5A模式对心脏瓣膜置换术后患者抗凝治疗依从性的影响
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摘要
目的探究5A模式对心脏瓣膜置换术后患者抗凝治疗依从性的影响。方法选取2016年1月至2018年1月期间海南省人民医院心脏外科收治的176例心脏瓣膜置换术后患者为研究对象,依据随机数表法将患者分为对照组和观察组,每组88例。对照组患者给予术后常规护理,观察组在常规护理的基础上联合5A模式护理。比较两组患者干预前、干预后对抗凝知识的掌握情况和对抗凝治疗的依从性(包括按时服药、定期复查、饮食调理、自我检测情况),并比较因抗凝不当引起的并发症发生情况。结果干预前,两组患者对抗凝知识的掌握情况、按时服药、定期复查、饮食调理、自我检测评分比较,差异均无统计学意义(P>0.05);干预后,两组患者对抗凝知识掌握情况、按时服药、定期复查、饮食调理、自我检测评分均较干预前显著改善,且观察组优于对照组,差异均具有统计学意义(P<0.05);观察组患者因抗凝不当引起的并发症总发生率为6.80%,明显低于对照组的22.68%,差异具有统计学意义(P<0.05)。结论心脏瓣膜置换术后患者经5A模式护理干预后能够有效改善其对抗凝知识的掌握情况,提高抗凝治疗依从性,降低因抗凝不当引起的并发症发生率,5A模式护理可在临床中进一步推广和改善。
Objective To investigate the effect of 5 A mode on the compliance of anticoagulation therapy in patients after cardiac valve replacement. Methods A total of 176 patients undergoing cardiac valve replacement from January 2016 to January 2018 were enrolled in the study, which were divided into control group(n=88) and observation group(n=88) according to random number table. The control group received routine postoperative care, and the observation group received 5 A mode care based on routine postoperative care. The mastery of anticoagulation knowledge before and after the intervention was compared between the two groups. The status of on-time medication, regular review, diet conditioning, and self-testing were scored, and the complications caused by improper anticoagulation were compared.Results There was no significant difference in the mastery of anticoagulant knowledge, on-time medication, regular review, dietary conditioning, and self-testing scores between the two groups before intervention(P>0.05). Before intervention, the mastery of anticoagulant knowledge, on-time medication, regular review, dietary conditioning, and self-testing scores were significantly improved, and the values in the observation group were superior to those in the control group(P<0.05). The total incidence of complications caused by improper anticoagulation was 6.80% in the observation group,significantly lower than 22.68% in the control group(P<0.05). Conclusion 5 A mode of nursing intervention can effectively improve their mastery of anticoagulant knowledge in patients with heart valve replacement, improve anticoagulant treatment compliance, and reduce the incidence of complications caused by improper anticoagulation, which worth further promotion and improvement.
Objective To investigate the effect of 5 A mode on the compliance of anticoagulation therapy in patients after cardiac valve replacement. Methods A total of 176 patients undergoing cardiac valve replacement from January 2016 to January 2018 were enrolled in the study, which were divided into control group(n=88) and observation group(n=88) according to random number table. The control group received routine postoperative care, and the observation group received 5 A mode care based on routine postoperative care. The mastery of anticoagulation knowledge before and after the intervention was compared between the two groups. The status of on-time medication, regular review, diet conditioning, and self-testing were scored, and the complications caused by improper anticoagulation were compared.Results There was no significant difference in the mastery of anticoagulant knowledge, on-time medication, regular review, dietary conditioning, and self-testing scores between the two groups before intervention(P>0.05). Before intervention, the mastery of anticoagulant knowledge, on-time medication, regular review, dietary conditioning, and self-testing scores were significantly improved, and the values in the observation group were superior to those in the control group(P<0.05). The total incidence of complications caused by improper anticoagulation was 6.80% in the observation group,significantly lower than 22.68% in the control group(P<0.05). Conclusion 5 A mode of nursing intervention can effectively improve their mastery of anticoagulant knowledge in patients with heart valve replacement, improve anticoagulant treatment compliance, and reduce the incidence of complications caused by improper anticoagulation, which worth further promotion and improvement.
引文
[1]陈玉梅,闫树英,姚辉,等.冥想训练对瓣膜性心脏病老年患者术后认知功能障碍的改善作用[J].中华行为医学与脑科学杂志,2016,25(12):1096-1099.
