延续性护理干预对急性心肌梗死患者经皮冠状动脉介入术术后服药依从性及不良情绪的影响

Influence of continuous nursing intervention on medication compliance and negative emotion of patients with acute myocardial infarction after percutaneous coronary intervention

目的 探讨出院后延续性护理对急性心肌梗死患者经皮冠状动脉介入术术后患者服药依从性及不良情绪的影响.方法 选择急性心肌梗死经皮冠状动脉介入术术后患者168例,采用掷币法结合随机对照表分为两组,即：予以延续性护理者归为观察组,予以常规护理措施者归为对照组,观察不同时间段两组患者的服药依从性以及不良情绪、生活质量改变情况.结果 对不同时间段患者的相关数据采用重复测量数据方差分析,出院3个月、6个月以及1年后,与对照组比较,观察组的服药依从性增加明显,SAS、SDS评分则降低明显,差异均统计学意义（t=1.432、2.781、5.683、2.451、2.504、3.783,2.761、4.621、4.884,均P〈0.05）.进一步对数据进行组间效应、时间效应、交互效应分析可见,随着出院时间的延长,两组患者的服药依从性与SAS、SDS评分差异渐趋显著（F=30.258,P 〈0.01;F=2.673,P〈0.05;F =2.024,P 〈0.05）.住院时,两组患者的各项生活质量评分差异均无统计学意义（t=1.250、1.250、1.654、1.334、0.694、1.113、2.463,均P〉0.05）;出院1年后,与对照组比较,观察组患者的运动和锻炼、人际间关系、营养、健康责任、自我实现、压力管理评分均增加明显,差异均有统计学意义（t=2.463、3.146、2.904、2.982、2.633、2.115;均P〈0.05）.结论 延续性护理可较好地提高急性心肌梗死患者经皮冠状动脉介入术术后患者的服药依从性,降低不良情绪的发生,提高患者的生活质量.

Objective To explore the effects of post-discharge continuous nursing intervention on medication compliance and negative emotion of patients with acute myocardial infarction after percutaneous coronary intervention （PCI）.Methods 168 patients with acute myocardial infarction were selected.All of them got emergency PCI after admitted.Then,they were simply randomized into observation group （84 cases） and control group （84 cases） using coin toss method combined with random comparison table.The observation group accepted continuous nursing intervention after discharged,including regular home visits,telephone feedback and clinical visits.The control group got a regular clinical follow-up.Their medication compliance and negative emotion were investigated after 1 month,3 months,6 months and 12 months from discharged,respectively.Results Relevant data with different periods of patients with repeated measurement data analysis of variance,discharge for 3 months,6 months and 1 year,compared with the control group,the medication compliance of the observation group increased obviously,the SAS and SDS scores decreased obviously,the differences were statistically significant （t =1.432,2.781,1.432,2.781,2.504,3.783,2.761,4.621,4.884,all P 〈 0.05）.Further analysis of the data between inter group effect,time effect,inter action effect showed that with the extension of the discharge time,the medication compliance and SAS,SDS scores of the two groups were significantly different （F =30.258,P 〈 0.01;F =2.673,P 〈 0.05;F =2.024,P 〈 0.05）.In hospital,there were no statistically significant differences in the quality of life of patients between the two groups（t =1.250,1.250,1.250,1.250,0.694,1.113,2.463,all P 〉 0.05）.1 year after discharge,compared with the control group,the movement and exercise,interpersonal relationships,nutrition,health responsibility,self-actualization,stress management scores in the observation group significantly increased,the differences were statistically significant （t =2.463,3.146,2.463,3.146,2.633,2.115,all P 〈 0.05）.Conclusion Continuous nursing interventions can effectively reduce acute myocardial infarction patients＆#39;anxiety and depression after PCI,improve their compliance and prevent recurrent cardiovascular events.