优效病例示范在冠心病冠脉支架术患者心理干预中的作用

Effect of Excellent Case Demonstration in Psychological Intervention of Patients with Coronary Heart Disease under the Percutaneous Coronary Intervention Surgical Treatment

目的探讨利用优效病例对冠心病经皮冠状动脉介入术患者进行引导示范,从而起到心理干预的作用。方法选取2018年1月1日-2019年12月31日于某院行经皮冠状动脉介入术的冠心病患者298例作为研究对象,采用随机数字表法分为对照组和观察组,每组149例。对照组实施常规护理干预,观察组实施基于优效病例示范的心理干预。比较2组治疗依从性,干预前后心理状态、希望水平、治疗依从性及生活质量。结果干预后观察组焦虑量表评分(18.57±1.42)和抑郁量表评分(20.44±3.08)均显著低于对照组(26.91±1.36、29.42±3.13)(P<0.05)。干预后观察组对现实和未来的态度(14.27±1.26)、采取的积极行动(13.93±1.54)、与他人保持亲密的关系(14.12±1.25)及总分(42.14±3.26)均显著高于对照组(11.91±1.42、11.59±1.22、12.48±1.02、36.06±3.48)(P<0.05)。观察组配合治疗(87.92%)、配合调查(92.62%)、按时吃药(91.28%)及听从医师建议(93.96%)的比例均显著高于对照组(54.36%、52.35%、51.01%、57.72%)(P<0.05)。干预后观察组心理健康(78.63±11.24)、情感角色(78.23±10.56)、社会功能(69.26±11.35)、活力(81.27±13.25)、躯体角色(57.83±9.42)、躯体功能(77.23±8.84)、疼痛(58.62±9.27)及整体健康(69.84±10.15)均显著高于对照组(67.86±12.15、71.18±11.63、62.42±10.3、64.21±11.45、51.25±8.84、68.75±10.37、70.46±13.24、62.17±9.64)(P<0.05)。结论优效病例示范能够改善冠心病患者PCI术后的负性情绪,提高患者希望水平、治疗依从性及生活质量。

Objectives To explore the effect of excellent case demonstration in psychological intervention of patients with coronary heart disease under the percutaneous coronary intervention(PCI)surgical treatment.Methods CHD patients who underwent PCI surgery in our hospital from 1 st,January 2018 to 31 st,December 2019 were selected as the subjects.The method of random digital table was divided into control group and observation group,149 cases in each group.The control group carried out routine nursing intervention,and the observation group carried out psychological intervention based on excellent case demonstration.The treatment compliance was compared between two groups,mental state,hope level treatment compliance and quality of life were also compared between two groups.Results The HAMA(18.57±1.42)and HAMD scores(20.44±3.08)of the observation group were significantly lower than those of the control group(26.91±1.36、29.42±3.13)(P<0.05).The attitude of observation group to reality and future(14.27±1.26),positive actions(13.93±1.54),close relationship with others(14.12±1.25)and total score(42.14±3.26)were significantly higher than those of control group(11.91±1.42,11.59±1.22,12.48±1.02,36.06±3.48)(P<0.05).The proportion of observation group with treatment(87.92%),cooperation with investigation 138(92.62%),taking medicine on time(91.28%)and following doctor’s advice(93.96%)were significantly higher than that of control group(54.36%,52.35%,51.01%,57.72%)(P<0.05).Mental health(78.63±11.24),emotional role(78.23±10.56),social function(69.26±11.35),vitality(81.27±13.25),somatic role(57.83±9.42),somatic function(77.23±8.84),pain(58.62±9.27)and overall health(69.84±10.15)were significantly higher in the observation group after intervention than in the control group(67.86±12.15,71.18±11.63,62.42±10.3,64.21±11.45,51.25±8.84,68.75±10.37,70.46±13.24,62.17±9.64)(P<0.05).Conclusions The excellent case demonstration could improve the negative emotion of coronary heart disease patients after operation,improve the hope level,quality compliance and quality of life.