Application and Promotion of Whole-Process Capacity Management Model for CHF Patients Led by Specialist Nurses in “Heart Failure Center Alliance Unit”

Objective: To implement the whole-process capacity management model led by specialist nurses, improve the capacity management behavior of medical staff, and build a standardized, standardized and operable CHF capacity management system. Methods: According to the evidence pyramid principle and search strategy, 2 evidence-based nursing backbone completed literature search in both Chinese and English, and finally included 7 literatures. Results: Around the three key links of capacity assessment, monitoring and management, stakeholders were invited to evaluate each evidence according to the FAME principle, that is, the feasibility, suitability, effectiveness and clinical significance of evidence. Finally, 11 best evidences were obtained and 5 clinical review indicators of the cost project were transformed. This study formulated the competence management plan for CHF patients based on the current situation, established competence load evaluation criteria for CHF patients, and determined the target “dry weight” value for CHF patients. Conclusion: The whole-course volume management model of CHF patients guided by specialist nurses should be established and applied and promoted in the “heart failure Center Alliance unit”, so as to improve the capacity management ability of medical staff for CHF patients, enhance the self-management ability of CHF patients, improve the capacity management behavior and health outcomes, and effectively reduce the hospitalization rate and mortality rate of CHF patients in the region.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Development of Nursing Protocol for Preventing Interruptions during Clinical Examinations and Treatments in the Early Days of Hospitalization for Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the research, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 73 subjects (84.9%) considered effective for patients, in terms of prevention of interruptions during clinical examinations and treatments in the early days of hospitalization. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 84.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We consider that this nursing protocol will be useful especially for newly graduated/employed nurses as a procedure manual which can reduce their anxiety or stress caused by lack of knowledge or experiences.

Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Development of a Nursing Protocol for Hospitalized Patients with Reduced Cognitive Function in the Process of Recovery from Acute Exacerbation of Chronic Heart Failure

The purpose of this study is to develop a nursing protocol aiming at early recovery of hospitalized patients with reduced cognitive functions in the process of recovery from acute exacerbation of chronic heart failure. At the first stage of the research, a draft nursing protocol was prepared based on a basic survey. At the second stage of research, a semi-structured interview was conducted for 4 nurses certified for chronic heart failure nursing and 11 nurses certified for dementia nursing so as to ensure content validity of the draft nursing protocol. At the third stage of the study, the possibility of clinical application of the nursing protocol revision plan proposed at the second stage of the study was examined. The nursing protocol revision plan was effective for 118 nurses (90.1%) who carried out the protocol for the target patient on assessment items, essential points of nursing care and specific nursing care. There were no items or contents for which confirmation of usefulness was less than 60%. Since 90.1% of the usefulness was confirmed by nurses working in the actual clinical setting, the authors believe that this nursing protocol was secured to a certain level. The nursing protocol developed in this study has been requested by nurses at clinical sites in the past. It is very meaningful in improving nursing for the early recovery of hospitalized patients with reduced cognitive function in the process of recovery from acute exacerbation of chronic heart failure.

The application of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes

Background At present,patients with chronic heart failure complicated with diabetes are often treated with drugs in clinical practice.Most patients cannot adhere to regular and quantitative medication for a long time,and their poor compliance has adverse effects on their rehabilitation.The aim of this study was to explore the application effects of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes.Methods A total of 75 patients with chronic heart failure and diabetes,admitted to our center from May 2020 to May 2023,were randomly divided into Group A(n=38)and Group B(n=37)using a random number table.Group A received integrated rehabilitation management,while Group B received conventional rehabilitation management.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PG),glycated hemoglobin(Hb Alc),and self-care ability were compared between the two groups before and after intervention.Results After intervention,the LVEDD and LVESD in both groups were lower than before,while LVEF was higher than before(P<0.05).The LVEDD and LVESD in Group A were lower than in Group B after intervention,while LVEF was higher than in Group B(P<0.05).After intervention,the levels of FBG,2h PG,Hb Alc,and the scores of the European Heart Failure Self-care Behavior Scale(EHFSc B-9)in both groups decreased,with Group A being lower than Group B(P<0.05).Conclusions Integrated medical and nursing rehabilitation can effectively improve the cardiac function and blood glucose levels of patients with chronic heart failure and diabetes,control the patients’condition,and enhance their quality of life and self-care ability.[S Chin J Cardiol 2024;25(1):44-49]

