个体化延续护理对急性心衰患者预后生存质量的影响

Effect of individualized continual nursing on quality of life in patients with acute heart failure after discharge

目的:研究个体化延续护理对急性心衰患者预后的影响,为延续护理措施的长期开展提供理论依据。方法:将2014年9月至2016年3月在我院住院的急性心衰患者86例按照入院时间进行匹配分为试验组(患者出院后接受个体化延续护理)和对照组(患者出院后接受常规随访),各43例,比较2组患者出院后1个月、3个月和5个月患者的遵医行为(遵医服药、停止吸烟、合理饮食)、生存质量、自我护理能力等的差异。结果:2组患者出院后1个月(χ2=6.08,P=0.04)、3个月(χ2=11.73,P=0.00)和5个月(χ2=13.67,P=0.00)遵医行为差异均有统计学意义;2组患者实施不同出院后护理措施后生存质量中生理机能(t=4.65,P=0.00)、一般健康状况(t=12.60,P=0.00)、精力(t=7.18,P=0.00)、社会机能(t=8.75,P=0.00)、情感职能(t=16.09,P=0.00)、精神健康(t=9.06,P=0.00)差异均有统计学意义;2组患者出院后1个月(t=34.26,P=0.00)、3个月(t=75.96,P=0.00)、5个月(t=47.04,P=0.00)自我护理能力差异均有统计学意义;2组患者出院后1个月(χ2=4.50,P=0.03)、3个月(χ2=4.44,P=0.04)、5个月(χ2=5.31,P=0.02)期间再次入院情况差异均有统计学意义。结论:个体化延续护理的实施和干预实现了急性心衰护理的持续性和延伸性,能有效监督患者的遵医行为,提高患者自我护理能力和生存质量,降低患者再次入院率,值得临床推广。

Objective: To investigate the effect of individualized continual nursing on the prognosis of patients with acute heart failure, and to provide a theoretical basis for the long-term development of nursing care. Methods: According to admission time, 86 patients with acute heart failure in our hospital from Sep 2014 to Mar 2016 were divided into experimental group that received individualized continual nursing after discharge and control group that received routine follow-up after discharge, 43 cases in each group. The patients′ compliance behavior, quality of life and self-care ability were compared between the two groups at 1, 3 and 5 months after discharge. Results: There were significant differences in compliance behaviors between the two groups at 1, 3 and 5 months after discharge (all P<0.05). The scores of physiological function, general health status, energy, social function, emotional function and mental health in experimental group were significantly higher than those in control group (all P<0.05). The score of selfcare ability in experimental group was significantly higher than that in control group at 1, 3 and 5 months after discharge (all P<0.05). And the re-admission rate in experimental group was significantly lower than that in control group at 1, 3 and 5 months after discharge (all P<0.05). Conclusion: The application of individualized continual nursing can effectively improve the patient′s compliance behavior, improve the self-care ability and quality of life, and reduce the re-admission rate, which is worthy of clinical promotion.