预见性护理联合心理干预对冠心病心肌缺血患者自我负担感受、心理状态及生活质量的影响

Effects of Predictive Nursing Combined with Psychological Intervention on Self-perceived Burden, Psychological Status and Quality of Life in Patients with Myocardial Ischemia of Coronary Heart Disease

目的探讨预见性护理联合心理干预对冠心病心肌缺血患者自我负担感受、心理状态及生活质量的影响。方法选取2016年10月~2017年10月在我院就诊的800例冠心病心肌缺血患者,按区划随机化设计分组,依次为观察组(n=400)和对照组(n=400),两组行常规临床路径护理,对照组给与心理干预,观察组则辅以预见性护理,比较两组患者护理前后的焦虑(SAS)、抑郁(SDS)评分、自尊量表(SES)评分、生活质量量表(SF-36)评分、心绞痛和心肌梗死发生率。结果护理干预前,两组患者SAS、SDS、SES、SF-36评分比较差异均无统计学意义(P>0.05),干预后,观察组SAS、SDS评分显著较对照组低,SES、SF-36评分明显较对照组高(均P<0.001);观察组心绞痛和心肌梗死发生率明显低于对照组(P<0.05)。结论预见性护理联合心理干预能有效减轻冠心病心肌缺血患者的焦虑、抑郁及自我负担感,增强其自尊感,降低心绞痛和心肌梗死发生率,从而提高其生活质量。

Objective Toexplore effects of predictive nursing combined with psychological intervention on self-perceived burden(SPB), psychological status and quality of life in patients with myocardial ischemia of coronary heart disease(CHD). Methods 800 patients with CHDmyocardial ischemiawho were treated in the hospital from October 2016 to October 2017 were enrolled. They were divided into observation group(n=400) and control group(n=400) by regionalization randomization design. Both groups underwent routine clinical pathway nursing.The control group was given psychological intervention, while observation group was supplemented with predictive nursing. The scores of self-rating anxiety scale(SAS), self-rating depression scale(SDS), self-esteem scale(SES) and short form 36 health survey(SF-36), incidence of anginaand myocardial infarction before and after nursing were compared between the two groups. Results Before nursing intervention, there was no significant difference in SAS, SDS, SES or SF-36 score between the two groups(P>0.05). After intervention, SAS and SDS scores of observation group were significantly lower than those of control group, while SES and SF-36 scores were significantly higher than those of control group(P<0.001).The incidence of angina and myocardial infarction in observation groupwas significantly lower than that in control group(P<0.05). Conclusion Predictive nursing combined with psychological intervention can effectively alleviate anxiety, depression and SPB of patients with CHDmyocardial ischemia, enhance their self-esteem, reduce incidence of angina and myocardial infarction, thus improving their quality of life.