Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Analysis of Perioperative Respiratory Care Methods and their Application Value in Children with Congenital Heart Disease

Objective:To analyze the perioperative respiratory care methods and application value in children with congenital heart disease.Methods:60 children with congenital heart disease(treated from January 2021 to October 2023)were screened and divided into two groups randomly.Each group consisted of 30 cases.The perioperative routine was used in the control group.The observation group underwent the perioperative routine along with better respiratory care.Oxygenation indicators,surgical complications,and family satisfaction levels of the groups were compared.Results:There was no significant difference in the oxygenation index between the two groups of children at admission(P>0.05).At discharge,the oxygenation indicators in the observation group were better than those of the control group,and the incidence of surgical complications was lower than that of the control group.The total satisfaction of family members in the observation group was higher than that of the control group(P<0.05).Conclusion:During the perioperative period for children with congenital heart disease,the implementation of respiratory care,which mainly involves symptomatic care,catheter care,sputum suction care,etc.,can actively improve the oxygenation indicators,reduce surgical complications,and promote faster and better recovery,of children with congenital heart disease.

Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.

Nursing care of a patient with programmed cell death protein-1 immunotherapy-related myocarditis combined with coronary heart disease

This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart disease(CHD)after receiving said treatment.In this case,immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy,yet the patient presented no clinical symptoms.Frequent nursing attention and close observation are so required for monitoring the patient’s status and updating the physicians for a swift control of the myocarditis.For this case,nursing care procedures vital for the successful recovery of the patient included condition observation,position management,pre-and postcoronary angiography care,infection prevention,hemorrhage prevention,venous access port maintenance,pain care,trachea care,psychological care,diet care,environment management,and health education.After receiving effective,successful treatment and care,the patient was discharged after 13 days of treatment with generally satisfying overall conditions.

Psychological needs of parents of children with complicated congenital heart disease after admitting to pediatric intensive care unit: A questionnaire study

BACKGROUND Parents of children with complicated congenital heart disease(CHD)have different needs after surgery.Little literature reports the impact factors for psychological needs of parents of children with complicated CHD.AIM To investigate the status quo of the needs of parents of children after surgery for complex CHD,and analyze the influencing factors,in order to provide a theoretical basis for formulating corresponding nursing countermeasures.METHODS A modified Chinese version of the Critical Care Family Needs Inventory(MCCFNI)was used to select 200 parents of children with complex CHD after surgery within 72 h after admission to the intensive care unit in our hospital to conduct an online questionnaire survey.The aim was to understand the needs of parents in relation to the following five aspects:The support from medical staff,comfort of the parents themselves,the acquisition of information,their closeness to the children,and assurance of the child’s condition.RESULTS Parents of children with complex CHD had a higher degree of demand,especially in terms of condition assurance,acquisition of information,and closeness to the children.The age,education level,and residence of the parents were related to the five dimensions of the needs of parents of children with complex CHD who had undergone surgery.CONCLUSION In practice,nurses should formulate corresponding nursing strategies based on the different cultural and social backgrounds of parents of children after complex CHD surgery to meet their different needs,and improve satisfaction.These findings provide a theoretical basis for constructing a family participatory nursing model for children in the intensive care unit in the future.

Perioperative Nursing for Adult Congenital Heart Disease with Severe Pulmonary Arterial Hypertension

Objectives: To explore the main points of perioperative nursing for adult congenital heart disease with severe pulmonary arterial hypertension. Methods: A retrospective study of 13 patients with congenital heart disease and severe pulmonary arterial hypertension who admitted to the perioperative period of care from January 2018 to December 2019. To prevent perioperative complications of the patients, the focus is on respiratory and circulatory system care, followed by blood coagulation monitoring, digestive system protection and psychological care. Results: All 13 patients passed the perioperative period and were discharged from ICU. Conclusion: Adult congenital heart disease with severe pulmonary arterial hypertension has high perioperative risk, respiratory and circulatory system care is the key.

