基于中医特色的延续护理对空巢老年高血压患者心理状态及生命质量的影响

Effect of extended nursing based on traditional Chinese medicine characteristics to mental status and quality of life in empty nest elderly patients with hypertension

目的探讨中医特色的延续护理干预对空巢老年高血压患者心理状态及生命质量的影响,为空巢老年高血压患者延续护理的发展提供循证理论依据。方法将100例空巢老年高血压患者按随机数字表法分为研究组和对照组各50例;2组患者住院期间均按医嘱给予调整血压药物及高血压病常规护理,对照组患者出院后给予常规延续护理干预,研究组患者在对照组的基础上给予中医特色的延续护理干预;用Zung焦虑自评量表(SAS)测量2组入院时、出院时、出院6个月的焦虑程度,比较2组入院时、出院时、出院6个月血压控制达标率及出院时、出院6个月临床疗效,出院后6个月心脑血管事件发生率,用简明健康调查量表(SF-36)评定2组入院时、出院时、出院6个月的生命质量。结果2组入院时、出院时SAS评分比较差异均无统计学意义(P>0.05),出院6个月研究组SAS评分(44.65±4.32)分,明显低于对照组的(46.91±4.56)分,差异有统计学意义(t=2.544,P=0.006);2组入院时、出院时收缩压、舒张压控制达标率比较差异均无统计学意义(P>0.05);出院6个月研究组收缩压、舒张压控制达标率均优于对照组(t=4.762、4.336,P=0.029、0.037);2组出院时临床疗效比较差异无统计学意义(P>0.05),出院6个月研究组患者临床疗效优于对照组(u=1.997,P=0.046);2组入院时、出院时SF-36各维度得分比较差异无统计学意义(P>0.05);出院6个月研究组SF-36各维度得分明显优于对照组(t=4.875~8.975,P均=0.000);出院6个月研究组无心脑血管事件发生,对照组发生不稳定性心绞痛4例,脑梗死2例,心脑血管事件发生率为12.00%(6/50),2组比较差异有统计学意义(χ^2=4.433,P=0.035)。结论中医特色的延续护理干预,能显著改善空巢老年高血压患者焦虑水平,利于血压的控制,提高临床疗效,降低心脑血管事件发生率,提高患者生命质量,且具有简便、安全可靠、价格低廉等优势,值得推广应用。

Objective To explore the effect of continuing nursing intervention with traditional Chinese medicine(TCM)characteristics on mental state and quality of life of empty nest elderly patients with hypertension,and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension.Methods Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method,50 cases in each group;two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension;control group patients were given routine continuing nursing intervention after discharge;study group patients were given traditional Chinese medicine characteristics on the basis of the control group.Sustained nursing intervention;Self-rating Anxiety Scale(SAS)was used to measure the degree of anxiety at admission,discharge and 6 months after discharge.The rate of blood pressure control reaching the standard at admission,discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups.SF-36 was used to assess the quality of life of the 2 groups at admission,at the time of discharge and 6 months after discharge.Results There was no significant difference in SAS scores between the two groups at admission and discharge(P>0.05).The SAS score in the study group at 6 months after discharge was(44.65±4.32)points and(46.91±4.56)points in the control group,and there was significant difference(t=2.544,P=0.006).There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge(P>0.05).The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge(t=4.762,4.336,P=0.029,0.037);there was no significant difference in the clinical efficacy between the two groups at discharge(P>0.05),and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group(u=1.997,P=0.046).There was no significant difference in the scores of SF-36 at discharge(P>0.05);the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group(t=4.875-8.975,P=0.000);no cardiovascular and cerebrovascular events occurred in the study group for 6 months,4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group.In 2 cases,the incidence of cardiovascular and cerebrovascular events was 12.00%(6/50).The difference between the two groups was statistically significant(χ^2=4.433,P=0.035).Conclusion Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension,is conducive to the control of blood pressure,improve the clinical efficacy,reduce the incidence of cardiovascular and cerebrovascular events,improve the quality of life of patients,and has the advantages of simplicity,safety and reliability,low cost,and so on.It is worth popularizing and applying.