慢性心力衰竭患者医院、社区、家庭一体化管理模式研究

Research on integrated management mode of hospital,community and family for patients with chronic heart failure

目的研究慢性心力衰竭患者医院、社区、家庭一体化管理模式的应用效果。方法选取2013年1月至2015年1月辖区内400例慢性心力衰竭患者作为研究对象,随机分为对照组100例、观察1组100例、观察2组100例、观察3组100例,分析其疾病健康知识知晓、依从性、抑郁状况、生活质量等评分和美国纽约心脏病协会(NYHA)心功能分级,研究不同条件下患者的健康情况。结果观察1组、观察2组、观察3组患者疾病健康知识知晓、依从性、抑郁状况、生活质量评分均优于对照组,差异均有统计学意义(P<0.05);观察3组各项评分均优于观察1组和观察2组,差异均有统计学意义(P<0.05)。在NYHA心功能分级方面,观察1组、观察2组、观察3组患者心功能Ⅰ~Ⅱ级比例均明显高于对照组,心功能Ⅲ~Ⅳ级比例均明显低于对照组,差异均有统计学意义(P<0.05);观察3组Ⅰ~Ⅱ级比例明显高于观察1组和观察2组,差异均有统计学意义(P<0.05)。结论慢性心力衰竭患者实施医院、社区、家庭一体化管理模式,效果明显,有利于改善患者的生活质量,促进患者的健康恢复。

Objective To study the application effect of integrated management model for hospitals,communities and families of patients with chronic heart failure.Methods A total of 400 patients with chronic heart failure in the jurisdiction from January 2013 to January 2015 were selected as the research subjects and randomly divided into the control group(n=100),observation group 1(n=100),observation group 2(n=100)and observation group 3(n=100).Then the scores of awareness of disease health knowledge,compliance,depression status and quality of life and the heart function classification of the New York Heart Association(NYHA)were analyzed.The health situation of the patients under different conditions was researched.Results The scores of awareness of disease health knowledge,compliance,depression status and quality of life in the observation group,1,2,3 were superior to those in the control group,and the differences were statistically significant(P<0.05);the scores in the observation group 3 were superior to those in the observation group 1 and 2,and the differences were statistically significant(P<0.05).In the aspect of NYHA heart function grade,the proportion of gradeⅠ-Ⅱin the observation group1,2,3 was significantly higher than that in the control group,and the difference was statistically significant(P<0.05),while the proportion of the heart function gradeⅢ-Ⅳwas significantly lower than that in the control group,and the difference was statistically significant(P<0.05);the proportion of the gradeⅠ-Ⅱin the observation group 3 was significantly higher than that in the observation group 1 and 2,and the differences were statistically significant(P<0.05).Conclusion Implementing the integrated management mode of hospital,community and family in the patients with chronic heart failure has the obvious effect and is conducive to improve the quality of life in the patients and promote the health recovery of the patients.