回馈教学式健康教育对机械瓣膜置换术后患者的影响

Effect of feedback teaching health education in patients after mechanical valve replacement

目的评价回馈教学式健康教育对机械瓣膜置换术后患者的影响。方法选取2018年8月至2020年5月本院心血管外科收治符合标准的110例行机械瓣膜置换术患者,根据入院顺序编号奇偶数分为对照组和观察组,每组55例。研究期间对照组失访3例,观察组失访1例,配合完成研究的对照组52例,观察组54例。观察组男24例,女30例,年龄(60.03±7.52)岁;对照组男24例,女28例,年龄(59.36±8.31)岁。对照组采用常规健康教育指导,观察组采用回馈教学式健康教育指导干预,患者出院后随访3个月。比较两组患者抗凝认知水平、服药依从性、国际标准化比值(INR)达标率及出血发生率。结果观察组护理干预后抗凝认知水平良好率为64.81%(35/54),高于对照组23.08%(12/52),差异有统计学意义(P<0.05)。观察组护理干预后服药依从性评分为(7.12±1.41)分,高于对照组(4.37±1.72)分,差异有统计学意义(t=9.02,P<0.001)。观察组护理干预后出血发生率为9.26%(5/54),低于对照组30.76%(16/52),INR达标率为79.18%(194/245),高于对照组59.23%(93/157),差异均有统计学意义(均P<0.05)。结论实施回馈教学式健康教育,可有效提高患者抗凝认知水平,增强机械瓣膜置换术后患者口服华法林的依从性,明显减少出血等并发症的发生率。

Objective To evaluate the effect of feedback teaching health education in patients after mechanical valve replacement.Methods A total of 110 patients who received mechanical valve replacement in the Cardiovascular Surgery of our hospital from August 2018 to May 2020 were selected,and were divided into a control group and an observation group according to the odd or even number of admission number,with 55 cases in each group.During the study period,3 cases were lost to follow-up in the control group and 1 case was lost to follow-up in the observation group;there were 52 cases remained in the control group and 54 cases in the observation group.There were 24 males and 30 females in the observation group,with an age of(60.03±7.52)years old;there were 24 males and 28 females in the control group,with an age of(59.36±8.31)years old.The control group was guided by conventional health education,and the observation group was guided by feedback teaching health education.All the patients were followed up for 3 months.The anticoagulant cognition level,medication compliance,rate of international normalized ratio(INR)reaching the standard,and bleeding rate were compared between the two groups.Results After the nursing intervention,the good rate of anticoagulant cognition level in the observation group was higher than that in the control group[64.81%(35/54)vs.23.08%(12/52)](P<0.05);the score of medication compliance in the observation group was higher than that in the control group[(7.12±1.41)points vs.(4.37±1.72)points](t=9.02,P<0.001);the bleeding rate in the observation group was lower than that in the control group[9.26%(5/54)vs.30.76%(16/52)]and the rate of INR reaching the standard in the observation group was higher than that in the control group[79.18%(194/245)vs.59.23%(93/157)](both P<0.05).Conclusion The implementation of feedback teaching health education can effectively improve the anticoagulant cognition level and patients'compliance on warfarin after mechanical valve replacement,and significantly reduce the incidence of complications such as bleeding.