健康信念模式对心脏机械瓣膜置换术后患者华法林抗凝管理的影响

Effect of Health Belief Model on Anticoagulation Management of Warfarin in Patients with Cardiac Mechanical Valve Replacement

目的:探讨健康信念模式对心脏机械瓣膜置换术后患者华法林抗凝管理的影响。方法:选取2017年1月1日~2018年12月31日于某三甲医院心外科行心脏机械瓣膜置换术的患者90例,随机分为干预组和对照组各45例;干预组采取健康信念模式,对照组采取常规健康教育;分别于干预前后对两组患者采用自行设计一般资料问卷、华法林抗凝知识问卷、抗凝依从性问卷、社会支持评定量表进行测评。结果:干预后6个月,干预组抗凝知识总得分、抗凝依从性得分均高于对照组(P<0.01);随出院时间延长,干预后6个月对照组社会支持略有下降,干预组社会支持升高,组间比较差异有统计学意义(P<0.01)。结论:健康信念模式教育有助于改善心脏机械瓣膜置换术后患者健康信念,提高患者抗凝认知、依从性及社会支持等水平,有助于进行华法林抗凝管理。

Objective:To investigate the effect of health belief model on the anticoagulation management of warfarin in patients with cardiac mechanical valve replacement.Methods:A total of 90 patients who underwent cardiac mechanical valve replacement from January 1,2017 to December 31,2018 in the department of cardiac surgery in a Grade 3 Class A hospital were randomly divided into the intervention group and the control group with 45 cases each.The intervention group adopted the mode of health belief,and the control group adopted the routine health education.The self-designed general information questionnaire,warfarin anticoagulation knowledge questionnaire,anticoagulation compliance questionnaire and social support rating scale were used to evaluate before and after the intervention for the two groups.Results:Six months after the intervention,the total score of anticoagulation knowledge and the score of anticoagulation compliance in the intervention group were higher than that in the control group(P<0.01).With the extension of discharged time,social support decreased slightly in the control group and increased in the intervention group 6 months after the intervention,with statistically significant differences(P<0.01).Conclusion:Health belief model education can improve the health belief of patients after cardiac mechanical valve replacement,and promote the anticoagulation cognition,compliance and social support of patients.It is helpful for warfarin anticoagulation management.