心理干预及健康教育对冠心病心绞痛病人生活质量影响的系统评价

Systematic review on effect of psychological intervention and health education on quality of life in patients with coronary heart disease and angina pectoris

[目的]系统评价心理干预及健康教育对冠心病心绞痛病人生活质量的疗效,为临床护理提供循证依据。[方法]检索相关数据库,分析软件为RevMan 5.3,对与本研究相关的随机对照试验(RCT)研究中收集的数据进行综合分析。[结果]采用生活质量量表(SF-36)评价病人的生活质量,随机效应模型结果显示,与对照组相比,干预组病人生活质量明显得到改善,社会功能[MD=14.09,95%CI(12.61,15.58),P<0.00001]、睡眠质量[MD=3.35,95%CI(2.71,3.99),P<0.00001]、自我管理[MD=9.97,95%CI(9.05,10.89),P<0.00001]、生理功能[MD=11.11,95%CI(9.17,13.05),P<0.00001];采用西雅图心绞痛调查量表进行评价,随机效应模型结果显示,与对照组相比,干预组病人生活质量得到明显改善,身体活动受限度[MD=7.34,95%CI(6.41,8.26),P<0.00001]、疾病认知度[MD=1.80,95%CI(1.52,2.08),P<0.00001]、心绞痛发作[MD=0.79,95%CI(0.50,1.08),P<0.00001]、心绞痛稳定[MD=0.51,95%CI(0.44,0.57),P<0.00001]、治疗满意度[MD=2.39,95%CI(0.87,3.91),P=0.002]。[结论]在常规治疗护理的基础上对冠心病心绞痛病人给予心理干预及健康教育,可有效改善病人的生活质量,具有良好的临床应用价值。

Objective:To systematically evaluate the effect of psychological intervention and health education on quality of life in patients with coronary heart disease and angina,and to provide evidence-based basis for clinical nursing.Methods:Computer-research related databases were used to perform meta-analysis of the data collected from randomized controlled trials(RCT)related to this study using RevMan 5.3 software.Results:The quality of life scale(SF-36)was used to evaluate the patient′s quality of life.The random effects model showed that compared with the control group,the quality of life of the patients in intervention group was significantly improved including the social function[MD=14.09,95%CI(12.61,15.58),P<0.00001],sleep quality[MD=3.35,95%CI(2.71,3.99),P<0.00001],self-management[MD=9.97,95%CI(9.05,10.89),P<0.00001],physiological function[MD=11.11,95%CI(9.17,13.05),P<0.00001].The evaluation was performed using the Seattle Angina Survey Scale,the results of the random effects model showed that the quality of life of patients in the intervention group was significantly improved compared with the control group including degree of physical activity limitation[MD=7.34,95%CI(6.41,8.26),P<0.00001],degree of disease cognition[MD=1.80,95%CI(1.52,2.08),P<0.00001],incidence of angina pectoris[MD=0.79,95%CI(0.50,1.08),P<0.00001],angina stability[MD=0.51,95%CI(0.44,0.57),P<0.00001],treatment satisfaction[MD=2.39,95%CI(0.87,3.91),P=0.002].Conclusions:On the basis of routine treatment and nursing care,psychological intervention and health education for patients with coronary heart disease and angina pectoris can effectively improve the quality of life of patients and have good clinical application value.