家庭护理干预对急性心肌梗死患者康复及家属护理能力的影响

Effect of family nursing intervention on rehabilitation and family nursing ability of patients with acute myocardial infarction

目的分析家庭护理干预对家属护理能力及生活质量的影响,为急性心肌梗死患者的临床护理和家庭治疗照护中的延续性护理提供依据。方法收集遂宁市中医院心内科2015年1月至2016年12月收治的183例急性心肌梗死患者为研究对象,按随机数字表法分为研究组(92例)和对照组(91例)。研究组采用家庭护理干预,对照组采用心内科常规护理干预,分析术后两组患者的并发症发生情况、家属护理能力和生活质量的差异。结果研究组患者干预后并发症发生率为17.39%,明显低于对照组的37.36%(χ~2=9.189,P<0.05),研究组干预后梗死后心绞痛发生率显著低于对照组(6.52%vs.18.68%,χ2=6.155,P<0.05),但干预后两组患者在心力衰竭、严重心律失常、死亡、再梗死等方面差异无统计学意义(P>0.05);研究组家属干预前家庭照顾者照顾能力量表(FCTI)评分(8.24±5.01)分明显高于干预后评分(3.97±2.68)分(t=5.368,P<0.05),对照组家属干预前后FCTI评分差异无统计学意义(P>0.05),再者研究组干预后FCTI评分(3.97±2.68)分明显低于对照组干预后评分(6.52±3.25)分(t=3.257,P<0.05),研究组干预前FCTI评分与对照组干预前评分差异无统计学意义(P>0.05);研究组干预前一般健康问卷-28量表(CHQ-28)评分为(6.01±2.33)分明显低于干预后评分(9.25±1.43)分(t=4.825,P<0.05),而对照组在干预前后CHQ-28评分差异无统计学意义(P>0.05),干预后研究组CHQ-28评分(9.25±1.43)分明显高于对照组评分(5.16±2.10)分(t=2.684,P<0.05),但干预前研究组CHQ-28评分与对照组评分差异无统计学意义(P>0.05)。结论采用家庭护理干预,能显著提高家属的护理技能和生活质量,并能有效降低急性心肌梗死患者的临床并发症。

Objective To analyze the effect of family nursing intervention on nursing ability and quality of life of family members,and to provide reference for clinical nursing and transitional care of patients with acute myocardial infarction. Methods A total of 183 patients with acute myocardial infarction admitted to Department of Cardiology,Suining Municipal Hospital of TCM from January 2015 to December2016 were enrolled in the study. The patients were randomly assigned into study group（ n = 92） and control group（ n = 91）. The study group received the family nursing intervention,while the control group received the routine nursing intervention. The complications,family nursing ability and quality of life of the two groups were analyzed. Results The incidence of postoperative complications in the study group was 17. 39%,which was significantly lower than 37. 36% of the control group（ χ^2= 9. 189,P〈0. 05）. The incidence of angina pectoris after the intervention in study group was significantly lower than that of control group（ 6. 52% vs. 18. 68%,χ^2= 6. 155,P〈0. 05）.However,there were no significant differences in heart failure,severe heart rate disorder,death and reinfarction between the two groups after treatment（ P〈0. 05）. The scores of FCTI were significantly decreased after intervention in study group [（ 8. 24 ± 5. 01） vs.（ 3. 97 ±2. 68）,t = 5. 368,P〈0. 05]. The scores of FCTI before and after the intervention in control group were not statistically different（ P〈0. 05）,and the score of FCTI after the intervention in study group was significantly lower than that of the control group [（ 3. 97 ± 2. 68）vs.（ 6. 52 ± 3. 25）,t = 3. 257,P〈0. 05]. There was no significant difference between study group and control group before the intervention（ P〈0. 05）. The score of CHQ-28 was significantly increased after intervention in study group [（ 6. 01 ± 2. 33） vs.（ 9. 25 ± 1. 43）,t =4. 825,P〈0. 05]. The score of CHQ-28 before and after the intervention in control group were not statistically significant（ P〈0. 05）. The scores of CHQ-28 after intervention in study group were significantly higher than those in control group [（ 9. 25 ± 1. 43） vs.（ 5. 16 ±2. 10）,t = 2. 684,P〈0. 05],but CHQ-28 score was no significantly different between control and study group before intervention（ P〈0. 05）. Conclusion The use of home care intervention can significantly improve the nursing skills and quality of life of family members,and can effectively reduce the clinical complications of patients with acute myocardial infarction.