[1]胡光玲,王静,王亚欣,等.多元协同护理在心房颤动患者中的应用[J].新乡医学院学报,2023,40(3):268-273.[doi:10.7683/xxyxyxb.2023.03.014]
　HU Guangling,WANG Jing,WANG Yaxin,et al.Application of multiple cooperative nursing in patients with atrial fibrillation[J].Journal of Xinxiang Medical University,2023,40(3):268-273.[doi:10.7683/xxyxyxb.2023.03.014]
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多元协同护理在心房颤动患者中的应用
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年3期
页码:
268-273
栏目:
护理研究
出版日期:
2023-03-05

文章信息/Info

Title:
Application of multiple cooperative nursing in patients with atrial fibrillation
作者:
胡光玲1; 王静2; 王亚欣2; 黄莉莉1; 赵雪琪1; 杨巧芳2
（1.阜外华中心血管病医院心血管内科，河南　郑州　451460；2.阜外华中心血管病医院护理部，河南　郑州　451460）
Author(s):
HU Guangling1; WANG Jing2; WANG Yaxin2; HUANG Lili1; ZHAO Xueqi1; YANG Qiaofang2
(1.Department of Cardiovascular Medicine,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451460,Henan Province,China;2.Department of Nursing,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451460,Henan Province,China)
关键词:
心房颤动; 多元协同护理; 服药依从性; 自我效能; 生活质量; 心血管事件
Keywords:
atrial fibrillation; multiple cooperative nursing; medication compliance; self-efficacy; quality of life; cardiovascular event
分类号:
R541.75
DOI:
10.7683/xxyxyxb.2023.03.014
文献标志码:
A
摘要:
目的探讨多元协同护理在心房颤动患者中的应用效果。
方法采用便利抽样法选择2021年10月至2021年12月阜外华中心血管病医院收治的58例心房颤动患者为对照组，选择2022年1月至2022年3月收治的56例心房颤动患者为观察组，对照组患者给予常规护理，观察组患者给予多元协同护理。入院时、出院后6个月，采用中文版服药依从性量表（MMAS-8）评估2组患者的服药依从性，采用中文版一般自我效能感问卷（GSES）评估2组患者的自我效能感，采用中文版心房颤动患者生活质量量表（AF-QoL-21）评估患者的生活质量。所有患者出院后随访6个月，统计出院后1、3、6个月时患者心血管事件发生情况。
结果入院时2组患者的MMAS-8、GSES、AF-QoL-21评分比较差异无统计学意义（P>"0.05），2组患者出院后6个月的MMAS-8、GSES、AF-QoL-21评分显著高于入院时（P<0.05）；出院后6个月，观察组患者的MMAS-8、GSES、AF-QoL-21评分显著高于对照组（P<0.05）。出院后1个月，观察组和对照组患者心血管事件发生率分别为1.79%（1/56）、5.17%（3/58），2组患者心血管事件发生率比较差异无统计学意义（χ2=0.254，P>0.05）。出院后3个月，观察组和对照组患者心血管事件发生率分别为5.36%（3/56）、17.24%（10/58），观察组患者心血管事件发生率显著低于对照组（χ2=3.958，P<0.05）。出院后6个月，观察组和对照组患者心血管事件发生率分别为12.50%（7/56）、32.76%（19/58），观察组患者心血管事件发生率显著低于对照组（χ2=6.211，P<0.05）。
结论多元协同护理可以提高心房颤动患者的服药依从性、自我效能和生活质量，降低患者心血管事件发生率。
Abstract:
ObjectiveTo investigate the effect of multiple cooperative nursing in patients with atrial fibrillation.MethodsFifty-eight patients with atrial fibrillation admitted to the Fuwai Central China Cardiovascular Hospital from October 2021 to December 2021 were selected as the control group by convenience sampling method,and 56 patients with atrial fibrillation admitted from January 2022 to March 2022 were selected as the observation group.The patients in the control group were given routine nursing,while the patients in the observation group were given multiple cooperative nursing.At the admission and six months after discharge,the medication compliance of patients in the both groups was evaluated by the Chinese version of the Morisky medication adherence scale (MMAS-8),the self-efficacy of patients was evaluated by the Chinese version of general self-efficacy questionnaire (GSES),and the quality of life of patients was evaluated by the Chinese version of atrial fibrillation effect on quality-of-life-21(AF-QoL-21).All patients were followed up for six months to observe the occurrence of cardiovascular events at 1,3 and 6 months afterdischarge.ResultsThere was no significant difference in MMAS-8,GSES and AF-QoL-21 score of patients between the two groups at admission (P>0.05).The scores of MMAS-8,GSES and AF-QoL-21 of patients in the both groups at 6 months after discharge were significantly higher than those at admission (P<0.05).Six months after discharge,the scores of MMAS-8,GSES and AF-QoL-21 of patients in the observation group were significantly higher than those in the control group (P<0.05).One month after discharge,the incidence of cardiovascular events in the observation group and the control group was 1.79% (1/56) and 5.17% (3/58),respectively.There was no significant difference in the incidence of cardiovascular events between the two groups(χ2=0.254,P>0.05).Three months after discharge,the incidence of cardiovascular events of patients in the observation group and the control group was 5.36% (3/56) and 17.24% (10/58),respectively.The incidence of cardiovascular events of patients in theobservation group was significantly lower than that in the control group(χ2=3.958,P<0.05).Six months after discharge,the incidence of cardiovascular events of patients in the observation group and the control group was 12.50% (7/56) and 32.76% (19/58),respectively.The incidence of cardiovascular events of patients in theobservation group was significantly lower than that in the control group(χ2=6.211,P<0.05).ConclusionMultiple cooperative nursing can improve the medication compliance,self-efficacy and quality of life of patients with atrial fibrillation,"and reduce the incidence of cardiovascular events.

