基于自我调节学习理论的干预在慢性心力衰竭患者中的应用

Application of intervention based on self-regulated learning theory in patients with chronic heart failure

目的探讨基于自我调节学习理论的干预对慢性心力衰竭患者自我护理行为、生活质量、再住院率的影响。方法采用便利抽样法,选择2018年7—12月郑州大学第一附属医院收治的47例慢性心力衰竭患者为对照组,2019年1—6月收治的45例慢性心力衰竭患者为观察组。对照组患者给予慢性心力衰竭常规护理,观察组患者在常规护理的基础上给予依据自我调节学习理论制订的干预措施。采用心力衰竭患者自我护理行为量表(SCHFI)、明尼苏达心力衰竭患者生活质量量表(MLHFQ)、再住院率评价干预效果。结果对照组最终纳入42例患者,观察组最终纳入44例患者。出院后3个月观察组患者SCHFI中的自我护理维持、管理、信心维度得分均高于对照组,差异有统计学意义(P<0.05)。出院后3个月观察组患者MLHFQ中的身体领域、情绪领域、其他领域得分均低于对照组,差异有统计学意义(P<0.05)。两组患者再住院率比较差异无统计学意义(P>0.05)。结论自我调节学习理论能够提高慢性心力衰竭患者的自我护理行为和生活质量,但其对于患者再住院率的影响仍需大样本、长期研究来证实。

Objective To explore effects of intervention based on self-regulated learning theory on self-care behavior,quality of life and rehospitalization rate of patients with chronic heart failure.Methods Using the convenient sampling method,47 patients with chronic heart failure who were admitted to the First Affiliated Hospital of Zhengzhou University from July to December 2018 were selected as the control group and 45 patients with chronic heart failure who were admitted from January to June 2019 were selected as the observation group.Patients in the control group were given routine nursing for chronic heart failure,while patients in the observation group were given interventions based on self-learning adjustment theory at basis of routine nursing.Self-Care of Heart Failure Index(SCHFI),Minnesota Living with Heart Failure Questionnaire(MLHFQ)and rehospitalization rate were used to evaluate the intervention effects.Results The control group finally included 42 patients,and the observation group finally included 44 patients.The scores of self-care maintenance,management and confidence dimensions in SCHFI of the observation group were higher than those of the control group at 3 months after discharge,and the differences were statistically significant(P<0.05).The scores of the physical field,emotional field and other fields in MLHFQ of the observation group were lower than those of the control group at 3 months after discharge,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the rehospitalization rate between the two groups(P>0.05).Conclusions Self-regulated learning theory can improve the self-care behavior and quality of life of patients with chronic heart failure,but its effect on the rehospitalization rate of patients still needs to be confirmed by large samples and long-term studies.