延续性护理对慢性心衰竭患者自我效能、依从性及再住院率的影响

Effect of transitional care on the self-efficacy,medicine adherence and readmission rates in patients with chronic heart failure

目的探讨延续性护理对慢性心力衰竭(CHF)患者自我效能、依从性以及在住院率的影响。方法将CHF患者104例随机分为观察组与对照组,各52例。对照组实施常规护理,观察组实施院后延续性护理。出院前及出院后6个月,评价并比较两组的服药依从性、自我护理能力、一般自我效能、明尼苏达心力衰竭生活质量量表(MLHFQ)、综合性医院焦虑-抑郁量表(HAD)及再住院率等指标。结果出院后6个月,观察组的服药依从性、自我护理能力、MLHFQ、一般自我效能评分均显著高于出院前及对照组,HAD焦虑亚量表(HADA)和抑郁亚量表(HADD)评分均显著低于出院前及对照组(P<0.05);出院后3和6个月,观察组的再住院率分别为3.85%、17.31%,均显著低于对照组的13.46%、36.54%(P<0.05)。结论延续性护理能够增强CHF患者的依从性、自我护理能力及自我效能,改善生活质量,降低再住院率。

Objective To investigate the transitional care on the self-efficacy,medicine adherence and readmission rates in patients with chronic heart failure（CHF）. Methods Totally 104 patients with CHF were randomly divided into observation group and control group,52 cases in each group. Routine care was provided to the control group,while the transitional care was provided to the observation group. Before and 6 months after discharge,the medicine adherence,self-care ability,general self-efficacy,readmission rates,the scores of Minnesota Heart Failure Quality of Life Scale（MLHFQ）and Hospital Anxiety-Depression Scale（HAD）between the two groups were compared. Results After 6 months since they were released from hospital,the scores of medicine adherence,self-care ability,general self-efficacy and MLHFQ in the observation group were significantly higher than those in the control group,the scores of HADA and HADD in the observation group were significantly lower than those in the control group.（P〈0.05）;3 and 6 months after discharge,the readmission rates were 3.85% and 13.46% in observation group,which significantly lower than 13.46% and 36.54% in the control group（P〈0.05）. Conclusion Transitional care can enhance the medicine adherence,self-care ability and self-efficacy of CHF patients,improve the quality of life and reduce the readmission rates.