基于恐惧-回避模型的康复护理方案在老年慢性心力衰竭患者中的应用

目的减轻老年慢性心力衰竭患者康复运动恐惧心理,促进其运动康复。方法便利抽取70例心内科住院老年慢性心力衰竭患者,按入院时间分为两组各35例;两组均行常规治疗护理,同时对照组行常规康复护理,干预组构建和实施基于恐惧-回避模型的康复运动方案,持续干预至出院后1个月评价效果。结果干预后干预组心功能指标显著优于对照组(均P<0.05),心脏病运动恐惧得分、明尼苏达州心力衰竭生活质量得分显著低于对照组(均P<0.05);运动方案实施过程中未发生运动相关不良事件。结论对老年慢性心力衰竭患者实施基于恐惧-回避模型的康复运动方案能减轻患者运动恐惧心理,改善心功能,提高生活质量。

循序渐进的运动康复护理对慢性心衰患者运动耐力、生活质量及不良心脏事件的影响

目的探究循序渐进的运动康复护理对慢性心衰患者运动耐力、生活质量及不良心脏事件的影响。方法选取2022年6月-2023年6月我院收治的106例慢性心衰患者进行研究。以随机数字表法均分为2组。对照组(53例):基础护理。观察组(53例):循序渐进的运动康复护理。比较6 MWD、生活质量、不良心脏事件、满意度。结果干预前,两组6 MWD相比差异不显著(t=0.267,P=0.790),干预3个月后,两组6 MWD均显著提升(t=11.710,P=0.000,t=8.469,P=0.000),且观察组(403.18±62.11)m高于对照组(375.51±68.43)分,差异显著(t=2.180,P=0.032)。干预前,两组生活质量评分相比差异不显著(t=1.690,P=0.094),干预3个月后,两组生活质量评分均显著提升(t=14.053,P=0.000,t=8.409,P=0.000),且观察组(47.11±3.16)分高于对照组(42.34±3.28)分,差异显著(t=7.625,P=0.000)。与对照组16.98%的心衰加重、心源性再入院、急性心肌梗死、心律失常等不良心脏事件总发生率相比,观察组(3.77%)显著降低,差异显著(χ^(2)=4.970,P=0.026)。观察组满意度(90.57%)优于对照组(75.47%),差异显著(χ^(2)=4.283,P=0.039)。结论循序渐进的运动康复护理在提升慢性心衰患者运动耐力方面有积极意义。该护理能够提高患者生活质量及满意度,降低不良心脏事件的发生率。

心脏超滤综合护理干预在重症心功能不全患者中的应用价值

目的探讨心脏超滤综合护理干预在重症心功能不全患者的疗效。方法选取2022年6月至2023年6月接受治疗的重症心功能不全患者44例,行心脏超滤技术。随机数字表法分为对照组和观察组,每组22例。对照组给予一般护理,观察组在对照组基础上给予综合护理。观察2组患者心功能情况、体循环血管阻力(SVR)、左心室射血分数(LVEF)、脑钠肽(BNP)及2组患者不良反应发生情况。结果观察组和对照组的总有效率分别为95.45%、72.72%,差异有统计学意义(P<0.05);护理后2组患者SVR、LVEF、BNP指标明显改善,且观察组优于对照组(P<0.05);观察组护理后满意程度高于对照组(P<0.05);观察组的不良反应发生率为4.55%,对照组为31.82%,差异有统计学意义(P<0.05)。结论综合护理干预心脏超滤技术治疗重症心功能不全患者,可以改善心功能情况,临床效果显著,有效降低不良反应发生情况,值得推广及应用。

Neuman理论指导下预对慢性心力衰竭患者自我效能、遵医行为的影响

目的探究Neuman理论指导下护理干预对慢性心力衰竭患者自我效能、遵医行为的影响。方法选取2021年1月至2022年1月于我院收治慢性心力衰竭患者110例,完全随机法分为对照组和观察组,每组55例,常规组给予常规护理干预,观察组给予Neuman理论指导下护理干预,观察2组一般自我效能感量表(GSES)、遵医行为、日常生活能力(ADL)、匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、心功能、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)、生活质量评分及护理满意率。结果观察组生活质量、ADL、GSES评分高于常规组,遵医不佳行为低于常规组,差异有统计学意义(P<0.05)。观察组心功能、APACHEⅡ、PSQI、SAS、SDS评分低于常规组,差异有统计学意义(P<0.05)。观察组护理满意率高于常规组,差异有统计学意义(P<0.05)。结论Neuman理论指导下护理干预对慢性心力衰竭患者,可有效提高自我效能、日常生活能力、降低负面情绪、睡眠质量、遵医不佳行为,改善其心功能,效果显著。

