信息-动机-行为技巧模型在心肌梗死急诊PCI术后护理管理中的应用

APPLICATION OF INFORMATION-MOTIVATION-BEHAVIORAL SKILLS MODEL IN NURSING MANAGEMENT OF PATIENTS WITH MYOCARDIAL INFARCTION AFTER EMERGENCY PCI

目的建立以信息-动机-行为技巧模型(IMB)为基础的心肌梗死急诊经皮冠状动脉介入(PCI)术后护理管理模式,探讨其对改善患者预后的价值。方法将2016年3月—2017年3月成功接受急诊PCI的120例心肌梗死患者随机均分为观察组和对照组,各60例。对照组采用常规延续护理模式进行干预,观察组采用以IMB为基础的延续护理模式进行干预。出院12个月后,对比二组患者服药依从性、戒烟、血糖、血压及血脂达标情况、心脏不良事件再发情况。结果观察组出院9个月、12个月时服药依从性明显好于对照组,观察组出院12个月时,血糖、血压及血脂达标率均明显高于对照组,观察组出院12个月内心绞痛、心肌梗死再发率明显低于对照组,上述差异均有统计学意义(P<0.05)。结论以IMB为基础的延续护理模式应用于心肌梗死急症PCI术后患者,能够有效改善患者用药依从性,提升其血糖、血压及血脂控制效果,并改善其预后。

Objective To establish a nursing management mode for patients with myocardial infarction after emergency percutaneous coronary intervention（PCI）based on the information-motivation-behavioral skills model（IMB）,and to evaluate the value of the nursing management mode to improve the prognosis of the patients.Methods A total of 120 patients with acute myocardial infarction treated with PCI successfully during March 2016 to March 2017 were randomly divided into the observation group and the control group,with 60 cases in each group.The control group was intervened by routine continuation nursing mode,while the observation group was intervened by IMD based continuing nursing mode.Twelve months after discharge,the medication compliance,the standard-reaching rate of smoking-quitting,blood glucose,blood pressure and blood lipid,and the recurrence of adverse cardiac events were observed and compared between the two groups.Results The medication compliance in the observation group was better than that in the control group at 9 and12 months after discharge.The standard-reaching rate of blood glucose,blood pressure and blood lipid in the observation group were also higher than those in the control group at 12 months after discharge.The recurrence rate of angina pectoris and myocardial infarctions in the observation group were significantly lower than those in the control group within 12 months after discharge.These differences were all statistically significant（P〈0.05）.Conclusion Continuous nursing mode based on IMB for patients with acute myocardial infarction after PCI can effectively improve the patient′s compliance,improve the control effect of blood glucose,blood pressure and blood lipid,and can improve their prognosis.