循证护理对老年冠心病患者负性情感及日常行为的影响

Influence of evidence based nursing strategies on negative emotion and daily behavior in aged patients with coronary heart disease

目的:探究基于循证医学理念为导向的护理对老年冠心病(CHD)患者负性情感及日常行为的影响。方法:选择2012年10月~2015年3月期间我院心内科收治的88例CHD患者,根据随机数字表法被随机均分常规护理组和循证护理组(在常规护理组基础上接受循证护理)。测量比较两组患者在干预前及干预4周后的不良生活方式情况、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、护理满意度及主要不良心血管事件(MACE)发生率。结果:与常规护理组比较,干预4周后,循证护理组吸烟(40.9%比22.7%)、饮酒(54.5%比38.6%)、高脂饮食(43.2%比29.5%)、缺乏运动(45.5%比25.0%)、体重超标(52.3%比29.5%)比例、SAS评分[(50.4±3.3)分比(45.8±3.2)分]、SDS评分[(53.4±4.7)分比(48.0±4.2)分]、以及MACE发生率(25.0%比11.4%)均显著降低,护理满意度(86.4%比97.7%)显著升高(除超重的P为<0.01外,余均P<0.05)。结论:循证护理模式对于老年冠心病患者,能有效改善其不良生活方式,且能缓解其消极情感,值得在临床上推广。

Objective： To explore influence of nursing strategies based on evidence based medical theory on negative emotion and daily behavior in aged patients with coronary heart disease （CHD）. Methods： A total of 88 CHD patients, who were treated in our department from Oct 2012 to Mar 2015, were selected. According to random number table, they were randomly and equally divided into routine nursing group and evidence based nursing group （received evidence based nursing based on routine nursing group）. Unhealthy lifestyles, scores of self-rating anxiety scale （SAS） and self-rating depression scale （SDS）, satisfaction for nursing and incidence rate of major adverse cardiovas- cular events （MACE） were measured and compared between two groups before and four months after intervention. Results： Compared with routine nursing group after four-week intervention, there were significant reductions in per- centages of smoking （40.9% vs. 22.7%）, drinking （54. 5% vs. 38.6%）, high-fat diet （43.2% vs. 29.5%）, physi- cal inactivity （45.5% vs. 25.0%） and overweight （52.3% vs. 29.5%）, scores of SAS [- （50.4 ± 3.3） scores vs. （45.8 ± 3.2） scores] and SDS [ （53.4 ± 4. 7） scores vs. （48. 0 ± 4. 2） scores], and incidence rate of MACE （25.0% vs. 11.4%）, and significant rise in satisfaction for nursing （86.4% vs. 97.7%） in evidence based nursing group （ except for the P of overweight was d0.01, others were P〈0.05 all）. Conclusion： Evidence based nursing mode can improve unhealthy lifestyle and relieve negative emotional status in aged patients with coronary heart disease, which is worth extending in clinic.