动机性访谈在心房颤动患者华法林抗凝治疗中的应用

Application of motivational interviewing in atrial fibrillation patients with warfarin therapy for anticoagulation

目的探讨动机性访谈(MI)在心房颤动(房颤)患者华法林抗凝治疗中的应用效果。方法选取房颤而行华法林抗凝治疗效果不稳定的患者80例,采用随机数字法将患者分为观察组和对照组。对照组失访2例,最终确定观察组40例,对照组38例。观察组患者实施MI,对照组接受常规自我管理健康教育。观察2组干预前后自我管理行为变化及国际标准化比值(INR)监测达标率。结果对照组患者在出院后的1、3、6个月自我管理能力评分下降,而观察组患者在出院时及出院后1、3、6个月自我管理能力评分上升,显著高于对照组(P<0.01)。观察组INR监测达标率为76.65%,高于对照组的68.97%(P<0.05)。结论实施MI能够提高行华法林抗凝治疗房颤患者的自我管理能力,确保抗凝治疗的稳定性。

Objective To investigate the effect of motivational interviewing(MI)in atrial fibrillation patients with warfarin therapy for anticoagulation.Methods Totally 80 atrial fibrillation patients with warfarin therapy for anticoagulation were assigned to the observation group(n=40)and the control group(n=38,2 cases lost to follow-up).Patients in the control group received routine health education during warfarin therapy,and those in the observation group were given MI.The ability of self-management was evaluated before and after the intervention,and the rate of achieving optimal International standardized ratio(INR)was compared between two groups.Results The score of self-management assessment was increased in the observation at discharge from hospital and 1,3,6 months after discharge,and was higher than that in the control group after discharge from hospital(P<0.01).The rate of achieving optimal INR was 76.65%in the observation group and 68.97%in the control group,with a significant difference(P<0.05).Conclusion The MI is potentially effective to improve the self-management skills of atrial fibrillation patients with warfarin therapy for anticoagulation,in order to ensure efficacy of anticoagulation.