自我行为管理在高原地区慢性心力衰竭患者中的应用研究

The Clinical Application Effect of Self-behavior Management in Patients with Chronic Heart Failure(CHF)in Plateau Areas

目的:探讨自我行为管理在高原地区慢性心力衰竭(chronicheartfailure,CHF)患者中的临床应用效果。方法:收集2019年3月—2019年12月在我院心内科住院治疗的CHF患者115例,随机分为观察组57例和对照组58例。对照组患者给予常规护理,观察组患者在常规护理的基础上行6个月自我行为管理干预。应用靶练习工具实施周计划进行自我行为管理,在出院时,出院1个月、3个月、6个月,应用自我管理量表、明尼苏达心力衰竭生活质量问卷(MLHFQ)、心力衰竭患者靶练习工具调查表评估两组患者在自我管理、生活质量管理及靶练习工具中的得分并进行比较,同时比较两组患者左心室射血分数(LVEF)、B型利钠肽(BNP)、6分钟步行试验水平及心脏事件发生率、再次住院率。结果:出院6个月时观察组患者药物管理、饮食管理、心理社会适应管理、症状管理及MLHFQ中症状领域、身体活动、情感领域和靶练习工具评分均优于对照组(P<0.05);观察组出院后6个月LVEF、BNP、6分钟步行试验及心脏事件发生率、再次住院率均优于对照组(P<0.05)。结论:对高原地区CHF患者实施自我行为管理,提高了服药和饮食依从性及心理社会适应能力,建立良好的饮食习惯,增强运动耐力,改善心功能,6个月内心脏事件的发生率和再次住院率显著降低,提高了患者的生存质量。

Objective:This study is to explore the clinical application effect of self-behavior management in patients with chronic heart failure(CHF)in plateau areas.Methods:A total of 115 CHF patients who were hospitalized in the cardiology department of our hospital from March 2019 to December 2019 were selected and randomly divided into an observation group of 57 cases and a control group of 58 cases.Patients in the control group were given routine care,while patients in the observation group were treated with self-behavior management intervention for 6 months on the basis of routine care,who were used with target practice tools to implement weekly plans for self-behavior management.When the patients are discharged from the hospital,at 1 month,3 months,and 6 months,the self-management scale and the Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)are used to evaluate the two groups of patients,comparing the scores in self-management,quality of life management and target exercise tools,then compare the left ventricular ejection fraction(LVEF),B-type natriuretic peptide(BNP),6-minute walk test scores and the incidence of cardiac events between the two groups and their re-hospitalization rate.Results:At 6 months after discharge from hospital,the scores of drug management,diet management,psychosocial adaptation management,symptom management,and MLHFQ in the self-management scale of the observation group were better than those in the control group(P < 0.05).The rate of LVEF,BNP,6-minute walk test,cardiac events,and rehospitalization rate were better than those of the control group(P < 0.05).Conclusions:The implementation of self-behavior management for CHF patients in plateau areas has improved medication and diet compliance and psychosocial adaptability,established good eating habits,enhanced exercise endurance,and improved heart function.The incidence and recurrence of cardiac events within 6 months and the hospitalization rate has significantly reduced,which can improve the quality life of patients.