基于健康行为改变整合理论的健康教育对慢性心力衰竭患者心功能、运动耐力及护理满意度的影响

Effects of health education based on the integrated theory of health behavior change on cardiac function and exercise tolerance and nursing satisfaction in patients with chronic heart failure

目的分析基于健康行为改变整合理论的健康教育对慢性心力衰竭患者心功能、运动耐力及护理满意度的影响。方法本研究为随机对照试验,选取2020年6月至2022年12月温州医科大学附属衢州医院收治的130例慢性心力衰竭患者为研究对象,根据随机数字表法分为对照组和试验组(各65例)。对照组给予常规护理,试验组在对照组基础上应用基于健康行为改变整合理论的健康教育,主要包括健康评估、健康宣教、行为干预、心理支持等,两组患者干预时间均为4周。采用独立样本t检验、χ^(2)检验及Mann-Whitney U检验比较两组患者干预前后心功能改善效果、血浆脑钠肽(BNP)、心脏超声指标[左心射血分数(LVEF)、左心室体积指数(LVMI)及左室舒张末期内径(LVEDD)]、运动耐力[最大摄氧量(VO2max)、最大功率、力竭时间]差异,并统计两组患者的护理满意度,分析基于健康行为改变整合理论的健康教育对慢性心力衰竭患者心功能、运动耐力及护理满意度的影响。结果干预前两组各项指标差异均无统计学意义(均P>0.05)。干预后,试验组BNP、LVMI及LVEDD水平均显著低于对照组[(572.87±89.72)比(680.46±104.32)mg/L、(140.74±9.54)比(151.91±11.52)g/m2、(77.62±4.32)比(80.31±5.57)mm],且显著低于干预前[(963.41±228.69)mg/L、(170.33±12.61)g/m2、(90.10±6.77)mm],试验组LVEF、VO2max、最大功率、力竭时间及护理满意度均显著高于对照组[54.55%±3.80%比52.16%±4.18%、(16.77±2.82)比(15.61±3.15)ml·kg-1·ml-1、(88.91±7.13)比(85.72±8.24)W、(13.47±1.62)比(12.00±1.56)min、95.4%比84.6%],且显著高于干预前[50.11%±4.22%、(14.03±3.26)ml·kg-1·ml-1、(81.42±6.46)W、(10.02±0.82)min](均P<0.05)。结论基于健康行为改变整合理论的健康教育有利于改善慢性心力衰竭患者的心功能及运动耐力,提升护理满意度。

Objective To analyze the impact of health education based on the integrated theory of health behavior change on the cardiac function,exercise endurance and nursing satisfaction in patients with chronic heart failure.Methods In this randomized controlled trial,130 patients with chronic heart failure admitted to Quzhou Hospital Affiliated with Wenzhou Medical University from June 2020 to December 2022 were selected as the research subjects.The patients were randomly divided into a control group and an experimental group(65 cases in each group)with a random number table method.The patients in the control group were given routine nursing care,the experimental group were given health education based on the integration theory of health behavior change on the basis of the control group,mainly including health assessment,health education,behavioral intervention,psychological support,etc.The intervention time for both group was 4 weeks.The independent sample t-test,χ^(2) test and Mann Whitney U test were applied to compare the improvement of cardiac function,plasma brain natriuretic peptide(BNP),echocardiographic indexes[left ventricular ejection fraction(LVEF),left ventricular volume index(LVMI)and left ventricular end-diastolic diameter(LVEDD)]and exercise endurance[maximum oxygen uptake(VO2max),maximum power and exhaustion time]between the two groups,and the nursing satisfaction of the two groups was compared too.Based on the above results,the impact of health education based on the integrated theory of health behavior change on the cardiac function,exercise endurance and nursing satisfaction in patients with chronic heart failure were analyzed.Results There was no statistically significant difference in various indicators between the two groups before intervention(all P>0.05).After the intervention,the BNP,LVMI and LVEDD in the experimental group were all clearly lower than those in the control group[(572.87±89.72)vs(680.46±104.32)mg/L,(140.74±9.54)vs(151.91±11.52)g/m2 and(77.62±4.32)vs(80.31±5.57)mm,respectively],and they were all significantly lower than those before intervention[(963.41±228.69)mg/L,(170.33±12.61)g/m2 and(90.10±6.77)mm,respectively].The LVEF,the VO2max,maximum power,exhaustion time,and nursing satisfaction in the experimental group were all significantly higher than those in the control group[54.55%±3.80%vs 52.16%±4.18%,(16.77±2.82)vs(15.61±3.15)ml·kg-1·ml-1,(88.91±7.13)vs(85.72±8.24)W,(13.47±1.62)vs(12.00±1.56)min,95.4%vs 84.6%],and they were all significantly higher than those before intervention[50.11%±4.22%,(14.03±3.26)ml·kg-1·ml-1,(81.42±6.46)W,(10.02±0.82)min,respectively](all P<0.05).Conclusion Health education based on the integration theory of health behavior change is beneficial for improving the cardiac function,exercise endurance and nursing satisfaction in patients with chronic heart failure.