基于正强化理论的个案护理对急性心肌梗死PCI术后康复的影响

Effect of case nursing based on the theory of positive reinforcement on the rehabilitation of acute myocardial infarction after PCI

目的探讨基于强化理论的个案护理对急性心肌梗死(AMI)经皮冠状动脉介入手术(PCI)术后康复的促进作用。方法选取医院2019年1月—2020年1月收治的86例PCI术后AMI患者,按照组间基本特征均衡的原则分为观察组和对照组,各43例。对照组实施常规护理,观察组予以基于正强化理论的个案护理。对比两组患者干预前后心理状态变化、干预前后心功能变化及护理期间主要不良心血管事件(MACE)发生率。结果干预前两组患者焦虑自评表(SAS)评分、抑郁自评表(SDS)评分、左心射血分数(LVEF)、E峰与A峰比值(E/A)及左心室舒张末期容积(LVEDV)等数据对比,差异无统计学意义(P>0.05);干预后两组SAS、SDS评分均下降,且观察组均低于对照组(P<0.05);干预后两组LVEF、E/A值均升高,且观察组均高于对照组(P<0.05);干预后两组LVEDV均下降,且观察组低于对照组(P<0.05);观察组总依从率高于对照组(P<0.05);护理期间观察组MACE发生率为4.65%,对照组MACE发生率为23.26%,观察组MACE发生率低于对照组(P<0.05)。结论基于正强化理论的个案护理能够缓解AMI患者PCI术后焦虑、抑郁情绪,有助于改善患者心功能,增加患者用药依从性,并降低MACE发生率。

Objective To explore the role of case nursing based on intensive theory in promoting the recovery of acute myocardial infarction(AMI)patients after percutaneous coronary intervention(PCI).Methods A total of 86 patients with AMI after PCI admitted to the hospital from January 2019 to January 2020 were selected and divided into an observation group and a control group,with 43 cases in each group,according to the principle of balanced basic characteristics between the groups.The control group received routine nursing,and the observation group received case nursing based on positive reinforcement theory.The changes in mental state before and after intervention,changes in heart function before and after intervention,and the incidence of major adverse cardiovascular events(MACE)during nursing were compared between the two groups.Results Before the intervention,there was no statistically significant difference in the self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,left ventricular ejection fractions(LVEF),ratio of peak E to peak A(E/A)and left ventricular end-diastolic volume(LVEDV)between the two groups of patients(P>0.05).After the intervention,SAS and SDS scores decreased in both groups,and the scores in the observation group were lower than those in the control group(P<0.05).After the intervention,the LVEF and E/A values of the two groups increased,and the values in the observation group were higher than those in the control group(P<0.05).After the intervention,LVEDV decreased in both groups,and the observation group was lower than the control group(P<0.05).The total compliance rate in the observation group was lower than that in the control group(P<0.05).During the nursing period,the incidence of MACE in the observation group was 4.65%,and the incidence of MACE in the control group was 23.26%,and the incidence of MACE in the observation group was lower than that in the control group(P<0.05).Conclusion The case nursing based on positive reinforcement theory can relieve anxiety and depression of AMI patients after PCI,help improve patients’cardiac function,increase patients’compliance with medication,and reduce the incidence of MACE.