CAJ | 학술논문

目的：观察基于医院的延续性护理对慢性心力衰竭（CHF）患者自我护理能力的影响，从而探讨适合我国当前医疗体制下CHF患者的延续性护理方式。方法采用随机对照临床研究方法，抽取2012年10月-2013年4月在安徽医科大学附属省立医院总院和南区2个心血管病区住院的CHF患者102例，根据随机数字表将患者分为对照组和试验组，各51例。两组患者入院后给予相同的常规护理、健康教育和出院指导；此外，试验组在常规护理的基础上给予基于医院的延续性护理干预。延续性护理是运用延续护理理论给予患者信息的延续、管理的延续、关系的延续3个方面的延续性护理干预。采用改良的欧洲心力衰竭自我护理行为评价量表（ EHFSCB-9），分别于患者出院时（干预前）、出院后6周（干预后）评价两组患者的自我护理能力。结果干预前对照组与试验组EHFSCB-9总分间无差异〔（24.0±7.5）分与（22.3±7.4）分， P＞0.05〕；干预后试验组EHFSCB-9总分低于对照组〔（14.5±4.1）分与（24.1±6.1）分， P＜0.05〕。干预前两组患者EHFSCB-9各条目（除外“每天测量体质量”）得分间无差异（ P＞0.05）；干预后试验组EHFSCB-9各条目（除外“采用低盐饮食”和“按医生医嘱吃药”）得分均低于对照组（ P＜0.05）。结论基于医院的延续性护理模式能够提高CHF患者的自我护理能力，可以在有条件的医疗机构临床护理工作中推广应用。
목적：관찰기우의원적연속성호리대만성심력쇠갈（CHF）환자자아호리능력적영향，종이탐토괄합아국당전의료체제하CHF환자적연속성호리방식。방법채용수궤대조림상연구방법，추취2012년10월-2013년4월재안휘의과대학부속성립의원총원화남구2개심혈관병구주원적CHF환자102례，근거수궤수자표장환자분위대조조화시험조，각51례。량조환자입원후급여상동적상규호리、건강교육화출원지도；차외，시험조재상규호리적기출상급여기우의원적연속성호리간예。연속성호리시운용연속호리이론급여환자신식적연속、관리적연속、관계적연속3개방면적연속성호리간예。채용개량적구주심력쇠갈자아호리행위평개량표（ EHFSCB-9），분별우환자출원시（간예전）、출원후6주（간예후）평개량조환자적자아호리능력。결과간예전대조조여시험조EHFSCB-9총분간무차이〔（24.0±7.5）분여（22.3±7.4）분， P＞0.05〕；간예후시험조EHFSCB-9총분저우대조조〔（14.5±4.1）분여（24.1±6.1）분， P＜0.05〕。간예전량조환자EHFSCB-9각조목（제외“매천측량체질량”）득분간무차이（ P＞0.05）；간예후시험조EHFSCB-9각조목（제외“채용저염음식”화“안의생의촉흘약”）득분균저우대조조（ P＜0.05）。결론기우의원적연속성호리모식능구제고CHF환자적자아호리능력，가이재유조건적의료궤구림상호리공작중추엄응용。
ObjectiveToobservetheeffectsofhospital-basedcontinuityofcareonself-careabilityinpatientswith chronic heart failure ( CHF) in order to explore suitable model of continuity of care for CHF patients under China ′s current medi-cal system.Methods By using randomized controlled clinical study method , 102 CHF patients hospitalized in Anhui Provincial Hospital from October 1st, 2012 to April 30th, 2013 were randomly divided into control group and experiment group , with each group 51 cases.The two groups were given identical routine nursing , health education and discharge instruction .Besides, the ex-periment group was given additional hospital -based continuity of care , which is a continuity of information , management and re-lationship by using theories on continuity of care .European Heart Failure Self Care Behaviors scale ( EHFSCB -9 score ) was used to evaluate the patients′self-care ability on discharge ( before intervention ) and six weeks after discharge ( after interven-tion) .Results The EHFSCB-9 total score between the control group and experiment group before intervention showed no sta -tistically significant difference 〔 (24.0 ±7.5) vs.(22.3 ±7.4), P>0.05〕 .After intervention, the EHFSCB-9 total score of experiment group was lower than control group 〔(14.5 ±4.1) vs.(24.1 ±6.1), P<0.05〕 .Before intervention, each di-mension of EHFSCB-9 in the two groups (except weight daily) showed no statistically significant difference (P>0.05) .After intervention , the scores of each dimension in experiment group ( except having low -salt diet and taking medicine according to doctor′s advice) were all lower than the control group ( P<0.05) .Conclusion Hospital-based continuity of care can improve CHF patients′self-care ability, and can be promoted in clinic with qualified condition .