基于IMB模型的出院准备服务在老年慢性心力衰竭患者中的应用

Application of discharge planning based on IMB model in the elderly patients with chronic heart failure

目的探讨基于IMB模型的出院准备服务在老年慢性心力衰竭患者中的应用效果。方法选取2020年9月至2021年9月南京大学医学院附属鼓楼医院老年医学科的82例老年慢性心力衰竭患者为研究对象,根据随机数字表法将患者分为对照组和观察组,各41例。对照组予常规护理及出院指导,观察组在对照组基础上实施基于IMB模型的出院准备服务方案。两组均于干预前、出院3个月后进行欧洲心衰自我护理行为评价量表(EHFSCB-9)评分、心功能指标[心排血量(CO)、左室射血时间(LVET)、B型尿钠肽(BNP)]、6 min步行距离(6MWD)、明尼苏达心衰生活质量评定量表(MLHFQ)评分的比较。结果干预后,观察组EHFSCB-9评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。对照组6MWD高于干预前、BNP低于干预前,观察组6MWD、CO、LVET均高于干预前、BNP低于干预前;且观察组6MWD、CO、LVET高于对照组,BNP低于对照组,差异有统计学意义(P<0.05)。两组MLHFQ评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论基于IMB模型的出院准备服务能有效改善老年心力衰竭患者自我护理能力、运动耐力、心功能状态,提高患者的生活质量。

Objective To explore the application effect of discharge planning based on IMB model in the elderly patients with chronic heart failure.Methods A total of 82 elderly patients with chronic heart failure admitted to the Department of Geriatric,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from September 2020 to September 2021 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 41 cases in each group.The control group was given routine nursing and discharge guidance,and on the basis of the control group,the observation group was given IMB model-based service plan for discharge preparation.Comparison of self-care ability(EHFSCB-9 score),cardiac function indicators(cardiac output[CO],left ventricular ejection time[LVET],B-type urinary natriuretic peptide[BNP]),6-min walking distance(6MWD),and minnesota living with heart failure questionnaire(MLHFQ)score between the two groups before intervention and three months after discharge.Results After intervention,the EHFSCB-9 score of the observation group was lower than before intervention,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).6MWD in the control group was higher than that before intervention,BNP was lower than that before intervention,6MWD,CO and LVET in the observation group were higher than those before intervention,BNP was lower than that before intervention,and 6MWD,CO,and LVET in the observation group were higher than those in control group,BNP was lower,and the differences were statistically significant(P<0.05).MLHFQ scores in both groups were lower than those before intervention,and observation group was lower than control group,and the differences were statistically significant(P<0.05).Conclusion The discharge planning based on IMB model can effectively improve the self-care ability,exercise endurance,and cardiac function of elderly patients with heart failure,and improve the quality of life of patients.