基于知信行评估的循环健康教育在心脏瓣膜置换术后患者抗凝用药管理中的应用

Application of KAP Assessment-based Circulatory Health Education in Anticoagulant Medication Management after Heart Valve Replacement

目的探讨基于知信行评估的循环健康教育在心脏瓣膜置换术后患者抗凝用药管理中的应用效果。方法于2018年1月—2019年3月,选择在广州市第一人民医院行心脏瓣膜置换术的患者90例为研究对象。采用随机数字表法将研究对象分为观察组(n=45)和对照组(n=45)。对照组患者住院期间接受心脏瓣膜置换术后抗凝用药常规健康教育,出院后接受责任护士每月1次的电话随访及用药指导。观察组在对照组基础上实施基于知信行评估的循环健康教育,1次抗凝用药的知信评估+基于评估的抗凝用药健康教育为一轮,每月实施1轮,共实施6轮以形成循环健康教育。比较两组患者干预6个月后抗凝药物相关知识得分与抗凝用药依从性得分,以及6个月内抗凝用药相关并发症的发生率。结果干预6个月后,观察组患者抗凝药物相关知识得分与抗凝用药依从性得分均高于对照组(P<0.05);干预6个月期间,观察组患者抗凝用药相关并发症的发生率低于对照组(P<0.05)。结论对心脏瓣膜置换术后行抗凝治疗的患者实施基于知信行评估的循环健康教育,可提高患者的抗凝药物相关知识与抗凝用药依从性,也可保证抗凝用药的安全性。

Objective To explore the effect of KAP(knowledge,attitudes and practices)assessment-based circulatory health education on anticoagulant medication management after heart valve replacement.Methods From January 2018 to March 2019,90 patients who underwent heart valve replacement in Guangzhou First People's Hospital were selected as the subjects.Then,the subjects were divided into the observation group(n=45)and the control group(n=45)according to a random number table.Patients in the control group received routine health education on anticoagulant medication after heart valve replacement during their hospitalization and telephone follow-up and medication guidance once a month by a primary nurse after their discharge.Patients in the observation group,on this basis,received KAP assessment-based circulatory health education.With 1 KAP assessment of anticoagulant medication+KAP assessment-based health education on anticoagulant medication as 1 round,1 round per month,a total of 6 rounds were conducted in the circulatory health education.The scores of anticoagulant drug-related knowledge and medication compliance after 6 months of intervention,as well as the incidence of anticoagulant drug-related complications within the 6 months,were compared between the two groups.Results After 6 months of intervention,the scores of anticoagulant drug-related knowledge and medication compliance in the observation group were higher than those in the control group(P<0.05);during 6 months of intervention,the incidence of anticoagulant drug-related complications in the observation group was lower than that in the control group(P<0.05).Conclusion KAP assessment-based circulatory health education can improve the anticoagulant drug-related knowledge and medication compliance in patients undergoing anticoagulant medication after heart valve replacement,and ensure the safety of anticoagulant medication.