Clinical Effect of an Improved Post-Operative Feeding Protocol“in Transition”Infants of Congenital Heart Disease with Pulmonary Hypertension

Background:To achieve successful management of infants with congenital heart disease(CHD)together with pulmonary hypertension(PH),postoperative care,especially feeding care is vital in addition to surgery.Postoperative feeding is comprised of three stages:feeding in the intensive care unit,feeding in the general ward and family feeding,in which the general ward is considered as the“transitional stage”.At present,there is little research on the optimal mode of feeding care for the transitional stage,and there is no universally recognized and accepted protocol.Methods:We retrospectively analyzed 114 CHD infants with PH who underwent family-centered(FC)feeding care from July 2017 to December 2018,and prospectively studied 122 CHD infants with the same baseline level who adopted the improved mode,nurse-parent-driven(NPD)feeding mode from January 2019 to June 2020.The feasibility and efficacy of NPD as a“transitional”feeding nursing mode in CHD infants with PH were compared with the FC cohort by observing and analyzing the stress of family caregivers,feedingrelated complications,the proportion of breastfeeding,improvement of nutritional status,acquisition of knowledge and skills of feeding care,inpatient’s satisfaction rating and prognosis.Results:When compared with the FC feeding care,the NPD mode significantly reduced the burden of family caregivers,improved the rate of feeding care knowledge and skills and inpatient’s satisfaction rating,reduced the incidence of improper feeding-related complications,and enhanced the proportion of breastfeeding and nutritional status of infants at the“transitional stage”(all P<0.05).The self-assessment score of care ability of family caregivers and weight gain of children in the NPD group were significantly higher than those in the FC group(all P<0.05)during the follow-up.Conclusions:As a transitional mode of feeding in CHD infants with PH,NPD feeding care is superior to the conventional FC mode,which therefore can be adopted as a standard protocol in clinical practice.

肝细胞特异性对比剂增强磁共振动脉期呼吸运动伪影的影响因素

目的分析肝细胞特异性对比剂增强磁共振患者动脉期呼吸运动伪影的影响因素,为采取针对性护理干预降低伪影发生率提供参考。方法回顾性分析233例初次行肝细胞特异性对比剂增强磁共振检查住院患者的临床资料,采用单因素及logistic回归分析确定动脉期呼吸运动伪影的危险因素。结果30.90%患者发生动脉期呼吸运动伪影。回归分析显示,文化程度、身体质量指数、心力衰竭、慢性阻塞性肺疾病、腹水是肝细胞特异性对比剂增强磁共振动脉期呼吸运动伪影发生的危险因素(均P<0.05)。结论肝细胞特异性对比剂增强磁共振检查患者动脉期呼吸运动伪影发生率高,影响因素较多。对高风险患者应及时干预,以降低动脉期呼吸运动伪影发生率。

单核细胞减少与分枝杆菌感染综合征患儿的护理

总结1例单核细胞减少与分枝杆菌感染综合征患儿的护理体会。针对患儿疾病罕见、移植高风险、预后未知等特点,采取降低有创诊疗风险等级,协助诊断、明确移植需求;居家肺部治疗联合远程康复,寻找最佳移植时机;双学科协同长程随访,优化患者预后等措施。患儿多次住院经反复穿刺活检及病理会诊,提示鸟分枝杆菌感染,PAS(+),DPAS(+),GATA2基因2号外显子插入突变,确诊为单核细胞减少与分枝杆菌感染综合征合并肺泡蛋白沉积症。于2022年10月行造血干细胞移植术,术后继续抗感染治疗。随访至今,间质性病变较移植前明显改善,继续抗排异治疗,现居家学习中。

叙事护理结合心脏康复护理对冠心病支架植入术患者自护能力、生活质量的影响

目的 观察叙事护理结合心脏康复护理对冠心病支架植入术患者自护能力、生活质量的影响。方法 选取2022年1月至2022年12月河南省胸科医院收治的100例冠心病支架植入术患者,以简单随机抽样法分组。对照组(50例)接受常规护理联合心脏康复护理,观察组(50例)在此基础上接受叙事护理。对比各指标。结果 应用叙事护理结合心脏康复护理后,观察组自我护理能力测定量表(ESCA)评分高于对照组(P<0.05);观察组生活质量水平更高(P<0.05)。结论 对冠心病支架植入术患者应用叙事护理结合心脏康复护理,可更好地提高患者自护能力,改善生活质量。

