以家庭为中心模式下的认知行为干预在主动脉夹层术后患者延续护理中的应用

Effect of cognitive⁃behavioral intervention under the family⁃based care model on continuing care of patients after aortic dissection surgery

目的探讨以家庭为中心(family-centered care,FCC)模式下的认知行为干预在主动脉夹层术后患者延续性护理中的应用效果。方法采用随机数字表法将2021年1月至2022年12月陕西省人民医院心脏外科收治的106例主动脉夹层术后患者分为对照组与观察组各53例。对照组给予常规延续性护理,观察组在对照组基础上实施FCC模式下认知行为干预的延续性护理,两组均干预8周。比较两组干预前后血压、体质量指数(BMI)、自护能力[采用自我护理能力量表(ESCA)]、生活质量[采用健康调查简表(SF-36)]、抑郁、焦虑状况[医院焦虑抑郁量表(HADS)]的差异。结果两组患者干预后血压、BMI、抑郁、焦虑状况均低于干预前(P<0.05),ESCA评分、SF-36评分均高于干预前(P<0.05);且观察组血压和BMI控制情况分别为[(116.47±28.23)mmHg、(25.33±1.11)kg/m^(2)]均优于对照组[(124.48±29.81)mmHg、(26.18±1.35)kg/m^(2)];观察组自护能力(ESCA)、生活质量(SF-36)评分分别为[(121.15±29.69)分、(67.92±13.69)分]均高于对照组[(106.68±24.71)分、(60.81±10.77)分];观察组抑郁、焦虑状况分别为[(11.07±4.00)分、(12.39±3.59)分]均明显低于对照组[(12.20±4.28)分、(13.45±4.15)分],差异均有统计学意义(t=7.193、2.454、8.243、7.436、3.873、2.852,均P<0.01)。结论将FCC模式下的认知行为干预应用于主动脉夹层术后患者延续性护理中,可明显改善患者血压、BMI和心理状况,提升患者自护能力及生存质量,值得在临床中推广应用。

Objective To investigate the effect of cognitive-behavioral intervention under the familycentered care(FCC)model on continuing care of patients after aortic dissection surgery.Methods One hundred and six patients undergoing aortic dissection in the Department of Cardiac Surgery of the hospital from January 2021 to December 2022 were evenly divided into control group and observation group by using random number table method,with 53 cases in each group.The control group was given routine continuing care,and the observation group was treated with continuing care with the cognitive behavior intervention under the FCC mode based on the control group,and both groups intervened for 8 weeks.The control group was treated with routine continuity care,while the observation group received continuity care with cognitive-behavioral intervention based on the FCC model in addition to routine continuing care,with a intervention duration of 8 weeks for both groups.The two groups were compared in terms of blood pressure,body mass index(BMI),self-care ability(measured using the Self-Care Ability Scale-ESCA),quality of life(measured using the Short Form-36 Health Survey-SF-36),and levels of depression and anxiety(measured using the Hospital Anxiety and Depression Scale-HADS)before and after the intervention.Results The level of blood pressure,BMI,and level of depression and anxiety after the intervention were all significantly lower than before the intervention(P<0.05)and the scores by ESCA and SF-36 were signifi⁃cantly higher than before intervention(P<0.05).The blood pressure and BMI in the observation group were both significantly better than in the control group[(116.47±28.23)mmHg vs.(124.48±29.81)mmHg and(25.33±1.11)kg/m^(2) vs.(26.18±1.35)kg/m^(2),t=7.193,2.454,P<0.01,respectively].The scores of self-care ability and quality of life in the observation group were higher than in the control group[(121.15±29.69)vs.(106.68±24.71)and(67.92±13.69)vs.(60.81±10.77),t=8.243,7.436,P<0.01,respectively].The scores of depression and anxiety in the observation group were significantly lower than in the control group[(11.07±4.00)vs.(12.20±4.28)and(12.39±3.59)vs.(13.45±4.15),t=3.873,2.852,P<0.01,respectively].Conclusion The cognitivebehavioral intervention under the FCC mode can significantly improve blood pressure,BMI,and psychological condition,as well as enhance patients'self-care ability and quality of life,when applied in the continuity of care for patients after aortic dissection.Therefore,it is worth promoting and applying in clinical practice.