专病一体化护理联合协同护理模式对老年慢性心力衰竭患者的影响

目的:探讨专病一体化护理联合协同护理模式对老年慢性心力衰竭(CHF)患者的影响。方法:选取2022年2月1日~2023年2月28日收治的98例老年CHF患者作为研究对象,依据入院时间采用抽签法分为对照组和观察组各49例,对照组给予常规护理,观察组在此基础上实施专病一体化护理联合协同护理模式;比较两组入院时、出院时、出院3个月的积极度评分,护理前后生命质量[简明健康状况调查问卷(SF-36)]评分、睡眠质量(明尼苏达心力衰竭睡眠质量量表)评分、自我护理(欧洲心力衰竭自我护理行为量表)评分、汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分,护理满意度。结果:干预后,两组积极度评分逐渐提高(P<0.01),观察组出院时、出院3个月积极度评分高于对照组(P<0.01);护理后,两组生命质量评分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组睡眠质量、自我护理评分及HAMA、HAMD评分低于护理前(P<0.05),且观察组低于对照组(P<0.01);观察组护理满意度高于对照组(P<0.01)。结论:专病一体化护理联合协同护理模式能够有效改善CHF患者的不良情绪和积极度,提高睡眠质量和生命质量,提升护理满意度。

探究居家慢性心力衰竭患者出入量监测纵向情况与预后的关系

目的分析慢性心力衰竭(chronic heart failure,CHF)患者入院至出院居家不同时期出入量监测现况,探究其与疾病预后的关系。方法采用方便抽样,纳入2021年6月-2022年6月某三级甲等医院收治的128例CHF患者为研究对象。对患者和照顾者开展规范化住院健康教育、居家出入量监测指导、出院电话与门诊随访等。于患者入院时、出院时、出院后1个月、3个月、6个月纵向收集患者不同时期出入量监测情况与预后相关指标,并进行相关性分析。结果(1)从入院到出院后6个月,CHF患者的出入量居家监测合格率分别为入院时14.2%,出院时79.7%,随访1个月、3个月、6个月时分别为60.9%、50%、40.6%,呈现下降趋势。(2)重复测量方差分析结果显示:不同时期患者预后相关症状发生率(呼吸困难、水肿)、心功能指标(NT-proBNP)、再住院率随出院时间延长,呈现风险升高趋势(P<0.05)。(3)出院后1个月、3个月、6个月,居家出入量监测不合格患者症状发生率、NT-proBNP高于监测合格患者。出院后3个月、6个月监测不合格患者再住院率显著高于合格者,差异有统计学意义(P<0.05)。结论CHF患者落实出入量监测是容量管理的重要内容。目前患者居家出入量监测状况不容乐观。不同时期监测情况与CHF居家疾病预后有显著相关性,建议结合随访期患者需求优化方案,着重提升出院后3个月与6个月患者的出入量监测能力,改善预后。

老年慢性心力衰竭住院患者中重度心力衰竭发生风险预测模型的构建

目的基于电子病历的方式,构建慢性心力衰竭(CHF)患者中重度心力衰竭发生风险预测模型,并验证该模型的预测效果。方法2019年1月-2020年12月,选择上海市某三级甲等医院心血管临床医学中心诊断为CHF的299例患者为研究对象,采用Logistic回归建立CHF患者中重度心力衰竭发生风险预测模型,采用Hosmer-Lemeshow和受试者操作特征曲线分别检验模型的拟合优度及预测效果,并纳入100例患者对模型进行验证。结果心超(运动幅度降低)(OR=5.109)、双下肢水肿(OR=3.947)、心房颤动(OR=2.772)、血肌酐升高(OR=1.015)是CHF患者发生中重度心力衰竭的危险因素;血清白蛋白升高(OR=0.939)是保护因素;Hosmer-Lemeshow检验P=0.127,受试者操作特征曲线下面积为0.858,约登指数为0.528,最佳临界值为0.805,灵敏度为0.731,特异度为0.797,实际应用的正确率为77.00%。结论本课题建立的CHF患者中重度心力衰竭发生风险的预测模型效果良好,有利于以后早期识别中重度心力衰竭发生风险电子系统报警提示程序的更新提供依据。

