[1]兰云霞,庞静,陈玉新.多学科团队协作模式在行经导管主动脉瓣置换术老年患者出院准备服务中的应用[J].新乡医学院学报,2023,40(9):883-886.[doi:10.7683/xxyxyxb.2023.09.016]
　LAN Yunxia,PANG Jing,CHEN Yuxin.Application of multidisciplinary team collaboration model in discharge preparation service in elderly patients undergoing transcatheter aortic valve implantation[J].Journal of Xinxiang Medical University,2023,40(9):883-886.[doi:10.7683/xxyxyxb.2023.09.016]
点击复制

多学科团队协作模式在行经导管主动脉瓣置换术老年患者出院准备服务中的应用
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年9
页码:
883-886
栏目:
护理研究
出版日期:
2023-09-05

文章信息/Info

Title:
Application of multidisciplinary team collaboration model in discharge preparation service in elderly patients undergoing transcatheter aortic valve implantation
作者:
兰云霞; 庞静; 陈玉新
（河南省胸科医院心血管病区，河南　郑州　450000）
Author(s):
LAN Yunxia; PANG Jing; CHEN Yuxin
(Department of Cardiovascular Ward,Henan Provincial Thoracic Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
多学科团队协作; 出院准备服务; 经导管主动脉瓣置换术
Keywords:
multidisciplinary team collaboration; discharge preparation service; transcatheter aortic valve implantation
分类号:
R654.2
DOI:
10.7683/xxyxyxb.2023.09.016
文献标志码:
A
摘要:
目的　探讨多学科团队协作模式在行经导管主动脉瓣置换术（TAVI）老年患者出院准备服务中的应用。
方法　选择2021年1月至2021年6月在河南省胸科医院行TAVI术的35例患者为对照组，2021年7月至2021年12月行TAVI术的35例患者为观察组。对照组患者术后采用常规管理，观察组患者术后采用多学科团队协作的出院准备服务模式。采用出院准备度量表（RHDS）评估2组患者的出院准备度，出院指导质量量表（QDTS）评估2组患者的出院指导质量，Barthel指数评估2组患者出院时和出院后6个月的自理能力，中国心血管疾病患者生活质量问卷（CQQC）评估2组患者出院时和出院后6个月的生活质量；记录并比较2组患者的再入院率。
结果　观察组患者的RHDS评分中出院适应能力、预期性支持、个人状态得分及RHDS总分均显著高于对照组（P<0.05）;观察组患者QDTS评分中需要的内容、实际获得内容、讲授技巧得分及QDTS总分均显著高于对照组（P<0.05）。2组患者出院时Barthel指数和QQC评分比较差异无统计学意义（P>0.05）。出院6个月时，2组患者的Barthel指数和CQQC评分均显著高于出院时，且观察组患者的Barthel指数及CQQC评分显著高于对照组（P<0.05）。观察组患者术后6个月再入院率显著低于对照组（P<0.05）。
结论　多学科团队协作服务模式可更有效地提高TAVI术后患者出院准备度和出院指导质量，降低患者再入院风险，提高患者术后生活质量，值得在医疗机构推广使用。
Abstract:
Objective　To investigate the application of multidisciplinary team collaboration model in discharge preparation service in elderly patients undergoing transcatheter aortic valve implantation (TAVI).
Methods　Thirty-five patients who underwent TAVI surgery in Henan Provincial Thoracic Hospital from January 2021 to June 2021 were selected as the control group,and another 35 patients who underwent TAVI surgery in Henan Provincial Thoracic Hospital from July 2021 to December 2021 were selected as the observation group.The patients in the control group were given routine management after surgery,while patients in the observation group were given multidisciplinary team collaborative discharge preparation service model.The discharge readiness of patients in the two groups was evaluated by readiness for hospital discharge scale(RHDS),the quality of discharge guidance of patients in the two groups was evaluated by quality of discharge teaching scale(QDTS),the self care ability of patients in the two groups was evaluated by Barthel index and the quality of life of patients in the two groups was evaluated by China questionnaire of quality of life in patients with cardiovascular diseases(CQQC) before discharge and 6 months after discharge;the readmission rate of patients was recorded and compared between the two groups at 6 months after surgery.
Results　The scores of discharge adaptability,expected support，personal status and the total score of RHDS of patients in the observation group were significantly higher than those in the control group(P<0.05).The scores of required content,actual obtained content,teaching skill and the total QDTS score of patients in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the Barthel index and CQQC scores of patients between the two groups(P>0.05).At 6 months after discharge,the Barthel index and CQQC scores of patients in the two groups were significantly higher than those at discharge,and the Barthel index and CQQC scores of patients in the observation group were significantly higher than those in the control group(P<0.05).The readmission rate of patients in the observation group was significantly lower than that in the control group at 6 months after surgery (P<0.05).
Conclusion　The multidisciplinary team collaboration service model can more effectively improve the discharge readiness and quality of discharge guidance for patients after TAVI surgery,reduce the risk of readmission of patients,and improve the quality of life of patients after surgery,it is worth promoting and using in the medical institution.