基于知信行模式的3H护理在慢性阻塞性肺疾病急性加重期患者中的应用

目的探究基于知信行模式的3H护理在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的应用价值。方法选取医院2019至2022年收治的73例AECOPD患者作为研究对象,随机分为观察组(n=37)和对照组(n=36)。对照组采用常规护理方式,观察组采用基于知信行模式的3H护理,比较2组患者心理弹性、生活质量、自护能力、自我效能。结果干预后2组患者心理弹性、生活质量、自护能力、自我效能得分较干预前均有升高(P<0.05),且观察组更高(P<0.05);结论相比于应用常规护理,应用基于知信行模式的3H护理对于AECOPD患者而言,更能提升心理韧性、改善生活质量、提升自护能力、提高自我效能,适合在临床推广使用。

基于专科护士主导的延续性护理在冠心病合并焦虑患者护理中的应用效果研究

研究基于专科护士主导的延续性护理在冠心病合并焦虑患者护理中的应用效果。选取2022年4月-2023年5月出院后出现焦虑情况的80例冠心病患者为研究对象,根据患者出院时间的不同将其分为对照组和观察组,每组各40例。对照组患者行常规出院指导护理,观察组行以专科护士为主导的延续性护理,对比两组患者的情绪状况、心律异常情况、生活质量及心血管疾病发生率等多项指标。结果显示,护理后,观察组焦虑和抑郁评分均低于对照组(P<0.05)、心律异常改善情况优于对照组(P<0.05)、各项生活质量指标评分高于对照组(P<0.05)、心血管疾病的发生率低于对照组(P<0.05)。研究发现,以专科护士为主导的延续性护理可以根据患者的具体情况采取针对性的干预措施,能够有效帮助患者缓解焦虑情绪,改善患者心律异常的情况,防止心血管疾病的发生,提高患者生活质量,促进患者积极面对后续的药物治疗。

先天性心脏病患者从青少年到成人过渡期护理的研究进展

先天性心脏病患者从青少年过渡到成人的过渡期是其实现疾病自主管理的重要阶段,为青少年先天性心脏病患者提供全面、完善的过渡期护理可以确保护理的连续性,提高青少年先天性心脏病患者的自我管理能力并改善其心脏功能状态。文章对青少年先天性心脏病患者的过渡期护理现状、护理需求、护理方案等方面的研究进行综述,并提出相关建议,为国内开展先天性心脏病患者的过渡期护理实践提供借鉴。

促进慢性阻塞性肺疾病哮喘患者自我监控空气质量的护理干预措施: 整合性综述

目的哮喘-慢性阻塞性肺疾病肺重叠症(Asthma-chronie obst ructive pulmonary disease overlap,A-CO)患者的生活质量较低,肺功能较差,病情经常加重。由于暴露于污染环境会加重其症状,增加发病率和病死率,环境管理对其至关重要。旨在通过系统性综述,寻找证据,以指导制订护理干预措施,促进ACO患者对空气质量的自我管理。方法2023年3月 ,系统检索CINAHL、Medline、Academie Search Complete .Scopus、WebofScience、Cochrane图书馆、乔安娜布里格斯研究所(JoannaBriggsInstitute,JBI)循证实践数据库,以及GoogleScholar。对纳人研究进行数据提取和综合,并对护理干预措施进行分类。采用JBI研究质量评估工具进行方法学质量评估。结果 共纳入5篇来自不同国家的研究。促进ACO患者自我监控空气质量的干预措施包括:警觉性干预措施(医务人员定期巡诊、进行症状评估),监测干预措施(监测室内外诱发因素) ,教育干预措施(空气质量警报、避免接触过敏原),以及相关政策的影响,如无烟政策和改善空气质量的综合战略。尽管这些研究报告了不同的干预措施,方法质量也存在差异,但这些干预措施显示了预防患者病情恶化、尽量减少急诊就诊和住院治疗的潜力。这些关键点可作为护理干预措施的关键组成部分。结论有必要采取全面措施,让护士参与促进患者自我监控空气质量的多学科团队.提高认识、制订和实施护理干预,从而使ACO患者受益。同时,需要进--步开展研究,以扩大证据基础并完善这些干预措施。

