专科引导下的角色互换病例模拟对冠心病患者自我管理水平的临床效果

Clinical outcome of self-management in patients with coronary heart disease by the specialist-guided role exchange in case simulation

目的 研究专科引导下的角色互换病例模拟干预对冠心病患者自我管理水平的临床效果。方法 纳入2022年1月至2023年3月收治的冠心病行介入治疗患者共计90例为研究对象,将其以数字表随机法分为观察组与对照组,每组45例。对照组患者实施常规健康管理方案,观察组以常规健康管理方案为基础实施专科引导下的角色互换病例模拟干预方案。对比不同干预方案对2组冠心病患者疾病认知水平、自我管理水平、自我效能、心功能水平、血脂水平、生活质量、心理状况及心血管事件半年期再发情况差异。结果 观察组患者服药依从性、运动锻炼依从率及自我效能感得分均高于对照组(P<0.05);2组患者干预前疾病认知得分无明显差异(P>0.05),干预后2组得分均提高(P<0.05),且观察组高于对照组(P<0.05);干预前2组患者LVESV、LVEDV、LVEF水平无无明显差异(P>0.05),干预后各指标水平均提升,观察组高于对照组(P<0.05);干预前2组患者低密度脂蛋白与总胆固醇水平无无明显差异(P>0.05),干预后2组指标水平均下降,观察组低于对照组(P<0.05);干预前2组患者焦虑与抑郁量表得分无无明显差异(P>0.05),干预后2组得分均下降,观察组低于对照组(P<0.05);干预前2组患者生活质量得分无无明显差异(P>0.05),干预后2组生活质量得分均提高,观察组高于对照组(P<0.05);观察组再入院率低于对照组(P<0.05)。结论 于专科引导下的角色互换病例模拟干预能够提高冠心病患者的疾病认知水平、自我管理水平与心脏康复质量,降低心血管事件再发风险与焦虑、抑郁程度,于生活质量提升有益。

Objective To analyze the clinical outcome of self-management in patients with coronary heart disease by the specialist-guided role exchange in case simulation.Methods A total of 90 patients with coronary heart disease undergoing interventional therapy were included as the study subjects.They were randomly assigned into the observation group and control group,with 45 patients in each group.A routine health management was given to all patients,while a specialist-guided role exchange in case simulation was additionally performed in the observation group.Disease awareness level,self-management level,self-efficacy,cardiac function,blood lipids,quality of life,psychological status,and recurrence of cardiovascular events within 6 months were compared between groups.Results Patients in the observation group had significantly higher scores of medication compliance,exercise compliance rate,and self-efficacy compared to those of the control group(P<0.05).There was no significant difference in the disease awareness score before interventions between the two groups(P>0.05),which significantly increased in both groups after interventions,especially higher in the observation group(P<0.05).Before interventions,there were no significant differences in the left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),and left ventricular ejection fraction(LVEF)between the two groups(P>0.05),which significantly increased in both groups after interventions,especially higher in the observation group(P<0.05).Before interventions,there were no significant differences in the low-density lipoprotein and total cholesterol between the two groups(P>0.05),which significantly decreased in both groups after interventions,especially lower in the observation group(P<0.05).Before interventions,there were no significant differences in the anxiety and depression scores between the two groups(P>0.05),which significantly decreased in both groups after interventions,especially lower in the observation group(P<0.05).Before interventions,there was no significant difference in the score of quality of life between the two groups(P>0.05),which significantly increased in both groups after interventions,especially higher in the observation group(P<0.05).The readmission rate of the observation group was significantly lower than that of the control group(P<0.05).Conclusion Specialist-guided role exchange in case simulation can improve the disease awareness level,self-management level,and cardiac rehabilitation quality,and reduce the risk of recurrence of cardiovascular events and the levels of anxiety and depression in patients with coronary heart disease patients,which is beneficial for improving the quality of life.