循证式督导护理对房颤抗凝患者自我管理能力及希望水平的影响

Effect of Evidence-based Supervised Nursing on Self-management Ability and Hope Level in Patients with AF Undergoing Anticoagulation

目的:探讨循证式督导护理对心房颤动(atrial fibrillation,AF)抗凝患者自我管理能力及希望水平的影响。方法:选取2020年11月—2021年11月在厦门大学附属第一医院心内科接受治疗并需按时服用抗凝药物的136例AF患者作为研究对象,按照系统随机化分配法将其分为两组,即对照组(n=68)和观察组(n=68)。对照组实施常规护理进行干预,观察组在此基础上实施循证式督导护理进行干预。对两组患者自我管理能力、希望水平及不良事件进行记录分析。结果:干预6个月后,观察组患者饮食自我管理、运动自我管理、疾病相关知识的获取及自我监测评分较对照组显著提升,差异有统计学意义(P<0.05);干预6个月后,观察组患者对现实和未来的积极态度、采取积极行动及与他人保持亲密关系评分较对照组明显上升,差异有统计学意义(P<0.05);观察组不良事件总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:对AF抗凝患者采用循证式督导护理的干预模式有助于患者自我管理能力及希望水平的有效提升,促使患者以积极的心态正视疾病,并主动配合医护人员工作,这对相关不良事件发生情况的减少及治疗效果的提升有积极影响。

Objective:To explore the effect of evidence-based supervised nursing on self-management ability and hope level in patients with atrial fibrillation(AF)undergoing anticoagulation.Method:A total of 136 AF patients who received treatment in the Department of Cardiology of the First Affiliated Hospital of Xiamen University from November 2020 to November 2021 and were required to take anticoagulant drugs on time were selected as the study objects,and they were divided into two groups according to systematic randomized allocation method,namely the control group(n=68)and the observation group(n=68).The control group carried out routine nursing intervention,and the observation group carried out evidence-based supervised nursing intervention on the basis of this.The self-management ability,hope level and adverse events of the two groups were recorded and analyzed.Result:After 6 months of intervention,the scores of diet self-management,exercise self-management,acquisition of disease-related knowledge and self-monitoring in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).After 6 months of intervention,the scores of positive attitude towards reality and future,taking positive action and keeping close relationship with others in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse events in the observation group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The intervention model of evidence-based supervised nursing for anticoagulation patients with AF is helpful to improve the self-management ability and the level of hope of the patients,and to promote the patients to face the disease with a positive attitude,and actively cooperate with the work of medical staff,which has a positive impact on the reduction of related adverse events and the improvement of treatment effect.