摘要
目的探讨基于初始核对-信息交流-准确性核对-反应(IIFAR)微信护理结合聚焦干预在急性心肌梗死(AMI)经皮冠脉介入治疗(PCI)后的应用效果。方法选取2023年1~4月河南科技大学第一附属医院收治的102例AMI患者纳入研究,按随机数表法分为对照组和观察组各51例。两组患者均接受PCI术治疗,对照组采取常规干预,观察组于此基础上采取基于IIFAR微信护理与聚焦干预相结合的管理模式,干预时间共6个月。干预前和干预2个月、6个月后,比较两组患者的冠心病自我管理行为量表(CSMS)评分、运动自我效能量表(SEE)评分,术后24 h内和干预2个月、6个月后,比较两组患者的心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心房内径(LAD)]和运动能力[无氧阈耗氧量(VO2AT)、峰值耗氧量(VO2peak)、6 min步行距离(6MWD)],并比较两组患者的主要不良心血管事件(MACE)发生情况。结果干预2个月和6个月后,两组患者的CSMS和SEE评分均呈逐渐升高趋势,且观察组患者的CSMS、SEE评分明显高于对照组,差异均有统计学意义(P<0.05);干预2个月和6个月后,两组患者的LVEF均呈逐渐升高趋势,而LVEDD、LAD均呈逐渐降低趋势,且观察组患者的LVEF明显高于对照组,LVEDD、LAD明显低于对照组,差异均有统计学意义(P<0.05);干预2个月和6个月后,两组患者的VO2AT、VO2peak、6 MWD均呈逐渐升高趋势,且观察组患者的VO2AT、VO2peak、6 MWD明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的MACE总发生率为5.88%,略低于对照组的13.73%,但差异无统计学意义(P>0.05)。结论基于IIFAR微信护理结合聚焦干预有助于提高AMI PCI术后患者自我效能与自我管理能力,恢复心功能,提高运动能力。
Objective To explore the application effect of initial check-information exchange-final accuracy check-reaction(IIFAR)WeChat nursing combined with focused intervention after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods A total of 102 patients with AMI admitted to the First Affiliated Hospital of Henan University of Science and Technology from January,2023 to April,2023 were selected for inclusion in the study.They were randomly divided into a control group and an observation group,with 51 patients in each group.Both groups received PCI treatment.The control group received conventional intervention,while the observation group received a management model based on IIFAR WeChat nursing combined with focused intervention on this basis.The intervention time for both groups was six months.Before intervention,after 2 months,6 months of intervention,the scores of the Coronary Heart Disease Self-management Behavior Scale(CSMS)and the Self-efficacy for Exercise Scale(SEE)were compared between the two groups of patients.Within 24 hours after surgery,after 2 months,and after 6 months of intervention,the cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)]and exercise capacity[oxygen consumption at anaerobic threshold(VO2AT),peak oxygen consumption(VO2peak),6-minute walk distance(6 MWD)]were compared between the two groups of patients,and the incidence of major adverse cardiovascular events(MACE)was compared between the two groups.Results After 2 months and 6 months of intervention,the CSMS and SEE scores of both groups showed a gradual increase,and the CSMS and SEE scores of the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05).After 2 months and 6 months of intervention,the LVEF of both groups showed a gradual increase,while LVEDD and LAD showed a gradual decrease;the LVEF of the observation group was significantly higher than that of the control group,and LVEDD and LAD were significantly lower than those of the control group;the differences were statistically significant(P<0.05).After 2 months and 6 months of intervention,the VO2AT,VO2peak,and 6 MWD of both groups showed a gradual increase trend,and the three indexes of the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05).The total incidence of MACE in the observation group was 5.88%,slightly lower than 13.73%of the control group(P>0.05).Conclusion IIFAR-based WeChat nursing combined with focused intervention helps improve self-efficacy and self-management,restore cardiac function,and improve exercise ability in AMI patients after PCI.
作者
蔡丹霞
郭燕
赵毅
陈士芳
CAI Dan-xia;GUO Yan;ZHAO Yi;CHEN Shi-fang(Department of Cardiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA)
出处
《海南医学》
CAS
2024年第12期1803-1808,共6页
Hainan Medical Journal
基金
2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20230463)。
作者简介
第一作者:蔡丹霞(1984-),女,主管护师,主要研究方向:心血管内科疾病的护理;通讯作者:陈士芳(1979-),女,副主任护师,主要研究方向:心血管内科疾病的护理,E-mail:fangzi791010@163.com。
