自我效能干预对机械瓣膜置换术后患者华法林服药依从性的影响

Effect of Self⁃efficacy Intervention on Warfarin Compliance in Patients after Mechanical Valve Replacement

目的探讨自我效能干预对机械心脏瓣膜置换术(MHVR)术后患者华法林服药依从性影响的的实用性和有效性,为临床实践自我效能干预护理提供参考。方法采用连续性抽查法,纳入2022年1月至2023年1月在福建某大型三甲医院行MHVR且术后采用口服华法林进行抗凝治疗的患者。通过数字表法随机分成对照组和实验组。对照组给予常规护理;实验组在常规护理的基础上实施基于自我效能干预的健康护理。比较两组患者出院后第1、3、6个月的服药依从性、血栓/栓塞和出血的发生率。结果实验组出院后第1、3、6个月的服药依从性均显著高于对照组,而血栓/栓塞和出血的发生率均较对照组低。结论基于自我效能干预的护理方案对MHVR患者服药依从性有显著提高,同时降低血栓/栓塞、出血等抗凝并发症的发生风险。

OBJECTIVE To explore the practicability and effectiveness of self⁃efficacy intervention on warfarin compliance in patients after mechanical heart valve replacement(MHVR),and to provide theoretical and data basis for clinical practice of self⁃efficacy intervention nursing.METHODS The continuous sampling method was used.From January 2022 to January 2023,patients who underwent MHVR in a third⁃class hospital in Fujian Province and received oral warfarin anticoagulation therapy after the operation were selected.They were randomly divided into a control group and an experimental group by digital table method.Patients in the control group were given routine nursing;In the experimental group,health care based on self⁃efficacy intervention was implemented based routine care.Medication compliance,the incidence of thrombosis/embolism,and bleeding were compared between the two groups at 1,3,and 6 months after discharge.RESULTS The medication compliance of the experimental group was significantly higher than that of the control group in the first,third,and sixth months after discharge.The incidence of thrombosis/embolism and hemorrhage was lower than that of the control group.CONCLUSION Nursing based on self⁃efficacy intervention can effectively improve the medication compliance of patients with MHVR.And to a certain extent,reduce the risk of thrombosis/embolism,bleeding,and other anticoagulant complications.