以提高自我管理能力为核心的门诊指导在慢性心力衰竭患者中的应用

Application of outpatient guidance based on improving self-management ability in patients with chronic heart failure

目的:探讨以提高自我管理能力为核心的门诊指导在慢性心力衰竭(CHF)患者中的应用效果。方法:选取2021年2月至2022年8月在烟台市烟台山医院确诊的80例CHF患者,采用简单随机分组法分为观察组和对照组各40例。对照组采用常规护理,观察组采用以提高自我管理能力为核心的门诊指导进行干预,均干预3个月。分别在干预前和干预3个月后,比较两组CHF患者自我效能、认知水平、自我管理、疾病负担、心功能、运动耐力和生活质量。结果:干预后,观察组心衰知识问卷(AHFKT)评分、一般自我效能感量表(GSES)评分和自我管理能力得分均高于对照组(P<0.05);干预后,观察组总负担、个人负担维度和角色负担维度得分均低于对照组(P<0.05);干预后,观察组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均低于对照组,左室射血分数(LVEF)和6 min步行距离高于对照组(P<0.05);干预后,观察组的生活质量各评分均高于对照组(P<0.05)。结论:CHF患者采用基于自我管理能力提升的医护联合门诊指导,可较好提高患者的自我效能和认知水平,减轻自我疾病负担。

Objective:To explore the application of outpatient guidance to improve self-management ability in patients with chronic heart failure(CHF).Methods:A total of 80 CHF patients diagnosed in Yantai Mountain Hospital from February 2021 to August 2022 were selected and divided into observation group and control group with 40 cases in each group by simple randomization method.The control group was treated with routine nursing,while the observation group was treated with outpatient guidance to improve self-management ability.The intervention lasted for 3 months.The self-efficacy,cognitive level,self-management,disease burden,cardiac function,exercise endurance and quality of life were compared between the two groups of CHF patients before and 3 months after intervention.Results:After intervention,the scores of Atlanta Heart Failure Knowledge Test(AHFKT),General Self-Efficacy Scale(GSES)and self-management ability in the observation group were higher than those in the control group(P<0.05).After intervention,the scores of total burden,personal burden dimension and role burden dimension in the observation group were lower than those in the control group(P<0.05).After intervention,left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)in the observation group were lower than those in the control group,and left ventricular ejection fraction(LVEF)and 6-minute walking distance in the observation group were higher than those in the control group(P<0.05).After intervention,the quality of life scores of the observation group were higher than those of the control group(P<0.05).Conclusions:Patients with chronic heart failure can better improve their self-efficacy and cognitive level and reduce their disease burden by adopting the combined medical and outpatient guidance based on the improvement of self-management ability.