以时机理论为指导的护理干预对老年慢性心力衰竭患者心功能和情绪的影响

Influence of nursing intervention based on ＂Timing It Right＂ on heart function and emotion in elder patients with chronic heart failure

目的观察以时机理论为指导的护理干预对老年慢性心力衰竭（CHF）患者心功能和情绪的影响。方法选取2016年1月-2017年1月河南省南阳市中心医院心内科住院的老年CHF患者100例，采用随机数字表法分为对照组和观察组，每组50例。对照组接受心内科常规护理和随访，观察组给予基于时机理论的护理干预，两组均干预12周。采用左室射血分数（LVEF％）、血B型钠尿肽（NT-proBNP）、心输出量及中文版简明心境量表（BPOMS）评价干预前后两组的心功能和情绪状况变化。结果干预后，两组患者心功能和情绪状况均有改善，观察组干预后LVEF（59．65±2．29）％、NT-proBNP（249．21±58．79）ng／L及心输出量（5．72±1．10）L／min，与对照组比较，差异有统计学意义“值分别为-28．473、8．473、-5．505；P〈0．05）。干预后对照组BPOMS量表总分（25．55±4．41）分，观察组（22．62±5．40）分，观察组优于对照组，差异有统计学意义（t=2．878，P〈0．05）。结论在老年CHF患者中实施以时机理论为指导的护理干预方式可以提高患者的心功能，改善患者的情绪状况，效果较常规的护理干预方式更明显。

Objective To observe the influence of nursing intervention on heart function and emotion in eider patients with chronic heart failure （CHF） based on ＂Timing It Right＂. Methods A total of 100 eider patient with CHF in Nanyang City Center Hospital from January 2016 to January 2017 were recruited, and divided into control group and observation group by random number table method, with 50 cases in each group. The control group received routine care and follow-up, while the observation group received routine care and nursing intervention base on ＂Timing It Right＂ for 12 weeks. The heart function and emotion were compared between those two group at before and after nursing intervention by LVEF%, NT-proBNP, heart output and Chinese version of Brief Profile of Mood States （BPOMS）. Results The patients＇ heart function and emotion of both groups improved after intervention. After intervention, the LVEF%, NT-proBNP and heart output of the observation group were （59.65 ± 2.29）%, （249.21 ±58.79） ng/L and （5.72 ± 1.10）L/min, the differences compared with the control group were statistically significant （t=-28.473, 8.473, -5.505; P 〈 0.05）. The total score of BPOMS of the control group and the observation group was （25.55 ± 4.41） and （22.62 ±5.40） respectively （t=2.878, P 〈 0.05）. Conclusions Nursing intervention based on ＂Timing It Right＂ can improve patient＇s heart function and emotion in elderly patients with CHF, which has better effect then routine nursing intervention.