以自我管理为导向的5A护理模式对冠心病经皮冠状动脉介入术后患者自我管理行为和早期康复的影响

Effect of self-management-oriented 5A nursing mode on self-management behavior and early rehabilitation of patients with coronary heart disease after percutaneous coronary intervention

目的:探讨以自我管理为导向的5A护理模式对冠心病经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后患者自我管理行为和心脏早期康复的影响。方法:将2020年1月至2020年12月亳州市人民医院接受PCI的102例冠心病患者,按照随机数字表法分为对照组(n=51)与观察组(n=51)。对照组实施常规护理模式,观察组实施以自我管理为导向的5A护理模式。比较2组疾病感知水平[修订的疾病感知问卷(Illness Perception Questionnaire-Revised,IPQ-R)]、自我管理能力[冠心病自我管理量表(Coronary Heart Disease Self-Management Behavior Scale,CSMS)]、临床指标(心率、血压、低密度脂蛋白)、心脏康复指标[左室射血分数(left ventricular ejection fraction,LVEF)及6 min步行试验(6-minute walk test,6MWT)]、心脏不良事件发生率及生活质量[中国心血管病人生活质量评定问卷(China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases,CQQC)]的变化。结果:干预6个月后,2组IPQ-R评分均下降(均P<0.05),且与对照组相比,观察组IPQ-R评分更低(P<0.05)。观察组CSMS中日常生活管理维度和疾病医学管理维度评分均高于对照组(均P<0.05)。观察组心率、舒张压及低密度脂蛋白水平均低于对照组(均P<0.05)。观察组LVEF及6MWT指标均高于对照组(均P<0.05)。2组CQQC评分均上升(均P<0.05),且与对照组相比,观察组CQQC评分更高(P<0.05)。观察组总心脏不良事件发生率低于对照组(P<0.05)。结论:以自我管理为导向的5A护理模式可提升冠心病PCI术后患者自我管理能力和心脏康复效果,降低心脏不良事件发生率,进而提高患者生活质量。

Objective:To explore the effect of self-management-oriented 5A nursing model on self-management behavior and early cardiac rehabilitation in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:A total of 102 patients with coronary heart disease who underwent PCI in People’s Hospital of Bozhou from January 2020 to December 2020 were divided into a control group and an observation group by random number table method,with 51 cases in each group.The control group received routine nursing mode,while the observation group received self-management-oriented 5A nursing mode.The disease perception level[Illness Perception Questionnaire-Revised(IPQ-R)],self-management ability[Coronary Heart Disease Self-Management Behavior Scale(CSMS)],cardiac rehabilitation index[left ventricular ejection fraction(LVEF)and 6-minute walk test(6MWT)],incidence of adverse cardiac events and quality of life[(China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases,CQQC)],incidence of adverse cardiac events and quality of life(CQQC)were compared between the 2 groups.Results:After 6 months of intervention,the IPQ-R scores of the 2 groups decreased(both P<0.05),and compared the control group,the IPQ-R scores of the observation group was lower(P<0.05).The scores of daily life management dimension and disease medical management dimension in the CSMS in the observation group were higher than those in the control group(both P<0.05).The heart rate,diastolic blood pressure,and low-density lipoprotein level in the observation group were lower than those in the control group(all P<0.05).The LVEF and 6MWT indexes in the observation group were higher than those in the control group(both P<0.05).The CQQC scores in the 2 groups increased(both P<0.05),and compared the control group,the CQQC scores of the observation group was higher(P<0.05).The total incidence of adverse cardiac events in the observation group was 11.76%,which was significantly lower than 29.41%in the control group(P<0.05).Conclusion:The self-management-oriented 5A nursing mode can improve the self-management ability and cardiac rehabilitation effect in patients with coronary heart disease after PCI,reduce the incidence of cardiac adverse events,and improve the quality of life of patients.