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专科护理门诊病例管理对冠状动脉旁路移植术后患者的影响。

Impact of specialized nursing outpatient case management on post-coronary artery bypass grafting patients.

作者信息

Li Tong, Lu Fang-Hui, Zhao Qing

机构信息

Department of Outpatient, Comprehensive Medical Service Center, The First Affiliated Hospital of Air Force University of Military Medicine, Xi'an 710032, Shaanxi Province, China.

出版信息

World J Clin Cases. 2024 Jun 16;12(17):3035-3044. doi: 10.12998/wjcc.v12.i17.3035.

Abstract

BACKGROUND

Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events (MACE) and require readmission after Coronary Artery Bypass Grafting (CABG) surgery. This is often attributed to patients' unhealthy lifestyles and dietary habits, inadequate understanding of the disease, and poor disease management compliance. Thus, searching for more targeted nursing intervention models that can enhance patients' self-management abilities and reduce the risk of readmission after CABG surgery is significant.

AIM

To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.

METHODS

A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample. The patients were divided into two groups using an odd-even number grouping method. The control group received routine nursing care, while the case management group received specialized nursing outpatient case management. The differences in psychological status, adherence to medical treatment, self-care ability, knowledge mastery, quality of life scores, and the occurrence rate of MACE were compared between the two groups.

RESULTS

After the intervention, the case management group had lower scores on the self-rating depression scale and self-rating anxiety scale and lower MACE rate, as well as higher scores for adherence to a healthy diet, medication adherence, good lifestyle habits, regular exercise, and timely follow-up, higher scores on the Coronary Heart Disease Self-Management Scale, higher scores for managing adverse habits, symptoms, emotional cognition, emergency response, disease knowledge, general lifestyle, and treatment adherence, higher scores for understanding coronary heart disease, recognizing the importance of medication adherence, understanding self-care points after CABG surgery, and being aware of post-CABG precautions, higher scores for physical well-being, disease condition, general health, social-psychological well-being, and work-related aspects ( < 0.05).

CONCLUSION

Specialized nursing outpatient case management can enhance patient adherence to medical treatment, knowledge mastery, psychological well-being, and overall quality of life in patients after CABG surgery.

摘要

背景

一些冠状动脉粥样硬化性心脏病患者在冠状动脉旁路移植术(CABG)后经历主要不良心脏事件(MACE)并需要再次入院。这通常归因于患者不健康的生活方式和饮食习惯、对疾病的认识不足以及疾病管理依从性差。因此,寻找更有针对性的护理干预模式以提高患者自我管理能力并降低CABG术后再次入院风险具有重要意义。

目的

观察专科护理门诊个案管理对CABG术后患者的影响。

方法

选取2021年4月至2022年4月在我院行CABG手术的103例患者作为研究样本。采用奇偶分组法将患者分为两组。对照组接受常规护理,个案管理组接受专科护理门诊个案管理。比较两组患者的心理状态、治疗依从性、自我护理能力、知识掌握情况、生活质量评分及MACE发生率。

结果

干预后,个案管理组的自评抑郁量表和自评焦虑量表得分较低,MACE发生率较低,健康饮食依从性、用药依从性、良好生活习惯依从性、规律运动依从性及及时随访依从性得分较高,冠心病自我管理量表得分较高,不良习惯管理、症状管理、情绪认知、应急反应、疾病知识、一般生活方式及治疗依从性得分较高,对冠心病的了解、对用药依从性重要性的认识、对CABG术后自我护理要点的了解及对CABG术后注意事项的知晓得分较高,身体状况、疾病状况、总体健康、社会心理状况及工作相关方面得分较高(<0.05)。

结论

专科护理门诊个案管理可提高CABG术后患者的治疗依从性、知识掌握程度、心理健康水平及总体生活质量。

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