规范化自我管理教育对冠心病患者治疗依从性的影响

Effects of standardized self-management education on treatment compliance in patients with coronary heart disease

目的 探讨规范化自我管理教育对冠心病患者治疗依从性的影响.方法 选择2013年3月—2014年3月在哈尔滨医科大学附属第一医院因冠心病住院的患者120例,按随机数字表法分为干预组和对照组,每组各60例;对照组接受常规护理方式,干预组在对照组常规护理的基础上,进行规范化自我管理教育;比较干预后两组一般自我管理效能与治疗依从性.结果 干预前对照组与干预组自我管理效能感评分分别为（21.22±5.63）,（20.56±5.74）分,两组差异无统计学意义（t=0.562,P〉0.05）;干预后对照组与干预组自我效能感评分分别为（25.26±8.01）,（35.56±5.33）分,干预后干预组的自我管理效能感明显比对照组提升（t=11.236,P〈0.01）,对照组与干预组在干预后自我管理效能感较干预前均有明显提升（t值分别为3.245,15.774;P〈0.01）;规范化自我管理教育干预实施后,干预组在遵医用药、合理休息、按时复查、合理饮食、戒烟戒酒、合理锻炼、预防感染等7个维度及总分评分上明显高于对照组,两组差异有统计学意义（t值分别为5.224,6.035,5.942,4.993,4.798,5.648,6.498,5.858;P〈0.01）.结论 对冠心病患者在常规教育的基础上实施规范化自我管理教育,能提高患者治疗的积极性和自我管理能力,提高依从性.

Objective To explore the effects of standardized self-management education on treatment compliance in patients with coronary heart disease （ CHD） . Methods The study investigated 120 patients with CHD who were admitted in First Affiliated Hospital of Harbin medical university from March 2013 to March 2014. According to random number table method, the participants were divided into two groups： intervention group and control group, 60 cases in each group. The patients of control group received normal nursing care;the patients of intervention group underwent standardized self-management educated based on the normal care. The effectiveness of self-management and patients′ treatment compliance of these two groups were evaluated and compared. Results Before the interventions, the scores of the effectiveness of self-management in control group and intervention group were （21. 22 ± 5. 63） and （20. 56 ± 5. 74） （t =0. 562, P 〉0. 05）. After the interventions, the scores in the control group and intervention group were （ 25. 26 ± 8. 01 ） and （ 35. 56 ± 5. 33）;both of the groups were significantly improved after the intervention （t=3. 245, 15. 774;P〈0. 01）;and the intervention group improved more obviously than that of the control group （t =11. 236,P 〈0. 01）. Moreover, the intervention group performed better in： adherence to medical regimens, reasonable rest, reviewon time, giving up smoking and drinking, proper diet, reasonable exercise, and preventing infection comparing with that of control group （t=5. 224, 6. 035, 5. 942, 4. 993, 4. 798, 5. 648, 6. 498, 5. 858;P〈0. 01）. Conclusions The standardized self-management education with normal nursing care is effective to motivate CHD patients and to improve their self-management ability and treatment compliance.