基于知信行评估的PDCA管理对心脏瓣膜置换术后患者临床疗效的影响及其安全性
Influence of PDCA management based on knowledge-attitude-belief-practice assessment on clinical therapeutic effect in patients after heart valve replacement and its safety
杨菲 1陈竹梅1
作者信息
- 1. 中国人民解放军空军军医大学第一附属医院门诊部,陕西西安 710032
- 折叠
摘要
目的:探究在知信行评估的基础上应用计划-执行-检查-处理循环法(PDCA)干预对心脏瓣膜置换术后患者临床疗效的影响和安全性.方法:选择2020年1月～2021年12月于中国人民解放军空军军医大学第一附属医院接受心脏瓣膜置换术的患者150例,根据电脑随机分组法分为对照组和观察组,各75例.对照组接受日常健康宣教,研究组在知信行评估方案基础上联合PDCA管理干预,两组均干预4周.对比两组抗凝治疗认知度、华法林抗凝国际标准化比值(INR)控制水平、自我护理能力、依从性、焦虑情况、生活质量和并发症发生率.结果:与对照组比较,观察组干预4周后对抗凝治疗认知度[(8.22±2.33)分比(13.57±2.79)分]、自我护理能力量表(ESCA)[(124.68±11.85)分比(155.16±10.45)分]评分及治疗依从性(73.33％比97.33％)均明显提升,汉密尔顿焦虑量表(HAMA)评分[(10.53±1.54)分比(7.13±1.25)分]显著降低(P均＜0.001);术后3、6个月,观察组INR均显著提高(P均＜0.01);6个月后,观察组健康状况调查简表(SF-36)评分[(77.20±3.59)分比(86.22±3.52)分]显著提高,并发症发生率(24.00％比5.33％)显著降低(P均＜0.001).结论:对行心脏瓣膜置换术患者应用基于知信行评估的PDCA管理,可显著提升患者抗凝药物认知度、抗凝疗效和依从性,同时减轻不良情绪和减少并发症,改善患者预后.
Abstract
Objective:To explore the influence of plan-do-check-process(PDCA)intervention based on knowl-edge-attitude-belief-practice assessment on clinical therapeutic effect in patients after heart valve replacement and its safety.Methods:A total of 150 patients who received heart valve replacement in First Affiliated Hospital of Chinese PLA Air Force Military Medical University between January 2020 and December 2021 were selected.Ac-cording to computer random grouping method,they were divided into control group(n=75,daily health education)and observation group(n=75,PDCA management intervention based on knowledge-attitude-belief-practice as-sessment),both groups were intervened for 4 weeks.Anti-coagulant therapy awareness,international normalized ratio(INR)control of warfarin,self-care ability,compliance,anxiety,quality of life and incidence of complica-tions were compared between two groups.Results:Compared with control group after 4-week intervention,pa-tients in observation group had significant higher scores of anti-coagulant therapy awareness[(8.22±2.33)points vs.(13.57±2.79)points],exercise of self-care agency[(124.68±11.85)points vs.(155.16±10.45)points]and therapeutic compliance(73.33％vs.97.33％),and significant lower score of Hamilton anxiety scale(HAMA)[(10.53±1.54)points vs.(7.13±1.25)points](P＜0.001 all);significant higher INR on 3 and 6 months after surgery(P＜0.01 both);after 6 months,observation group had significant higher score of Medical Outcomes Study 36-item Short Form(SF-36)[(77.20±3.59)points vs.(86.22±3.52)points]and significant lower incidence rate of complications(24.00％vs.5.33％)(P＜0.001 both).Conclusion:PDCA management based on knowledge-attitude-belief-practice assessment can significantly improve the awareness of anticoagulant agent,anti-coagu-lant efficacy and compliance,reduce adverse emotions and complications,and improve the prognosis in patients un-dergoing heart valve replacement.
关键词
心脏瓣膜假体植入/抗凝药/焦虑Key words
Heart valve prosthesis implantation/Anticoagulants/Anxiety引用本文复制引用
出版年
2024
NETL
NSTL
万方数据