参考文献/References:

［1］　YCEL M G.TAVI for very severe aortic stenosis［J］.Turk Kardiyol Dern Ars,2021,49(2):94-96.
［2］　尹福容，周家梅，涂建鑫，等.心脏瓣膜置换术病人出院准备服务研究进展［J］.护理研究，2022，36（23）：4233-4237.
YIN F R,ZHOU J M,TU J X,et al.Research progress on discharge preparation services for patients undergoing cardiac valve replacement［J］.Nurs Res,2022,36 (23):4233-4237.
［3］　XIAO S,TOURANGEAU A,WIDGER K,et al.Discharge planning in mental healthcare settings:a review and concept analysis［J］.Int J Ment Health Nurs,2019,28(4):816-832.
［4］　LINO P.Challenges and complexities of discharge planning from a district nursing perspective［J］.Br J Community Nurs,2021,26(4):184-188.
［5］　中国老年护理联盟.老年患者出院准备服务专家共识（2019版）［J］.中华护理杂志，2020，55（2）：62-69.
CHINA ELDERLY CARE ALLIANCE.Expert consensus on the discharge planning for hospitalized elderly patients(version 2019)［J］.Chin J Nurs,2020,55 (2):62-69.
［6］　MENNUNI M,GULIZIA M M,ALUNNI G,et al.ANMCO position paper:hospital discharge planning:recommendations and standards［J］.Eur Heart J Suppl,2017,19(Suppl D):244-255.
［7］　WEISS M E,PIACENTINE L B.Psychometric properties of the readiness for hospital discharge scale［J］.J Nurs Meas,2006,14(3):163-180.
［8］　WEISS M E,PIACENTINE L B,LOKKEN L.et al.Perceived readiness for hospital discharge in adult medical-surgical patients［J］.Clin Nurse Spec,2007,21(1):31-42.
［9］　SMITH V C.Discharge planning considerations for the neonatal intensive care unit［J］.Arch Dis Child Fetal Neonatal Ed,2021,106(4):442-445.
［10］　郑燕蓉，柴源，牛晓晨.多学科协作模式的出院准备服务在老年慢性胰腺炎患者中的应用［J］.中华现代护理杂志，2022，28（28）：3964-3968.
ZHENG Y R,CHAI Y,NIU X C.Effect of multidisciplinary collaborative discharge preparation services in elderly patients with chronic pancreatitis［J］.Chin J Mod Nurs,2022,28(28):3964-3968.
［11］　李玲，张芳，何小凤，等.多学科团队合作模式在缺血性脑卒中患者出院准备度中的应用［J］.昆明医科大学学报，2019，40（11）：165-170.
LI L,ZHANG F,HE X F,et al.Application of multidisciplinary team cooperation on discharge readiness of patients with ischemic stroke［J］.J Kunming Med Univ,2019,40(11):165-170.
［12］　YEN H Y,CHI M J,HUANG H Y.Effects of discharge planning services and unplanned readmissions on post-hospital mortality in older patients:a time-varying survival analysis［J］.Int J Nurs Stud,2022,128:104175.
［13］　WEDIN J O,VEDIN O,RODIN S,et al.Patients with bicuspid aortic stenosis demonstrate adverse left ventricular remodeling and impaired cardiac function before surgery with increased risk of postoperative heart failure［J］.Circulation,2022,146(17):1310-1322.
［14］　李秋忆，陈可冀，赵振燕，等.高龄重度主动脉瓣狭窄患者的远期预后及危险因素分析［J］.中国循环杂志，2022，37（4）：362-367.
LI Q Y,CHEN K J,ZHAO Z Y,et al.Long-term prognosis and risk factors of worse outcome in elderly patients with aortic stenosis［J］.Chin J Circ,2022,37(4):362-367.
［15］　KUCHARCZUK C,LIGHTHEART E,KODAN A,et al.Standardized discharge planning tool leads to earlier discharges and fewer readmissions［J］.J Nurs Care Qual,2022,37(1):54-60.

更新日期/Last Update: 2023-09-05