问题导向式健康宣教在ACS患者治疗及康复中的应用价值分析

Application value analysis of problem-oriented health education in the treatment and rehabilitation of ACS patients

目的:探究问题导向式健康宣教在急性冠脉综合征(ACS)患者中的应用效果。方法:选择2021年8月-2022年10月我院收治的ACS患者100例,依据随机数字表法分为常规组(n=50,接受常规健康宣教干预)和导向组(n=50,接受问题导向式健康宣教),两组均干预3个月。对比两组干预前后心功能、心电图检查指标、自我护理能力量表(ESCA)、世界卫生组织生存质量测定简表(WHOQOL-BREF)评分、治疗依从性及并发症发生情况。结果:与常规组比较,导向组干预后LVEF[(51.98±3.24)%比(55.44±3.64)%]、ESCA评分[(132.34±3.09)分比(162.44±3.68)分]、WHOQOL-BREF的生理状态[(65.16±6.12)分比(72.18±5.17)分]、心理状态[(68.59±5.72)分比(76.85±6.71)分]、社会关系[(71.51±5.85)分比(80.30±5.33)分]及环境领域[(74.45±4.82)分比(82.80±5.72)分]维度分均显著升高,左室舒张末内径(LVEDd)[(58.85±4.84)mm比(56.65±4.74)mm]、校正后QT间期(QTc)[(448.33±11.95)ms比(442.02±12.87)ms]、T波峰末间期(Tp-Tec)[(114.13±8.71)ms比(102.74±9.34)ms]显著降低,P<0.05或<0.01。与常规组比较,导向组总依从率(64%比88%)显著升高,并发症发生率(58%比20%)显著降低,P均<0.01。结论:问题导向式健康宣教可显著改善ACS患者心功能及心电图检查指标,提高自我护理能力、生活质量、治疗依从性,降低并发症发生率,有助于改善预后,值得临床推广。

Objective:To explore the application effect of problem-oriented health education in patients with acute coronary syndrome(ACS).Methods:A total of 100 ACS patients admitted to our hospital from August 2021 to October 2022 were selected and divided into conventional group(n=50,received routine health education intervention)and oriented group(n=50,received problem-oriented health education)according to random number table method,both groups were intervened for three months.Cardiac function,ECG indexes,scores of exercise of self-care agency(ESCA),World Health Organization quality of life-BREF(WHOQOL-BREF)before and after intervention,therapeutic compliance and incidence of complications were compared between the two groups.Results:Compared with conventional group,there were significant rise in LVEF[(51.98±3.24)%vs.(55.44±3.64)%],ESCA score[(132.34±3.09)points vs.(162.44±3.68)points],dimensional scores of physical[(65.16±6.12)points vs.(72.18±5.17)points],psychological[(68.59±5.72)points vs.(76.85±6.71)points],social relation[(71.51±5.85)points vs.(80.30±5.33)points]and environment domain[(74.45±4.82)points vs.(82.80±5.72)points]of WHOQOL-BREF,and significant reductions in left ventricular end diastolic diameter(LVEDd)[(58.85±4.84)mm vs.(56.65±4.74)mm],corrected QT interval(QTc)[(448.33±11.95)ms vs.(442.02±12.87)ms],T peak-T end interval(Tp-Tec)[(114.13±8.71)ms vs.(102.74±9.34)ms]in oriented group after intervention,P<0.05 or<0.01.Compared with conventional group,there was significant rise in total compliance rate(64%vs.88%)and significant reduction in incidence rate of complications(58%vs.20%)in oriented group,P<0.01 both.Conclusion:Problem-oriented health education can significantly improve the cardiac function and ECG indexes,self-care ability,quality of life,therapeutic compliance,and reduce the incidence rate of complications in ACS patients,which helps to improve prognosis,and is worthy of clinical promotion.