三主体双轨道院外干预模式对老年慢性心力衰竭的影响

Effect of three-subject and dual-track out-of-hospital intervention in elderly patients with chronic heart failure

目的探讨三主体双轨道院外干预模式对老年慢性心力衰竭患者的影响。方法纳入2017年9月至2018年9月我院98例老年慢性心力衰竭患者,按所属社区分为观察组51例和对照组47例。对照组接受双主体单轨道院外干预,观察组接受三主体双轨道院外干预。分别于出院前、出院6个月后评测患者欧洲心力衰竭自我护理行为量表(EHFSCBS)及慢性病自我效能量表(CDSES)得分、6 min步行距离、静息心率。结果出院前,2组患者各项指标比较差异均无统计学意义(P>0.05)。出院6个月后,观察组患者EHFSCBS得分、静息心率低于对照组,CESES得分高于对照组,6 min步行距离高于对照组,差异均有统计学意义(P<0.05)。2组再入院及病死率比较,差异均无统计学意义(P>0.05)。结论三主体双轨道院外干预模式有助于提升老年慢性心力衰竭患者自我护理能力及自我效能,并改善其运动耐力。

Objective To investigate the effect of three-subject and dual-track out-of-hospital intervention in elderly patients with chronic heart failure. Methods A total of 98 elderly patients with chronic heart failure admitted to our hospital from September 2017 to September 2018 were included in the study. All patients were divided into the study group(n=51) and the control group(n=47) according to their communities. The control group received two-subject and single-track out-of-hospital intervention, while the study group received three-subject and dual-track out-ofhospital intervention. The scores of European heart failure self-care behavior scale(EHFSCBS) and the chronic disease self-efficacy scale(CDSES), the 6-min walking distance and resting heart rate at the baseline before discharged home and at 6 months after discharged home were determined, respectively. Results There were no statistically significant differences in the indexes between the two groups at the baseline before discharged home( P>0.05). At 6 months after discharged home, the EHFSCBS scores and resting heart rate in the study group were lower than those in the control group, whereas the CDSES scores and 6-min walking distance were higher than those in the control group,with statistically significant differences(all P<0.05). There were no significant differences in the readmission rate and mortality between the two groups(both P>0.05). Conclusion The three-subject and dual-track out-of-hospital intervention favors the self-care ability and self-efficacy in elderly patients with chronic heart failure, and it may improve their exercise tolerance.