PAGEPAGE8慢性心力衰竭患者的延續(xù)性護(hù)理有效模式探究,護(hù)理碩士論文本篇論文目錄導(dǎo)航：【第1部分】慢性心力衰竭患者的延續(xù)性護(hù)理有效形式探究【第2部分】【第3部分】【第4部分】【第5部分】中文內(nèi)容內(nèi)容內(nèi)容內(nèi)容摘要目的了解慢性心力衰竭患者的自我護(hù)理行為和生活質(zhì)量現(xiàn)在狀況，出院后的護(hù)理需求及社區(qū)衛(wèi)生資源的利用情況，觀察基于醫(yī)院的延續(xù)性護(hù)理形式對(duì)慢性心力衰竭患者自我護(hù)理能力及生活質(zhì)量的影響，討論合適我們國(guó)家當(dāng)下醫(yī)療體制下慢性心力衰竭患者的延續(xù)性護(hù)理形式。方式方法研究一：采用描繪敘述性研究中的橫斷面調(diào)查方式方法，抽取2020年10月1日～2020年4月30日某三級(jí)甲等醫(yī)院符合研究標(biāo)準(zhǔn)的115例慢性心力衰竭〔Chronicheartfailure，CHF〕患者為研究對(duì)象，失訪13例。采用自編患者一般情況調(diào)查問卷、改進(jìn)的歐洲心力衰竭自我護(hù)理行為量表〔EuropeanHeartFailureSelfCareBehaviourscale9，EHFSCB-9〕、明尼蘇達(dá)心力衰竭生活質(zhì)量問卷〔MinnesotaLivingwithHeartFailureQuestionnaire，MLHFQ中文版〕調(diào)查心力衰竭患者的自我護(hù)理行為和生活質(zhì)量狀況。研究二：采用隨機(jī)對(duì)照臨床試驗(yàn)研究方式方法，將研究一中的研究對(duì)象運(yùn)用隨機(jī)數(shù)字表將患者分為試驗(yàn)組51例和對(duì)照組51例。兩組患者在住院期間給予一樣的護(hù)理措施，試驗(yàn)組由經(jīng)過培訓(xùn)的專門的護(hù)士施行延續(xù)性護(hù)理干涉，對(duì)照組常規(guī)護(hù)理。延續(xù)性護(hù)理是運(yùn)用延續(xù)護(hù)理理論給予患者信息的延續(xù)，管理的延續(xù)，關(guān)系的延續(xù)三個(gè)方面的延續(xù)性護(hù)理干涉。干涉6周進(jìn)行自我護(hù)理能力〔EHFSCB-9得分〕、生活質(zhì)量〔MLHFQ得分〕評(píng)價(jià)。采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析。結(jié)果研究一：導(dǎo)致心力衰竭的原發(fā)疾病以冠心病最多見，占39.2%，其次是是擴(kuò)張型心肌病，占35.3%；EHFSCB-9得分最高的是體重增加會(huì)就醫(yī)〔3.651.39〕，最低的是按醫(yī)囑吃藥〔1.390.90〕；MLHF問卷得分最高的是性生活困難〔3.271.87〕，最低的是由于治療出現(xiàn)了副作用〔0.751.21〕；年齡、經(jīng)濟(jì)收入、文化程度以及心力衰竭病史對(duì)自我護(hù)理行為和生活質(zhì)量均無統(tǒng)計(jì)學(xué)意義〔p0.05〕。研究二：自我護(hù)理能力方面：EHFSCB-9總分情況：干涉前對(duì)照組23.967.48，試驗(yàn)組為22.277.38，無統(tǒng)計(jì)學(xué)意義〔p=0.080)；干涉后對(duì)照組24.146.08，試驗(yàn)組14.514.09，有統(tǒng)計(jì)學(xué)意義〔p0.000)。EHFSCB-9各分條目得分情況：干涉前兩組除天天測(cè)量體質(zhì)量外，其余各條目得分均無統(tǒng)計(jì)學(xué)意義〔p0.05〕；干涉后各條目中除按醫(yī)生醫(yī)囑吃藥、采用低鹽飲食外，得分均具有統(tǒng)計(jì)學(xué)意義〔p0.000)。生活質(zhì)量方面：MLHFQ總分干涉前后得分差值：對(duì)照組5.4902.434，試驗(yàn)組21.1182.179，有統(tǒng)計(jì)學(xué)意義〔p0.000)；MLHFQ各維度得分情況：異常感覺和狀態(tài)維度兩組在干涉后較干涉前降低，均具有統(tǒng)計(jì)學(xué)意義〔p0.05)，而身體活動(dòng)維度、情感維度對(duì)照組較干涉前無變化，而試驗(yàn)組較干涉前得分降低，有統(tǒng)計(jì)學(xué)意義〔p0.000)。衛(wèi)生資源利用情況：102例患者寓居區(qū)都有社區(qū)醫(yī)療衛(wèi)生資源的配置,但利用率低，只要6例〔5.88%〕到過社區(qū)就診，3例〔2.94%〕在社區(qū)醫(yī)療機(jī)構(gòu)建立檔案。結(jié)論合肥市社區(qū)醫(yī)療衛(wèi)生資源較好，但CHF患者對(duì)社區(qū)衛(wèi)生資源的利用較差。由醫(yī)院護(hù)士主導(dǎo)的基于醫(yī)院的延續(xù)性護(hù)理形式比擬合適當(dāng)下三級(jí)醫(yī)院開展延續(xù)性護(hù)理工作，且能夠提高CHF患者的自我護(hù)理能力和生活質(zhì)量，同時(shí)護(hù)士的價(jià)值也得到了具體表現(xiàn)出。本文本文本文本文關(guān)鍵詞語語語語延續(xù)性護(hù)理慢性心力衰竭自我護(hù)理能力生活質(zhì)量AbstractObjectiveTheaimwastoinvestigatethechronicheartfailurepatientsself-carecompetenceandqualityoflife，careneedsafterhospitalandtheirutilizationofcommunityhealthresources,toobservetheeffectsonself-careabilityandqualityoflifeinpatientswithchronicheartfailure(CHF)whoweresuppliedwithhospital-basedcontinuityofcare，andtoexploresuitablecontinuityofcaremodelforCHFpatientsunderChinesecurrentmedicalsystem.MethodsPart1:Across-sectionalinvestigationmethodwascarriedout.Byconveniencesampling,115samplepatientswereselectedfrom2cardiovascularwardsofAnhuiProvincialHospitalfromOctober1,2020toApril30,2020.13patientslosttofollow-up.Demographicdataanddiseasecharacteristicsvariablesquestionnairewasusedtoinvestigatethecharacteristicsofpatients，EuropeanHeartFailureSelfCareBehaviourscale9(EHFSCB-9)wasusedtomeasurethepatientsself-carecompetenceandMinnesotaLivingwithHeartFailurequestionnaire(MLHFQ)wasusedtomeasurethepatientsqualityoflife.Part2:Usingarandomizedcontrolledclinicalstudymethod,thesamplepatients(n=102)wererandomlyassignedtointervention-group(IG,n=51)whoreceivedhospital-basedcontinuityofcareorcontrol-group(CG,n=51)whoreceivedcareaccordingtohospitalroutines.ProgrammeeffectswereevaluatedwithMLHFQscoreandEHFSCB-9scoreondischargeandin6weeksafterdischarge.ResultsPart1:Coronaryheartdiseasewasthemostcommoncourseofheartfailure(39.2%),followedbydilatedcardiomyopathy(35.3%);thehighestEHFSCB-9scorewasseeingadoctorwhenweightgain(3.651.39),thelowestwastakingmedicineaccordingtothedoctorsadvice(1.390.90);thehighestMLHFscorewassexuallifedifficulties(3.271.87),thelowestissideeffectscausedbythetreatment(0.751.21);age,income,educationlevelandhistoryofheartfailurehadnostatisticalsignificanceonself-carebehaviorandqualityoflife(p0.05).Part2:Selfcarecompetence:TherewerenostatisticaldifferencesinEHFSCB-9totalscorebeforeintervention,CGwas23.967.48andIGwas22.277.38,p=0.080.Therewasstatisticalsignificanceafterinterventionbetweenthetwogroups,CGwas24.146.08andIGwas14.514.09,p0.000.ResultofeachitemofEHFSCB-9scoreshows:weighdaily(respectively3.901.33,3.331.53)andseeingadoctorwhenweightgain(respectively3.881.35,3.411.40)werethetwohighscoreitemsinthetwogroupsbeforeintervention;Beforeinterventioneachdimension,exceptweighdaily,ofEHFSCB-9scoreshadnostatisticalsignificance(p0.05),whileafterinterventionwerestatisticallysignificant(p0.000),besidetakingmedicineaccordingtodoctorsadviceandwithlowsaltdiet.Qualityoflife:ThedifferenceofMLHFQuestionnairetotalscorebeforeandaftertheinterventionwere5.4902.434inCGand21.1182.179inIG,p0.000;eachdimensionofMLHFQuestionnairescoreresult:symptomdimensionsscorewasloweraftertheinterventioninbothgroups,p0.05;ComparedwithbeforeinterventiontherewerenochangesinphysicalactivitydimensionandemotionaldimensioninCG,whiledecreasedinIG,p0.000.Utilizationofhealthresources:Allpatientslivingareatherewerecommunityhealthcareresources,buttheutilizationratewaslow,only6cases(5.88%)hadbeentothecommunityhealthcare,3cases(2.94%)wereestablishedarchivesincommunitymedicalinstitutions.ConclusionAllocationofcommunityhealthcareresourcesisappropriateinHefeicity,buttheCHFpatientsutilizationoftheresourcesispoor.Nurseleadinghospital-basedcontinuityofcaremodelissuitabletothecurrentgreathospital.ItcanimproveCHFpatients`self-carecompetenceandtheirqualityofl