居家式自我护理对老年慢性心衰患者心功能及自护能力的影响

Effects of home-based self-care on cardiac function and self-care ability in elderly patients with chronic heart failure

目的探讨居家式自我护理对老年慢性心力衰竭患者心功能及自护能力的影响。方法选取该院2015年10月~2017年2月收治的老年慢性心力衰竭患者108例为研究对象,采用随机数字法将其分为对照组和观察组,各54例。对照组患者接受常规护理干预,观察组患者在此基础上接受居家式自我护理干预。比较两组患者出院时和出院后3个月的心功能、生活质量和自护能力,同时比较出院后不良事件发生率和再次住院率。结果出院后3个月,观察组的自护技能、按时复查、自我概念及自我责任感评分比较均明显高于对照组,差异有统计学意义(均P<0.01),LVEF、CO及6MWT值均明显高于对照组,差异有统计学意义(均P<0.01),GH、PF、SF及MH值均明显高于对照组,差异有统计学意义(均P<0.01);出院后3个月内,观察组心衰发生率明显低于对照组,差异有统计学意义(均P<0.01),再次住院率明显低于对照组,差异有统计学意义(均P<0.01)。结论居家式自我护理能够明显提高老年慢性心衰患者预后质量,促进心功能和生活质量恢复,提高患者自护能力,并能降低出院后不良事件风险,值得在临床推广。

Objective To explore the effect of home-based self-care on cardiac function and self-care ability in elderly patients with chronic heart failure. Methods A total of 108 elderly patients with chronic heart failure admitted to the hospital from October 2015 to February 2017 were selected as the research objects.They were divided into control group and observation group by random number method with 54 cases each.Patients in the control group received routine nursing intervention.Patients in the observation group received home-based self-nursing intervention on this basis.Cardiac function, quality of life, and self-care ability at discharge and 3 months after discharge were compared between the two groups, and the incidence of adverse events after discharge and the rate of re-hospitalization were also compared. Results Three months after discharge, the self-care skills, regular review, self-concept and self-responsibility scores of the observation group were significantly higher than those of the control group, and the differences were statistically significant(P<0.01). LVEF, CO and 6MWT values were significantly higher than the control group, and the differences were statistically significant(P<0.01). GH, PF, SF and MH values were significantly higher than the control group, and the differences were statistically signifiant(P<0.01). The incidence of heart failure in the observation group was significantly lower than that in the control group within 3 months after discharge, and the difference was statistically significant(P<0.01). The rate of re-hospitalization was significantly lower than the control group, and the differences were statistically significant(P<0.01). Conclusions Home-based self-care can significantly improve the prognosis quality of elderly patients with chronic heart failure, promote the recovery of cardiac function and quality of life, improve patients' self-care ability, and reduce the risk of adverse events after discharge, which is worthy of clinical promotion.