个体需求导向的生理-心理维度协同式护理对老年慢性心力衰竭伴心律失常患者心理状态及生活质量的影响

Effect of individual demand-oriented physiological-psychological dimension cooperative nursing on psychological state and quality of life of elderly patients with chronic heart failure complicated with arrhythmia

目的探讨个体需求导向的生理-心理维度协同式护理对老年慢性心力衰竭(CHF)伴心律失常患者心理状态及生活质量的影响。方法选取2016年8月-2019年8月河南省某医院收治的120例老年CHF伴心律失常患者为研究对象,根据入院顺序分为对照组和观察组,每组60例。对照组患者给予常规护理,观察组患者在对照组基础上实施个体需求导向的生理-心理维度协同式护理。比较2组患者护理干预前后焦虑亚量表(HADA)及抑郁亚量表(HADD)评分、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、6 min步行距离(6MWD)及遵医行为情况和护理满意度。结果护理干预前,2组患者HADA及HADD评分比较,差异无统计学意义(P>0.05);护理干预后,2组患者HADA及HADD评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者合理饮食、规律运动、心理调适、遵医用药等遵医率均高于对照组,差异均有统计学意义(P<0.05)。护理干预前,2组患者6MWD及MLHFQ评分比较,差异均无统计学意义(P>0.05);护理干预后,2组患者6MWD长于干预前,MLHFQ评分低于干预前,且观察组患者6MWD长于对照组,MLHFQ评分低于对照组,差异均有统计学意义(P<0.05)。观察组患者护理满意度为93.33%,高于对照组的76.67%,差异有统计学意义(P<0.05)。结论个体需求导向的生理-心理维度协同式护理应用于老年CHF伴心律失常患者,有助于改善患者心理状态、遵医行为,提高患者运动耐量、生活质量及护理满意度。

Objective To explore the effect of individual-oriented coordinated physio-psychological nursing on the mental state of elderly patients with chronic heart failure(CHF)with arrhythmia and the Minnesota Heart Failure Quality of Life Scale(MLHFQ)score.Methods A total of 120 elderly patients with CHF and arrhythmia from August 2016 to August 2019 in our hospital were selected and grouped according to the order of admission,with 60 cases in each group.The control group was given routine nursing care,and the observation group was based on the control group to implement individual-oriented coordinated nursing of physiological-psychological dimensions.Hospital anxiety and depression scale(HAD)[including anxiety subscale(HADA)score,depression subscale(HADD)],MLHFQ score,six min walking distance(6 MWD),compliance behavior,and nursing satisfaction were compared between the two groups before and after the intervention.Results Before nursing intervention,there was no statistically significant difference in HADA and HADD scores between the two groups of patients(P>0.05);The HADA and HADD scores in the observation group were lower than those in the control group after intervention(P<0.05).The compliance behavior of the observation group was better than that of the control group(P<0.05).Before nursing intervention,there was no statistically significant difference between the 6 MWD and MLHFQ scores of the two groups of patients(P>0.05);After the intervention,the 6 MWD in the observation group was longer than that in the control group,and the MLHFQ score was lower than that in the control group(P<0.05).The nursing satisfaction of the observation group was 93.33%higher than that of the control group(76.67%)(P<0.05).Conclusion The individual-oriented coordinated physio-psychological dimension of coordinated nursing applied to elderly patients with CHF and arrhythmia can improve psychological state,compliance behavior,exercise tolerance,MLHFQ score and nursing satisfaction.