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。

慢性心力衰竭病人血清miR-487b表达水平及其与心肌重构的关系

目的:分析慢性心力衰竭病人血清微小核糖核酸-487b(miR-487b)表达水平及其与心肌重构的关系。方法:选取2019年10月—2021年10月西安高新医院收治的96例慢性心力衰竭病人作为研究组,按照纽约心脏病协会心功能分级将病人分为Ⅰ级或Ⅱ级22例,Ⅲ级41例,Ⅳ级33例;另选取同期在同一所医院体检的健康者102名作为对照组。采用实时荧光定量聚合酶链式反应(qRT-PCR)法检测所有研究对象血清miR-487b表达水平。比较研究组与对照组血清miR-487b表达水平及研究组不同心功能分级病人血清miR-487b表达水平。采用Pearson法分析慢性心力衰竭病人血清miR-487b表达水平与心肌重构指标[包括左室重构指数(LVRI)、左室舒张末期内径(LVEDD)、左心房内径(LAD)、左室质量指数(LVMI)、左室后壁厚度(LVPW)]的关系。结果:研究组血清miR-487b表达水平低于对照组(P<0.001);研究组LVEDD、LAD、LVMI、LVPW均高于对照组(P<0.001),LVRI低于对照组(P<0.001)。研究组心功能Ⅳ级病人LVEDD、LAD、LVMI、LVPW均高于Ⅰ级或Ⅱ级、Ⅲ级病人(P<0.05),miR-487b表达水平、LVRI均低于Ⅰ级或Ⅱ级、Ⅲ级病人(P<0.05);Ⅲ级病人LVEDD、LAD、LVMI、LVPW均高于Ⅰ级或Ⅱ级病人(P<0.05),miR-487b表达水平、LVRI均低于Ⅰ级或Ⅱ级病人(P<0.05)。Pearson相关分析结果显示,慢性心力衰竭病人血清miR-487b与LAD、LVMI、LVPW均呈负相关(r值分别为-0.578、-0.502、-0.514,P<0.001),与LVRI呈正相关(r=0.464,P<0.001)。结论:慢性心力衰竭病人血清miR-487b表达水平降低,且与心肌重构密切相关。

抗阻训练对老年慢性心力衰竭合并衰弱病人的影响

目的:探讨抗阻训练对老年慢性心力衰竭合并衰弱病人的影响。方法:选取2022年1月—8月在南昌大学第二附属医院心内科住院的110例老年慢性心力衰竭合并衰弱病人为研究对象,采用随机数字表法将病人分为对照组50例和试验组60例,对照组采取热身运动、有氧运动(呼吸操)、平衡训练及柔韧运动,试验组在对照组基础上进行抗阻训练(弹力带)。比较两组病人衰弱状况、握力、6 min步行距离(6MWD)。结果:干预后4周及8周试验组衰弱状况均低于对照组(P<0.05),干预后4周及8周试验组握力均高于对照组(P<0.05),干预后4周及8周试验组6MWD均长于对照组(P<0.05)。结论:在热身运动、有氧运动(呼吸操)、平衡训练、柔韧运动基础上联合抗阻训练有利于改善老年慢性心力衰竭合并衰弱病人的衰弱状况,提高病人握力及运动耐力。