安宁疗护在老年慢性阻塞性肺疾病患者中的应用效果

目的:观察安宁疗护在老年慢性阻塞性肺疾病(COPD)患者中的应用效果。方法:选取2020年12月至2022年6月该院收治的172例老年COPD患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各86例。对照组采用常规护理,观察组在对照组基础上采用安宁疗护,比较两组护理前后自我管理能力评分、疾病相关指标[COPD评估测试(CAT)评分、呼吸困难指数(MRC)评分、6分钟步行试验(6MWD)、第1秒用力呼气容积(FEV1)/用力肺活量(FVC)]水平和护理依从性评分。结果:护理后,两组日常生活能力、症状、自我效能、情绪及信息等自我管理能力评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组MRC、CAT评分均低于护理前,且观察组低于对照组,两组6MWD均长于护理前,且观察组长于对照组,两组FEV1/FVC水平均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组服药剂量、服药次数、遵医治疗、定期复查及运动指导等护理依从性评分均高于对照组,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用安宁疗护应用于老年COPD患者可提高自我管理能力和护理依从性评分,改善疾病相关指标水平,其效果优于单纯常规护理。

认知行为联合预防性护理干预对冠心病患者PCI后焦虑抑郁及生活质量的影响

目的 分析冠心病患者接受经皮冠状动脉介入术(PCI)后身心状况,评价认知行为联合预防性护理干预的积极意义。方法选择我院2021年5月至2023年5月期间收治的PCI冠心病患者,总计80例。进行随机数字表法分组护理,对照组行常规护理,观察组配合认知行为+预防性护理干预,比较两组患者PCI术后焦虑抑郁、自护能力及生活质量情况,其中两组患者焦虑抑郁情况分别应用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评价;以自我护理能力实施量表(ESCA)对患者PCI术后自护能力进行评价;以健康调查简表(SF-36)对患者PCI术后生活质量进行评价。结果 PCI治疗后,观察组患者SAS评分(40.05±3.30)分、SDS评分(39.50±3.50)分均低于对照组(P <0.05);干预后观察组患者ESCA评分(130.50±4.50)分高于对照组(P <0.05);生活质量对比方面,观察组患者生理功能(75.50±6.50)分、生理职能(65.50±5.50)分、总体健康(60.50±5.30)分、躯体疼痛(68.80±4.50)分、精神健康(74.50±4.50)分、社会功能(80.50±5.50)分、情感职能(65.80±5.60)分、活力(78.70±6.50)分均高于对照组(P <0.05)。结论 对PCI治疗冠心病患者进行认知行为指导联合预防性护理干预,对患者预后康复有重要影响,可以显著降低患者不良情绪,提高自我护理能力,增强患者术后生活质量。

中医护理干预在老年慢性肺心病合并心力衰竭患者中的应用效果

目的探讨中医护理干预在老年慢性肺心病合并心力衰竭患者中的应用效果。方法纳入2020年1月至2021年6月于本院接受治疗的100例老年慢性肺心病合并心力衰竭患者为研究对象,以随机数字表法将其分为参考组(50例,常规护理)和中医组(50例,常规护理+中医护理干预)。比较两组患者的心功能、肺功能及生活质量。结果干预后,两组的左室射血分数(LVEF)、心排血量(CO)、每搏输出量(SV)、每分钟最大通气量(MVV)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)均高于干预前,且中医组高于参考组(P<0.05)。干预后,两组的生活质量综合评定问卷(GQOLI-74)各维度评分均高于干预前,且中医组高于参考组(P<0.05)。结论中医护理干预可显著改善老年慢性肺心病合并心力衰竭患者的心肺功能,且对于提高生活质量有积极作用。