参考文献/References:

［1］　DI CARLO A,BELLINO L,CONSOLI D,et al.Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union:the FAI Project［J］.Europace,2019,21(10):1468-1475.
［2］　《中国心血管健康与疾病报告2021》编写组.《中国心血管健康与疾病报告2021》概述［J］.中国心血管病研究，2022，20（7）：577-596.
THE WRITING COMMITTEE OF THE REPORT ON CARDIOVASCULAR HEALTH AND DISEASES IN CHINA 2021.Key points of report on cardiovascular health and diseases in China 2021［J］.Chin J Cardiovasc Res,2022,20(7):577-596.
［3］　金雪娟，周京敏.心力衰竭与心房颤动共存的流行病学和相关临床研究进展［J］.临床心血管病杂志，2019，35（3）：199-202.
JIN X J,ZHOU J M.The coexistence of heart failure and atrial fibrillation:progress in Epidemiology and related clinical research［J］.J Clin Cardiol,2019,35(3):199-202.
［4］　张怀南.高职育人工作的多元协同治理：框架模式、基本机制及实现路径［J］.教育科学论坛，2021（36）：20-25.
ZHANG H N.Multiple cooperative governance of higher vocational education:framework mode,basic mechanism and realization path［J］.Educ Sci Forum,2021(36):20-25.
［5］　JANUARY C T,WANN L S,CALKINS H,et al.2019 AHA／ACC／HRS focused update of the 2014 AHMACC／HRS guideline for the management of patients with atrial fibrillation：a report of the American College of Cardiology／American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society［J］.J Am Coll Cardiol,2019,74(1):104-132．
［6］　OPREA A,MOLNAR A,TURTURICA S,et al.The best approach for patients with stable coronary disease:the importance of a multidisciplinary heart team［J］.Chirurgia (Bucur),2020,115(5):626-634.
［7］　褚彦香，熊欢，邓妍，等.多学科团队协作对乳腺癌患者深静脉血栓防治的效果［J］.护理学杂志，2022，37（5）：27-30.
CHU Y X,XIONG H,DENG Y,et al.Effect of multidisciplinary teamwork on prevention and treatment of deep vein thrombosis in breast cancer patients［J］.J Nurs Sci,2022,37(5):27-30.
［8］　SIMMONS A,MCMAHON L,CROSBIE V,et al.A multidisciplinary team approach to screening,assessment and early intervention for young people with type 1 diabetes and disordered eating behaviour［J］.Clin Child Psychol Psychiatry,2021,26(3):629-642.
［9］　CAMERON J I,GIGNAC M A.“Timing it right” :a conceptual framework for addressing the support needs of family caregivers to stroke survivors from the hospital to the home［J］.Patient Educ Couns,2008,70(3):305-314.
［10］　孙娟，李岩，郑蔚，等.基于时机理论的赋能教育在PCI手术患者中的应用［J］.护理学报，2022，29（2）：73-78.
SUN J,LI Y,ZHENG W,et al.Application of enabling education based on timing theory in PCI patients［J］.J Nurs,2022,29(2):73-78.
［11］　李玉，陈可英，周黎辉.基于时机理论的步行运动法在老年慢性心力衰竭患者中的应用［J］.解放军护理杂志，2021，38（6）：72-75.
LI Y,CHEN K Y,ZHOU L H.Application of walking exercise method based on timing theory in elderly patients with chronic heart failure［J］.Nurs J Chin PLA,2021,38(6):72-75.
［12］　JIANG X P,GU Q Y,JIANG Z H,et al.Effect of family-centered nursing based on timing it right framework in patients with acute cerebral infarction［J］.Am J Transl Res,2021,13(4):3147-3155.
