冠状动脉搭桥术围术期双心路径护理模式对患者健康行为的促进效应

Promoting effects of dual heart care mode on patients＇ health behaviors in perioperative period of coronary artery bypass surgery

目的 探讨冠状动脉搭桥术围术期双心路径护理模式对冠状动脉粥样硬化性心脏病患者焦虑、健康促进行为以及心血管不良事件发生率的影响。方法 采用便利抽样法，选取2011 年1 月— 2016 年12 月江苏省盐城市第三人民医院心外科收治的冠状动脉粥样硬化性心脏病患者131 例作为研究对象。根据住院日期将患者分为观察组（2014年1月—2016年12月）和对照组（2011年1月—2013年12月），观察组68 例，对照组63 例。观察组采用双心路径护理模式，对照组采用常规围术期护理措施。比较两组患者焦虑情况、健康促进行为评分以及心血管不良事件发生率。结果 入院当日，两组患者焦虑发生率及SAS 评分差异均无统计学意义（P＞ 0.05）；健康促进行为评分差异无统计学意义（P＞ 0.05）；术前及术后7 d，观察组患者焦虑发生率以及SAS 评分均低于对照组，差异有统计学意义（P ＜ 0.05）。出院前，观察组健康促进行为评分较对照组高，差异有统计学意义（P＜ 0.05）。术后，观察组发生 6 例心血管不良事件，对照组发生17 例，观察组心血管不良事件发生率低于对照组，差异有统计学意义（P＜ 0.05）。结论 双心路径护理模式引导护理人员根据预定护理计划给予围术期患者标准化整体护理与心理护理，使围术期护理工作更规范、更安全，更体现护理人性化，全面提高了护理质量。

Objective To evaluate the effects of dual heart care mode in perioperative period of coronary artery bypass grafting （CABG） surgery on improving health behavior in patients with coronary atherosclerotic heart disease. Methods A total of 131 patients with atherosclerotie heart disease who were treated in the Cardiac Surgery Department of Yancheng Third People＇s Hospital of Jiangsu Province from January 2011 to December 2016 were recruited by convenience sampling method. All the patients were divided into observation group （2014.1-2016.12, n=68）and control group （2011.1-2013.12, n=63）according to the admission date. The observation group was treated with dual heart path nursing mode, while the control group was treated with routine perioperative care. The scores of self-rating anxiety scale （SAS）, health promoting lifestyle profile （HPLP） and the incidence of adverse cardiovascular events were compared between the two groups. Results There was no significant difference in the incidence of anxiety, the scores of SAS and HPLP between the two group on admission （P 〉 0.05）. Before surgery and 7 days after surgery, the incidence of anxiety and the score of SAS of the observation group were all lower than those of the control group, and the difference was statistically significant （P 〈 0.05）. The score of HPLP of the observation group was higher than that of the control group before discharge, and the difference was statistically significant （P 〈 0.05）. After surgery, there were 6 cases of adverse cardiovascular events in the observation group, and 17 cases in the control group. The incidence of adverse cardiovascular events in the observation group was significantly lower than that in the control group, with statistical significant difference （P 〈 0.05）. Conclusions Dual heart path nursing mode guides nurses to give standardized perioperative holistic nursing and psychological nursing according to predetermined care plan, so that the perioperative nursing work is more standardized, more secure and more humanized. In conclusion, it improves the quality of nursing overall.