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[4]曾碧茹,潘楚云,刘春燕,等.综合护理干预对心脏瓣膜置换术后患者抗凝治疗依从性的影响[J].海南医学,2016,27(3):511-513.
[5]陈娜丽,崔智君,李秀川,等.5A模式护理干预方案在老年人体位性低血压中的应用[J].蚌埠医学院学报,2017,42(10):1397-1399,1403.
[6]陆敏,费淑袆.延续性护理干预对心脏瓣膜置换术后患者抗凝治疗依从性及生活质量的影响[J].中国基层医药,2015,11(24):3828-3831.
[7]URENA M,WEBB JG,ELTCHANINOFF H,et al.Late cardiac death in patients undergoing transcatheter aortic valve replacement incidence and predictors of advanced heart failure and sudden cardiac death[J].Journal of the American College of Cardiology,2015,65(5):437-448.
[8]吴庆珠,方小君,李琼妹,等.微信教育对心脏瓣膜置换术后抗凝知识教育及治疗依从性的影响[J].护理实践与研究,2016,13(4):48-49.
[9]曾雅力,曾燕华,谭创,等.应用5A模式提高乳腺癌患者术后功能锻炼依从性和健康信念[J].护理与康复,2017,16(9):948-951.
[10]张国莉,张丽敏.应用5A护理模式提高肺癌术后化疗患者自我效能[J].护理学杂志,2016,31(6):91-92.
[11]李荣,胡秀丽,孙惠金,等.基于5A模式的戒烟干预方案在COPD患者中的应用[J].齐鲁护理杂志,2016,22(1):31-32
[12]陈娟,马玲.应用自我管理为导向的5A护理模式提高晚期前列腺癌患者自我效能[J].中国护理管理,2015,15(8):917-920.
[13]王玲玲,张国良,高重阳,等.5A护理模式对白介素治疗的脊柱结核患者自我认知、效能的影响[J].中国药物经济学,2016,11(9):143-146.
[2]KHERADVAR A,GROVES EM,SIMMONS CA,et al.Emerging Trends in Heart Valve Engineering:Part III.Novel Technologies for Mitral Valve Repair and Replacement[J].Annals of biomedical engineering,2015,43(4):858-870.
[3]KASHIYAMA N,KURATANI T,TORIKAI K,et al.Urgent transcatheter aortic valve replacement for severe aortic valve stenosis with acute decompensated heart failure:report of a case[J].Surgery today,2015,45(7):911-914.
[4]曾碧茹,潘楚云,刘春燕,等.综合护理干预对心脏瓣膜置换术后患者抗凝治疗依从性的影响[J].海南医学,2016,27(3):511-513.
[5]陈娜丽,崔智君,李秀川,等.5A模式护理干预方案在老年人体位性低血压中的应用[J].蚌埠医学院学报,2017,42(10):1397-1399,1403.
[6]陆敏,费淑袆.延续性护理干预对心脏瓣膜置换术后患者抗凝治疗依从性及生活质量的影响[J].中国基层医药,2015,11(24):3828-3831.
[7]URENA M,WEBB JG,ELTCHANINOFF H,et al.Late cardiac death in patients undergoing transcatheter aortic valve replacement incidence and predictors of advanced heart failure and sudden cardiac death[J].Journal of the American College of Cardiology,2015,65(5):437-448.
[8]吴庆珠,方小君,李琼妹,等.微信教育对心脏瓣膜置换术后抗凝知识教育及治疗依从性的影响[J].护理实践与研究,2016,13(4):48-49.
[9]曾雅力,曾燕华,谭创,等.应用5A模式提高乳腺癌患者术后功能锻炼依从性和健康信念[J].护理与康复,2017,16(9):948-951.
[10]张国莉,张丽敏.应用5A护理模式提高肺癌术后化疗患者自我效能[J].护理学杂志,2016,31(6):91-92.
[11]李荣,胡秀丽,孙惠金,等.基于5A模式的戒烟干预方案在COPD患者中的应用[J].齐鲁护理杂志,2016,22(1):31-32
[12]陈娟,马玲.应用自我管理为导向的5A护理模式提高晚期前列腺癌患者自我效能[J].中国护理管理,2015,15(8):917-920.
[13]王玲玲,张国良,高重阳,等.5A护理模式对白介素治疗的脊柱结核患者自我认知、效能的影响[J].中国药物经济学,2016,11(9):143-146.