基于医院的延续性护理模式对静脉血栓栓塞症术后患者近期预后及遵医行为的影响

Effects of hospital-based continuous nursing model on short-term prognosis and compliance behavior in patients after operation for venous thromboembolism

目的探讨基于医院的延续性护理模式对静脉血栓栓塞症(VTE)术后患者近期预后及遵医行为的影响,为建立VTE患者延续性护理模式及静脉疾病专病数据库提供依据。方法将90例静脉血栓栓塞症患者按真实世界研究的前瞻性非随机分组方式将入组患者分为研究组和对照组,每组45例。研究组实施延续性护理模式,对照组实施常规护理模式,比较两组出院时、出院3个月、出院6个月中文版静脉功能不全患者生活质量/症状问卷中VEINES-Sym子问卷评分。同时比较两组出院3个月、出院6个月Villalta评分、Morisky服药依从性量表-8评分和患者的遵医行为率。结果两组患者出院时VEINES-Sym子问卷评分比较,差异无统计学意义(P>0.05);出院3个月和出院6个月VEINES-Sym子问卷评分,研究组均高于对照组,差异有统计学意义(P<0.01)。出院3个月和出院6个月研究组Villalta评分均低于对照组,差异均有统计学意义(P<0.01)。出院3个月和6个月研究组血栓后综合征发生率均为0,对照组发生率分别为4.44%、8.89%,出院3个月两组间比较差异无统计学意义(P>0.05),出院6个月研究组低于对照组,差异有统计学意义(P<0.05)。出院3个月和出院6个月研究组Morisky服药依从性量表-8评分均高于对照组,差异有统计学意义(P<0.01)。两组患者出院3个月和出院6个月总遵医行为率比较,差异均有统计学意义(P<0.01)。结论基于医院的延续性护理模式在VTE术后患者院后疗效巩固和近期预后方面起到决定性作用,有利于改善静脉症状,减少血栓后综合征的发生,提高患者服药依从性,改善遵医行为。

Objective To explore the effect of hospital-based continuous nursing model on the short-term prognosis and compliance behavior in patients after operation for venous thromboembolism(VTE)so as to provide basis for the establishment of continuous nursing model and venous disease specific database.Methods Ninety VTE patients were divided into research(n=45)and control(n=45)group according to prospective non-random grouping method of real world research.Research group received continuous care model,control did routine care model,and the scores on Chinese version of Venous Insufficiency Epidemiological and Economic Study-Symptoms(VEINES-Sym)on discharge and in the 3 rd and 6 th month after discharge were compared between two groups.At the same time scores on the Villalta Scale(VS)and Morisky Medication Adherence Scale-8(MMAS-8)and patients'compliance behavior rate were compared between two groups in the 3 rd and 6 th month after discharge.Results There was no significant intergroup difference in scores on the VEINES-Sym on discharge(P>0.05);scores on the VEINES-Sym in the 3 rd and 6 th month after discharge were higher in research than control group,differences had statistical significance(P<0.01).Villalta scores in the 3 rd and 6 th month after discharge were lower in research than control group,differences had statistical significance(P<0.01).The incidence of post thrombotic syndrome(PTS)in the 33 rd and 6 th month after discharge were 0 and 0 in research and 4.44%and 8.89%in control group,there was no significant intergroup difference in the 33 rd month after discharge(P>0.05),that was lower in research than control group,and difference had statistical significance(P<0.01).Scores on the MMAS-8 in the 33 rd and 6 th month after discharge were higher in research than control group,differences had statistical significance(P<0.01).Intergroup differences in total compliance behavior rates in the 33 rd and 6 th month after discharge were statistically significant(P<0.01).Conclusion The hospital-based continuous nursing model plays a decisive role in consolidating the curative effect and short-term prognosis in patients after operation for the VTE and is conducive to the improvement of venous symptoms,reduction of the PTS occurrence,and improvement of patients'medication adherence and compliance behavior.