三位一体护理管理模式在慢性心衰院外延续性护理中的应用价值

Application value of trinity nursing management model in extra-hospital continuous nursing of chronic heart failure

目的探讨三位一体护理管理模式在慢性心衰院外延续性护理中的应用价值。方法选取我院2015年6月至2018年6月收治的慢性心衰患者96例,根据随机数字表法将其分为对照组(n=48)和观察组(n=48)。对照组采用常规延续性护理管理,观察组采用三位一体护理管理模式。比较两组出院后3个月的急诊就诊率、再入院率;采用欧洲心衰自护行为量表(EHFSCB-9)评估患者出院时、护理3个月后的自护行为,观察两组蒙特利尔认知评估量表(MoCA)、服药依从性(MORISKY)评分差异,采用明尼苏达心衰生活质量问卷(MLHFQ)评估患者生活质量。结果观察组急诊就诊率、再住院率均为4.17%,低于对照组的18.75%、16.67%,差异具有统计学意义(P<0.05)。出院时,两组EHFSCB-9、MoCA、MORISKY评分比较,差异无统计学意义(P>0.05);护理后,观察组EHFSCB-9评分低于对照组,MoCA、MORISKY评分高于对照组,差异具有统计学意义(P<0.05)。护理后,观察组躯体领域、情感领域、症状领域评分及总分均低于对照组,差异具有统计学意义(P<0.05)。结论慢性心衰患者接受三位一体管理模式的延续性护理能降低急诊就诊率、再住院率,进一步改善患者的自护能力与生活质量。

Objective To explore the application value of trinity nursing management model in extra-hospital continuous nursing of chronic heart failure.Methods Ninety-six chronic heart failure patients admitted in our hospital from June 2015 to June 2018 were selected and divided into control group(n=48)and observation group(n=48)according to the random number table method.The control group adopted routine continuous nursing management,while the observation group adopted trinity nursing management model.The emergency visits rate and readmission rate after 3 months of discharge were compared between the two groups.European heart failure self-care behavior scale(EHFSCB-9)was used to evaluate the self-care behavior of patients at discharge and after 3 months of nursing.The score difference of the montreal cognitive assessment scale(MoCA)and medication adherence(MORISKY)between the two groups were observed.The quality of life was assessed by minnesota heart failure quality of life questionnaire(MLHFQ).Results The emergency visits rate and readmission rate of the observation group were 4.17%,which were lower than 18.75%and 16.67%of the control group respectively,and the differences were statistically significant(P<0.05).At discharge,there were no differences in the scores of EHFSCB-9,MoCA and MORISKY between the two groups(P>0.05);after nursing,the EHFSCB-9 score in the observation group was lower than that in the control group,the MoCA and MORISKY score were higher than those in the control group,and the differences were statistically significant(P<0.05).After nursing,the scores of body field,emotion field,symptom field and total scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Continuous nursing of chronic heart failure patients with trinity management model can reduce the emergency visits rate and readmission rate,and further improve the self-care ability and quality of life of patients.