精细化容量管理对慢性心力衰竭急性加重患者的影响

目的:分析精细化容量管理在慢性心力衰竭急性加重患者出院前后护理中的应用效果,以期进一步提高慢性心力衰竭急性加重患者的临床护理水平。方法:采用便利抽样法选择2022年9月至2023年3月在北京市某三级甲等医院心内科住院的60例慢性心力衰竭急性加重患者,随机分为对照组和实验组。对照组采用药物常规治疗加常规心内科护理,实验组在对照组的基础上进行精细化容量管理干预,评价精细化容量管理对住院天数、氨基末端脑钠肽前体、明尼苏达心力衰竭生活质量问卷、出院3个月心力衰竭再住院情况的影响。结果:实验组的住院天数明显短于对照组(P=0.024),且住院期间实验组的氨基末端脑钠肽前体下降水平优于对照组(P=0.025),干预2周后,实验组的明尼苏达心力衰竭生活质量问卷评分明显低于对照组(P=0.048),但实验组与对照组的出院3个月再住院情况比较,差异无统计学意义(P=0.731)。结论:精细化容量管理方法可行、有效,在不增加治疗成本的基础上,可以明显缩短慢性心力衰竭急性加重患者的住院时间,提高生活质量。

沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭的临床效果

目的观察沙库巴曲缬沙坦联合美托洛尔治疗慢性心力衰竭(以下简称为心衰)的临床效果。方法选取2021年7月—2023年3月九江市第一人民医院收治的68例慢性心衰患者,根据随机数字表法分为A组和B组,各34例。A组予美托洛尔,B组在A组基础上联合沙库巴曲缬沙坦,2组均需持续用药12周。比较2组临床疗效,用药前及用药12周后心功能指标[左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心室舒张末期内径(LVEDD)]、24 h尿量及实验室指标[血肌酐、血浆B型脑钠肽(BNP)及血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)],不良反应。结果B组总有效率高于A组(97.06%vs.76.47%,χ^(2)=4.610,P=0.032)。用药12周后,2组LVEF高于用药前,LVFS大于用药前,LVEDD小于用药前,且B组优于A组(P<0.01);2组24 h尿量多于用药前,血肌酐、血浆BNP及血清CRP、TNF-α、IL-6水平低于用药前,且B组优于A组(P<0.05或P<0.01)。B组不良反应总发生率为11.76%,与A组的5.88%比较,差异无统计学意义(χ^(2)=0.183,P=0.669)。结论慢性心衰患者采用沙库巴曲缬沙坦联合美托洛尔治疗能增强疗效,可有效改善患者心功能,减轻炎性反应,且联合用药不会增加不良反应,用药较安全。

症状管理策略配合三位一体延续护理模式对慢性心衰患者病情控制及居家自我管理能力的影响

目的探究症状管理策略配合三位一体延续护理模式对慢性心衰患者病情控制及居家自我管理能力的影响。方法择取2020年1月至2022年1月收治的90例慢性心衰患者为研究对象,根据床位奇偶数将其分为对照组和观察组,各45例。对照组采用常规护理干预,观察组在对照组基础上采用症状管理策略配合三位一体延续护理模式进行干预。比较两组的干预效果。结果干预后,观察组的Memorial心力衰竭症状评估量表(MSAS-HF)各维度评分均低于对照组(P<0.05)。干预后,观察组的居家服药、居家饮食、病情自我监测、居家心脏康复锻炼评分均高于对照组(P<0.05)。干预后,观察组的左室射血分数(LVEF)、左心室高峰射血时间(LVTPER)高于对照组,左心室高峰射血率(LVPER)低于对照组(P<0.05)。结论症状管理策略配合三位一体延续护理模式不仅能够加大慢性心衰患者病情控制力度,还能提高患者居家自我管理能力,进而有效改善心功能。

基于循证理论的精准护理结合Snyder希望护理对慢性心力衰竭患者情绪调节能力及应对方式的影响

目的探讨基于循证理论的精准护理结合Snyder希望护理对慢性心力衰竭患者情绪调节能力及应对方式的影响。方法选择2019年10月至2022年2月收治的130例慢性心力衰竭患者为研究对象,以随机数字表法将其分为对照组与观察组,各65例。对照组实施常规护理,观察组在对照组基础上实施基于循证理论的精准护理结合Snyder希望护理。比较两组的干预效果。结果干预后,观察组的负性情绪调节能力量表(NMR-S)各维度评分均高于对照组(P<0.05)。干预后,观察组的面对评分高于对照组,回避、屈服评分低于对照组(P<0.05)。干预后,观察组的6 min步行距离长于对照组,左心室射血分数(LVEF)高于对照组(P<0.05)。结论基于循证理论的精准护理结合Snyder希望护理能够提高慢性心力衰竭患者的情绪调节能力及运动耐量,纠正应对方式,改善心功能。