4C干预模式对老年经皮冠状动脉介入术后患者的影响

Effect of 4C intervention mode in elderly patients after percutaneous coronary intervention

目的探讨4C干预模式对老年经皮冠状动脉介入(PCI)术后患者自我效能、心理状态及再住院率的影响。方法选取4C干预模式实施前(2020年1月—2021年2月)行PCI术的患者54例为对照组;选取4C干预模式实施后(2021年3月—2022年3月)的就诊者54例为观察组。随访期间,观察组失访1例,最终纳入53例。对照组给予常规护理,观察组给予常规护理联合4C干预模式护理。比较2组出院时及随访3个月时的自我效能[一般自我效能量表(GSES)]、心理状态[华西心晴指数(HEI)问卷]及自理能力[日常生活能力量表(ADL)]。记录2组术后不良事件发生情况及再入院率。结果2组随访3个月时的GSES评分、ADL评分高于出院时,差异有统计学意义(P<0.05)。随访3个月时,观察组GSES评分、ADL评分高于对照组,差异有统计学意义(P<0.05);与对照组比较,观察组的HEI情绪障碍严重程度改善,差异有统计学意义(P<0.05)。2组术后不良事件发生率比较,差异无统计学意义(P>0.05)。随访期间,观察组再入院率为1.89%,低于对照组的16.67%,差异有统计学意义(P<0.05)。结论4C干预模式可有效改善老年PCI术后患者的自我效能、心理状态及日常生活能力,可降低其术后再入院率。

Objective To investigate the effects of 4C intervention mode on self-efficacy,psychological state and readmission rate of elderly patients after percutaneous coronary intervention(PCI).Methods A total of 54 patients who underwent PCI before the implementation of 4C intervention mode(from January 2020 to February 2021)were selected as control group.After the implementation of 4C intervention mode(from March 2021 to March 2022),54 patients were selected as observation group.During the follow-up period,1 case was lost to follow-up in the observation group,and 53 cases were eventually included.The control group was given routine nursing,and the observation group was given routine nursing combined with 4C intervention mode nursing.The self-efficacy[General Self-efficacy Scale(GSES)],psychological state[Huaxi Emotion-distress Index(HEI)questionnaire]and self-care ability[Activities of Daily Living Scale(ADL)]were compared between the two groups at the time of discharge and follow-up for 3 months.The incidence of postoperative adverse events and readmission rate of the two groups were recorded.Results The GSES scores and ADL scores of two groups were significantly higher at 3 months of follow-up than at discharge(P<0.05).After 3 months of follow-up,GSES scores and ADL scores in the observation group were significantly higher than those in the control group(P<0.05);compared with the control group,the severity of HEI mood disorder in the observation group was significantly improved(P<0.05).There was no significant difference in the incidence of postoperative adverse events between the two groups(P>0.05).During the follow-up period,the readmission rate of the observation group was 1.89%,which was significantly lower than 16.67%of the control group(P<0.05).Conclusion The 4C intervention mode can effectively improve the self-efficacy,psychological state and daily living ability of elderly patients after PCI,and reduce the rate of postoperative readmission.