多学科协作护理新模式对慢性阻塞性肺疾病患者肺功能及护理效果的影响

目的 对慢性阻塞性肺疾病(慢阻肺)实施多学科协作护理新模式的效果观察及有关指标分析。方法 选择2022年1月至2023年1月我院收治的68例慢阻肺患者,按随机数字表法分为两组,对照组(34例)予常规护理,观察组(34例)予多学科协作护理新模式,比较两组护理效果。结果 干预后,观察组肺功能(FVC、FEV1、MVV)均高于对照组,护理总有效率高于对照组(P <0.05),SAS、SDS分值均低于对照组(P <0.05),各项生存质量分值均低于对照组(P <0.05),睡眠质量改善效果均优于对照组(P <0.05)。结论 慢阻肺实施多学科协作护理新模式后可取得较好的护理效果,利于强化肺功能,纠正心理及睡眠状况,提升生存质量。

Cox健康行为互动模式对老年心瓣膜病患者的康复效果及对生活质量的影响

目的:探究Cox健康行为互动模式对老年心瓣膜病患者的康复效果及对患者生活质量的影响。方法:于2020年6月-2022年6月入组的老年心瓣膜病患者120例,按照随机数字表法分为常规护理组(60例)和Cox组(Cox健康行为互动模式干预,60例)。两组均干预6个月。比较两组一般资料,干预前后心功能、6min步行距离(6MWD)、生活质量、睡眠质量及疾病感知。结果:治疗6个月后,与常规护理组相比,Cox组患者左室射血分数(LVEF)[(48.87±4.41)%比(51.94±4.04)%]、6MWD[(353.20±4.83)m比(424.93±4.40)m]、中国心血管病人生活质量评定问卷(CQQC)[(84.67±4.05)分比(134.46±4.58)分]和修订版控制态度量表(CAS-R)[(22.13±3.21)分比(34.98±3.39)分]显著增加(P均=0.001);左室收缩末期内径(LVESd)[(54.99±6.07)mm比(49.01±5.48)mm]、左室舒张末期内径(LVEDd)[(59.20±7.16)mm比(54.05±6.14)mm]及匹兹堡睡眠质量指数(PSQI)[(14.53±2.42)分比(9.31±1.10)分]均显著缩窄或降低(P均=0.001)。结论:Cox健康行为互动模式在老年心瓣膜病患者的治疗和康复中发挥作用,可显著提高心功能、体能,改善生活质量。

专病一体化护理模式对COPD伴冠心病患者心肺功能及预后的影响

目的探讨专病一体化护理模式对慢性阻塞性肺疾病(COPD)伴冠心病患者心肺功能及预后的影响。方法选择2021年3月至2022年9月收治的96例COPD伴冠心病患者,随机分为对照组和观察组,每组48例。其中对照组给予常规方法进行护理,观察组给予专病一体化护理模式护理,出院后进行3个月的随访。比较2组干预前和干预后3个月的肺功能[最大呼气中期流量(MMEF)、用力肺活量(FVC)、呼气高峰流速(PEF)、第1秒用力呼气量(FEV1)]、心功能[脑钠肽(BNP)、6 min步行距离(6MWD)]及生存质量评分变化,分析2组护理满意度差异。结果观察组护理满意度明显高于对照组(P<0.05)。与治疗前比较,2组MMEF值及血清BNP水平明显降低,FVC、PEF、FEV1及6MWD值明显升高,且观察组更明显(P<0.05)。与治疗前比较,2组生存质量、社会适应性、心理维度及生理维度评分均明显升高,且观察组更明显(P<0.05)。结论专病一体化护理模式干预COPD伴冠心病患者,可有效改善其心肺功能,提高护理满意度和预后生存质量,具有一定的临床应用价值。