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基于赋权理论的电话随访对提高冠状动脉支架植入术后患者心理弹性及生活质量的影响:一项随机对照试验

Telephone follow-up based on empowerment theory to improve resilience and quality of life among patients after coronary artery stent implantation: a randomized controlled trial.

作者信息

Hua Yan, Wang Mei, Li Lu, Guo Chunmian, Huang Zhaoxu, Li Yang, Lin Yue, Xiao Yingjing, Ni Chunping, Lv Aili

机构信息

School of Nursing, Fourth Military Medical University, Xi'an, China.

Basic Medical Science Academy, Fourth Military Medical University, Xi'an, China.

出版信息

Front Psychiatry. 2024 Apr 25;15:1248424. doi: 10.3389/fpsyt.2024.1248424. eCollection 2024.

Abstract

BACKGROUND

Coronary heart disease has a high incidence rate, a high mortality rate, a high recurrence rate, and a high medical cost. In addition, some patients need to undergo percutaneous coronary artery stent implantation (CASI), which is a kind of traumatic treatment. Patients can easily experience negative emotions such as anxiety and depression after surgery, which seriously affects quality of life.

OBJECTIVES

The aim of this study was to evaluate the effectiveness of an empowerment-based telephone follow-up intervention on resilience and quality of life in patients who underwent CASI.

DESIGN

The design of the study is a randomized controlled trial.

METHODS

A total of 92 patients were recruited after CASI from the Internal Medicine Cardiovascular Department of a Grade A tertiary hospital in Xi'an, China. The patients were randomly divided into a control group and an intervention group. The control group performed routine care, whereas the intervention group developed a telephone follow-up program based on empowerment theory while carrying out routine care. Patients were investigated using the coronary heart disease-related knowledge questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the 36-Item Short-Form Health Survey (SF-36) to compare the effects of the intervention before and after 1 month of intervention.

RESULTS

After a 1-month telephone follow-up intervention based on the empowerment theory for patients after CASI, the variations in knowledge related to coronary heart disease and all of its subscale scores were greater in the intervention group than in the control group. Except for the three dimensions of risk factor, induction factor, and rehabilitation-related knowledge, the variations in knowledge related to coronary heart disease and the other subscale scores were significantly different between the two groups ( < 0.05). The variations in resilience and scores on the three subscales in the intervention group were greater than those in the control group, and the difference between the two groups was statistically significant ( < 0.05). The variations in the quality of life and overall health, emotional functions, and social functions were significantly greater in the intervention group than in the control group ( < 0.05).

CONCLUSIONS

A telephone follow-up intervention based on the empowerment theory can effectively improve the resilience and quality of life of patients after CASI. This follow-up approach can provide a theoretical basis and practical reference for hospitals and communities to carry out targeted continuing nursing for patients after CASI. The long-term effects of the intervention and its underlying mechanisms require further study.

CLINICAL TRIAL REGISTRATION

http://www.chictr.org.cn/showproj.aspx?proj=173682, identifier ChiCTR2200064950.

摘要

背景

冠心病发病率高、死亡率高、复发率高且医疗费用高。此外,部分患者需要接受经皮冠状动脉支架植入术(CASI),这是一种有创治疗。患者术后易出现焦虑、抑郁等负面情绪,严重影响生活质量。

目的

本研究旨在评估基于赋权理论的电话随访干预对接受CASI患者心理弹性和生活质量的效果。

设计

本研究为随机对照试验。

方法

从西安某三级甲等医院心内科招募92例CASI术后患者。将患者随机分为对照组和干预组。对照组进行常规护理,干预组在进行常规护理的同时,基于赋权理论制定电话随访方案。采用冠心病相关知识问卷、Connor-Davidson心理弹性量表(CD-RISC)和36条目简明健康调查问卷(SF-36)对患者进行调查,比较干预1个月前后的干预效果。

结果

对CASI术后患者进行为期1个月的基于赋权理论的电话随访干预后,干预组冠心病相关知识及其各维度得分的变化幅度均大于对照组。除危险因素、诱发因素和康复相关知识三个维度外,两组冠心病相关知识及其余维度得分的变化差异有统计学意义(<0.05)。干预组心理弹性及其三个子量表得分的变化幅度大于对照组,两组差异有统计学意义(<0.05)。干预组生活质量及总体健康、情感功能和社会功能的变化幅度显著大于对照组(<0.05)。

结论

基于赋权理论的电话随访干预可有效提高CASI术后患者的心理弹性和生活质量。这种随访方式可为医院和社区对CASI术后患者开展针对性延续护理提供理论依据和实践参考。干预的长期效果及其潜在机制有待进一步研究。

临床试验注册

http://www.chictr.org.cn/showproj.aspx?proj=173682,标识符ChiCTR2200064950

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