05）。观察组患者GQOLI-74的心理功能维度、社会功能维度、总体生活质量因子评分及总分分别为（68.7±9.1）,（65.3±8.6）,（17.0±2.4）,（267.7±23.1）分,均优于对照组,差异有统计学意义（t值分别为3.810,2.553,2.923,3.783；P〈0.05）。结论 JCI标准下的团队健康教育可以提高HVR患者的治疗依从性及生活质量,为患者提供满意、高质量的医疗服务。

Objective To investigate the effects of group health education under Joint Commission on Accreditation of Healthcare Organization （ JCI ） criteria on patients with heart valve replacement （ HVR ） . Methods A total of 192 patients, who underwent HVR from February 2013 to January 2014, were selected as sampling and randomly divided into observation group （n=96） and control group （n=96） by random number table. Patients in the control group were given conventional health education while cases in the observation group were given group health education under JCI standard, which included outpatient, inpatient, perioperative, discharge and follow-up every stage of patients from the team consisting of doctors and nurses. In the 6 months after discharge, the follow-up results and satisfaction were compared between two groups. Generic Quality of Life Inventory 74 （GQOLI-74） was performed to assess the quality of life in two groups. Results The rates of taking medicine on time and periodic review were 96. 9%, 93. 8% compared with 86. 5%, 80. 2% in the control group （P〈0. 01）;total satisfactory of the observation group （86. 5%） were significantly higher than the control group （68. 8%） （Z=3. 28,P=0. 001）, but the rates of complications and readmission of the observation group were significantly lower than the control group （χ2 = 6. 501,4. 364;P 〈 0. 05）. The psychological function dimension, social function dimension and total quality of life dimension and total score were （68. 7 ± 9. 1）, （65.3±8.6）,（17.0±2.4）,（267.7±23.1）,betterthanthoseofthecontrolgroup（t=3.810,2.553, 2. 923, 3. 783;P〈0. 05）. Conclusions Group health education under JCI criteria can significantly improve the treatment compliance and quality of life in patients undergoing HVR, and provide satisfactory and high quality medical service.