［13］　HINDRICKS G,POTPARA T,DAGRES N,et al.2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery(EACTS)［J］.Eur Heart J,2021,42(5):373-498.
［14］　司在霞，郭灵霞，周敏，等.修订版Morisky服药依从性量表用于抗凝治疗患者的信效度检测［J］.护理学杂志，2012，27（22）：23-26.
SI Z X,GUO L X,ZHOU M,et al.Reliability and validity of the modified Morisky Medication Compliance Scale in patients with anticoagulant therapy［J］.J Nurs Sci,2012,27 (22) :23-26.
［15］　王才康，胡中锋，刘勇.一般自我效能感量表的信度和效度研究［J］.应用心理学，2001，7（1）：37-40.
WANG C K,HU Z F,LIU Y.Research on the reliability and validity of the Chinese Version of General Self Efficacy Scale［J］.Chin J Appl Psychol,2001,7 (1) :37-40.
［16］　张诚霖.心房颤动患者生活质量的量表汉化及信效度检验［D］.苏州：苏州大学，2017.
ZHANG C L.Quality of life scale in patients with atrial fibrillation and its reliability and validity test［D］.Suzhou:Soochow University,2017.
［17］　SADLONOVA M,SENGES J,NAGEL J,et al.Symptom severity and health-related quality of life in patients with atrial fibrillation:findings from the observational arena study［J］.J Clin Med,2022,11(4):1140.
［18］　郑爱娣，王咏梅，徐静，等.基于时机理论的延续护理在房颤合并慢性心力衰竭患者中的应用［J］.中华全科医学，2022，20（7）：1259-1262.
ZHENG A D,WANG Y M,XU J,et al.Application of extended care based on timing theory in patients with atrial fibrillation complicated with chronic heart failure［J］.Chin J Gen Pract,2022,20 (7):1259-1262.
［19］　CAPRARA M,DI GIUNTA L,BERMUDEZ J,et al.How self-efficacy beliefs in dealing with negative emotions are associated to negative affect and to life satisfaction across gender and age［J］.PLoS One,2020,15(11):e0242326.
［20］　蔡志敏，谢士芳，丁金玲，等.多学科团队协作在房颤患者门诊综合管理中的干预研究［J］.护理学报，2019，26（10）：57-60.
CAI Z M,XIE S F,DING J L,et al.Study on the intervention of multidisciplinary team collaboration in outpatient comprehensive management of patients with atrial fibrillation［J］.J Nurs,2019,26 (10) :57-60.
［21］　杜宜修，吴芳琴，卢晓英，等.多学科团队延续性护理模式在心房颤动患者中的应用研究［J］.中华护理杂志，2020，55（7）：969-974.
DU Y X,WU F Q,LU X Y,et al.Application of multidisciplinary team continuous nursing model in patients with atrial fibrillation［J］.Chin J Nurs,2020,55 (7) :969-974.
［22］　YAN H,DU Y X,WU F Q,et al.Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation:Randomized controlled trial［J］.Int J Nurs Stud,2022,127:104159.
［23］　TENBULT N,KRAAL J,BROUWERS R,et al.Adherence to a multidisciplinary lifestyle program for patients with atrial fibrillation and obesity:feasibility study［J］.JMIR Form Res,2022,6(4):e32625.
［24］　文秀，陈湘玉，丁金玲，等.房颤中心多学科团队规范化管理临床实践及成效［J］.中国全科医学，2020，23（S1）：26-29.
WEN X,CHEN X Y,DING J L,et al.Practice and effect of standardized management of multidisciplinary team in atrial fibrillation center［J］.Chin Gen Pract,2020,23 (S1):26-29.

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更新日期/Last Update: 2023-03-05