心理暗示结合共享决策方案对老年稳定性冠心病患者心理弹性、决策冲突及自我效能的影响

Effects of psychological suggestion combined with shared decision-making scheme on psychological elasticity,decision-making conflict and self-efficacy in elderly patients with coronary heart disease

目的:探讨心理暗示结合共享决策方案对老年稳定性冠心病患者心理弹性、决策冲突及自我效能的影响。方法:选取90例老年稳定性冠心病患者为研究对象,依据护理干预方式不同分为对照组和观察组,每组各45例。对照组给予常规护理干预;观察组在对照组的基础上结合心理暗示+共享决策方案护理干预。干预后6个月比较两组患者健康行为、心理弹性、决策冲突、自我效能、生活质量。结果:干预后,两组患者健康行为能力自评量表(SRAHP)中运动、营养、健康责任和心理安适维度评分、中文版康纳-戴维森韧性量表(CD-RISC)中乐观、自强和坚韧维度评分、慢性病自我效能量表(CDSES)中症状管理和疾病共性管理维度评分及总分、西雅图心绞痛量表(SAQ)中躯体受限程度、心绞痛稳定状况、心绞痛发作频率、疾病认知程度及治疗满意度评分均升高(P<0.05),且观察组高于对照组(P<0.05);决策冲突量表(DCS)中感知有效决策、决策不确定性、导致决策不确定性的因素评分及总分均降低,且观察组低于对照组(P<0.05)。结论:在常规护理的基础上联合心理暗示+共享决策方案,有利于改善对老年稳定性冠心病患者健康行为及心理弹性,降低决策冲突,提升其自我效能及生活质量。

Objective:To investigate the effects of psychological suggestion combined with shared decision-making scheme on psychological elasticity,decision-making conflict and self-efficacy in elderly patients with coronary heart disease.Methods:90 elderly patients with stable coronary heart disease were divided into control group and observation group according to the different nursing intervention methods,and 45 cases in each group.The control group was given routine nursing intervention,and the observation group was combined with psychological suggestion+shared decision-making scheme intervention on the basis of the control group.After 6 months of continuous intervention,the health behavior,psychological elasticity,decision-making conflict,self-efficacy and quality of life of the two groups were compared.Results:After 6 months of intervention,the scores of exercise,nutrition,health responsibility and psychological well-being in Self-rated abilities health practices scale(SRAHP),the scores of optimism,self-improvement and tenacity in the Chinese version of Connor-Davidson resilience scale(CD-RISC),the scores and total scores of symptom management and disease commonness management in the Chronic disease self-efficacy scale(CDSES),and the degree of physical restriction,stable state of angina pectoris,attack frequency of angina pectoris,disease cognition and treatment satisfaction scores in Seattle angina pectoris scale(SAQ)increased in the two groups(P<0.05),and the observation group was higher than the control group(P<0.05).The scores and total scores of perceived effective decision-making,decision uncertainty,factors leading to decision uncertainty in the Decision conflict scale(DCS)decreased in the two groups,and the observation group was lower than the control group(P<0.05).Conclusion:On the basis of routine nursing,combined with psychological suggestion+shared decision-making scheme,it is conducive to improve the health behavior and psychological elasticity of elderly patients with stable coronary heart disease,reduce decision-making conflict,and improve their self-efficacy and quality of life.