摘要
目的 探讨基于微信等移动平台的延续性护理对老年冠心病(Coronary heart disease,CHD)不稳定型心绞痛(Unstable angina pectoris,UAP)患者心理状态、自我护理能力及生存质量的影响.方法 选取2020年8月～2022年1月本院收治的老年CHD并发UAP患者102例,根据随机数字表法分为对照组51例(实施常规电话随访)与观察组51例(实施基于微信等移动平台的延续性护理).出院后对所有老年CHD并发UAP患者均进行6个月随访,记录两组老年CHD并发UAP患者护理前(出院时)与护理后(出院后6个月)心理状态、自我护理能力、生存质量评分及心脏不良事件发生情况,并进行统计学分析.结果 护理后观察组老年CHD并发UAP患者HAMD评分(15.61±3.73)分低于对照组(20.82±4.48)分、HAMA评分(14.61±3.67)分低于对照组(19.31±4.59)分,有统计学意义(t值依次为6.383、5.711,P＜0.05).护理后观察组老年CHD并发UAP患者自我概念(28.72±3.13)分高于对照组(23.65±2.97)分,自我护理技能(29.11±3.29)分高于对照组(24.63±3.01)分,自护责任感(26.87±2.72)分高于对照组(22.21±2.51)分,健康知识水平(50.34±3.64)分高于对照组(43.87±3.21)分,有统计学意义(t值依次为8.391、7.175、8.992、9.521,P＜0.05).护理后观察组老年CHD并发UAP患者生理职能(81.67±8.42)分高于对照组(73.16±7.25)分、情感职能(78.68±8.25)分高于对照组(69.24±6.49)分、躯体功能(80.79±8.46)分高于对照组(71.22±7.19)分、社会功能(82.14±7.29)分高于对照组(73.27±6.76)分、机体疼痛(78.81±7.94)分高于对照组(71.41±7.43)分、活力(79.08±7.12)分高于对照组(70.67±6.65)分、精神健康(77.67±8.16)分高于对照组(70.82±7.31)分、总体健康(81.27±7.57)分高于对照组(74.52±6.94)分,有统计学意义(t 值依次为 5.470、6.113、6.156、6.372、4.860、6.165、4.465、4.694,P＜0.05).护理期间,观察组老年 CHD并发UAP患者心脏不良事件发生率7.84％(4/51)低于对照组25.49％(13/51),有统计学意义(x2=4.518,P＜0.05).结论 对老年CHD并发UAP患者出院后实施基于微信等移动平台的延续性护理可明显改善患者抑郁焦虑情绪,提升患者自我护理能力及生存质量,且心脏不良事件发生率较低,值得借鉴.
Abstract
Objective To discuss the effect of of continuous nursing based on wechat and other mobile platforms on psychological status,self-care ability and quality of life of elderly CHD patients complicated with UAP.Methods 102 cases of elderly CHD patients complicated with UAP in our hosipital were selected from Aug 2020 to Jane 2022,then divided into the control group 51 cases(given routine telephone follow-up)and the observation group 51 cases(given continuous nursing based on wechat and other mobile platforms)according to the random number table method.After discharge,all elderly CHD patients complicated with UAP were followed up for 6 months.The psychological status,self-care ability,quality of life score and adverse cardiac events of the two groups of elderly CHD patients complicated with UAP before nursing(at discharge)and after nursing(6 months after discharge)were recorded and statistically analyzed.Results The HAMD score(15.61±3.73)points after nursing of the observation group elderly CHD patients complicated with UAP was lower than the control group(20.82±4.48)points,the HAMA score(14.61±3.67)points was lower than the control group(19.31±4.59)points,which were statistical significance(the values of t were 6.383,5.711 respectively,P＜0.05).The self concept(28.72±3.13)points of the elderly CHD patients complicated with UAP of the observation group after nursingwas higher than the control group(23.65±2.97)points,self-care skills(29.11±3.29)points was higher than the control group(24.63±3.01)points,self-care responsibility(26.87±2.72)points was higher than the control group(22.21±2.51)points,health knowledge level(50.34±3.64)points was higher than the control group(43.87±3.21)points,which were statistical significance(the values of t were 8.391,7.175,8.992,9.521 respectively,P＜0.05).The the physiological function(81.67±8.42)points of the elderly CHD patients complicated with UAP of the observation group after nursing was higher than the control group(73.16±7.25)points,emotional function(78.68±8.25)points was higher than the control group(69.24±6.49)points,physical function(80.79±8.46)points was higher than the control group(71.22±7.19)points,so-cial function(82.14±7.29)points was higher than the control group(73.27±6.76)points,body pain(78.81±7.94)points was higher than the control group(71.41±7.43)points,vitality(79.08±7.12)points was higher than the control group(70.67±6.65)points,mental health(77.67±8.16)points was higher than the control group(70.82±7.31)points,overall health(81.27+7.57)points was higher than the control group(74.52±6.94)points,which were statistical signifi-cance(the values of t were 5.470,6.113,6.156,6.372,4.860,6.165,4.465,4.694 respectively,P＜0.05).During the nursing period,the incidence of adverse cardiac events of the observation group elderly CHD patients complicated with UAP 7.84％(4/51)was lower than the control group 25.49％(13/51),which were statistical significance(x2=4.518,P＜0.05).Conclusion The implementation of continuous care based on wechat and other mobile platforms for elderly CHD patients with UAP after discharge can significantly improve patients'depression and anxiety,improve patients'self-care abil-ity and quality of life,and the incidence of adverse cardiac events is low,which is worthy of reference.
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