基于行为转变理论的护理干预在老年冠心病患者中的应用

Application of nursing intervention based on the transtheoretical model and stages of change in elderly patients with coronary heart disease

目的探讨在老年冠心病患者中采取基于行为转变理论(TTM)的护理的效果。方法选取2020年2月至2022年2月抚州市第一人民医院收治的66例冠心病患者作为研究对象,采用随机数字表法分为对照组与观察组,每组各33例。对照组采取常规护理干预,观察组实施基于TTM的护理,两组均护理6个月。比较两组患者护理前、护理6个月的遵医行为情况、心理弹性、自我效能以及生活质量。结果观察组的遵医率为93.94%(31/33),高于对照组的75.76%(25/33),差异有统计学意义(P<0.05)。观察组护理后的心理弹性量表(CD-RISC)、一般自我效能量表(GSES)评分高于对照组,差异有统计学意义(P<0.05)。观察组护理后的中国心血管患者生活质量评定问卷(CQQC)评分高于对照组,差异有统计学意义(P<0.05)。结论老年冠心病患者接受基于TTM的护理,可促进遵医行为改善,提高患者心理弹性水平,增强自我效能,从而提升患者生活质量。

Objective To investigate the effect of the transtheoretical model and stages of change(TTM)-based care in elderly patients with coronary heart disease.Methods A total of 66 patients with coronary heart disease admitted to the First People's Hospital of Fuzhou City from February 2020 to November 2022 were enrolled and divided into two groups by random number table method,with 33 cases in both groups.The control group received usual nursing intervention,and the observation group received TTM-based care,and both groups received a 6-month follow-up.The compliance behavior,psychological resilience,self-efficacy and quality of life of two groups were compared pre-nursing and at 6-month nursing.Results The compliance rate in the observation group was 93.94%(31/33),which was higher than that in the control group(75.76%)(25/33),the difference was statistically significant(P<0.05).The Conner-Davidson resiliences scale(CD-RISC)and general self efficacy scale(GSES)scores were higher in the observation group than those in the control group,the differences were statistically significant(P<0.05).The Chinese quality of life assessment questionnaire cardiovascular(CQQC)score of the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion TTM-based nursing care for elderly patients with coronary heart disease can promote the improvement of medical compliance behavior,improve the psychological resilience level of patients,enhance self-efficacy,and thus improve the quality of life of patients.