综合护理干预对冠心病患者自我管理能力及心理状态的影响

Effect of comprehensive nursing intervention on self-management ability and psychological state of patients with coronary heart disease

目的探讨综合护理干预对冠心病患者自我管理能力及心理状态的影响。方法选取2015年1月~2016年5月来我中心和北京市丰台区中西医结合医院进行治疗的冠心病患者520例作为对象进行研究,将其随机分为观察组(n=260例)和对照组(n=260例),对照组给予常规护理,观察组在常规护理基础上进行综合护理。采用自行设计的冠心病患者自我管理能力调查表、SAS和SDS评分,比较两组患者干预前及干预后3个月的自我管理能力和心理状态的变化。结果干预前,观察组和对照组的SDS评分分别为(61.22±5.12)分和(60.88±4.52)分,SAS评分分别为(56.46±6.13)分和(56.35±5.42)分,两组患者SDS和SAS评分比较,差异无统计学意义(P>0.05)。干预后,两组SDS评分分别为(40.33±6.45)分和(51.62±4.90)分,均较干预前明显下降(均P<0.05),两组SAS评分分别为(42.11±5.25)分和(49.61±4.71)分,均较干预前明显下降(均P<0.05),而且观察组患者SDS和SAS评分均明显低于对照组(均P<0.05)。另外,干预后,观察组患者在自我管理能力的五个方面均明显优于对照组,分别为自我调节(85.00%vs.51.92%)、适当运动(90.38%vs.65.00%)、控制饮食(93.08%vs.60.00%)、服药管理(93.08%vs.53.85%)和定期复查(96.15%vs.43.08%)(均为P<0.05)。结论综合护理干预能有效提高冠心病患者的自我管理能力,改善冠心病患者的心理状态,对提高冠心病患者的生活质量,增加冠心病患者战胜疾病的信心和面对生活的勇气具有重要的作用。

Objective To explore the effect of comprehensive nursing intervention on self-management ability and psychological state of patients with coronary heart disease （CHD）.nethods Ahogether 520 cases of CHD patients who were treated in our center and Integrated Traditional Chinese and Western Medicine Hospital of Fengtai District fiom January 2015 to May 2016 were selected as the object of this research and randomly divided into observation group （n= 260） and control group （n=260）.The control group was treated with routine nursing,while,the observation group was given comprehensive nursing care based on theroutine nursing.The self-designed self-management ability questionnaire, self-rating anxiety scale （SAS） and self rating depression scale （SDS） of CHD patients were used.The pre-interventional and 3-month post-interventionaXself-management ability and mental state of the two groups were compared.Results The pre-interventional SDS and SAS scores of observation group and control group were （61.22±5.12） points vs.（60.88±4.52） points and （56.46±6.13） points vs.（56.35±5.42） points,without significant difference between the two groups （P〉 0.05）.The post-interventional SDS and SAS scores of observation group and control group were （40.33±6.45） points vs.（51.62±4.90） points and （42.11±5.25） points vs. （49.61± 4.71）points,significantly decreased compared with preintervention ones （P〈0.05）.In addition,the post-interventional self-management ability of patients in observation group was significantly better than that of control group in the five aspects,including self-regulation （85% vs. 51.92%）, proper exercise （90.38% vs. 65.00%）,diet control （93.08% vs. 60%）,medication management （93.08% vs. 53.85%） and periodic review （96.15% vs. 43.08%） （P〈0.05）.Conelusion Comprehensive nursing intervention can effectively promote the self-management ability of patients with CHD,improve the psychological status and the quality of life of CHD patients,which plays an important role in the increase of the CHD patients＇ confidence to overcome the disease and the courage to face life.