Zhao Youwei, Wei Wei, Wang Zhiyuan, Dong Yanbo, Su Zhenyu, Guo Shichao
Department of Cardiac Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang, 050000, Hebei, China.
J Cardiothorac Surg. 2025 Jan 31;20(1):109. doi: 10.1186/s13019-024-03219-3.
This study investigates the impact of nursing interventions, guided by behavior change theory, on the recovery of cardiac function and quality of life in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
A total of 120 patients scheduled for CPB in the Department of Cardiology at our hospital, from February 2021 to May 2023, were enrolled. According to the study protocol, patients were randomly assigned to either a control group (n = 60) or an observation group (n = 60) post-surgery. The control group received routine nursing care, while the observation group received nursing interventions based on behavior change theory, including health education, psychological support, and behavioral incentives. Informed consent was obtained from all patients. General patient data were collected from clinical records. Cardiac function was assessed using echocardiography. The wall motion score index (WMSI) and 6-minute walk distance (6MWD) were evaluated post-care. Serum levels of inflammatory cytokines TNF-α, IL-6, and IL-10 were measured via ELISA. Quality of life was assessed using the WHOQOL-BREF questionnaire, while anxiety and depression levels were evaluated using the HAM-A and HAM-D scales, respectively.
The baseline clinical characteristics and biochemical data of both groups were comparable (P > 0.05). The observation group showed a significantly higher left ventricular ejection fraction (LVEF) compared to the control group (P < 0.05), while both left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were significantly lower (P < 0.05). Additionally, the observation group had a significantly lower WMSI score and a longer 6MWD (P < 0.05). Regarding inflammatory markers, TNF-α and IL-6 levels were significantly reduced in the observation group, while IL-10 levels were significantly elevated compared to the control group (P < 0.05). In terms of quality of life, the observation group reported significantly higher scores in physical health, mental health, social relationships, and environmental factors (P < 0.05). Moreover, anxiety and depression levels were significantly lower in the observation group, as evidenced by reduced HAM-A and HAM-D scores (P < 0.05).
Nursing care guided by behavior change theory significantly improves cardiac function and overall quality of life in patients recovering from cardiac surgery with CPB. This approach enhances LVEF, reduces left intraventricular diameter, lowers inflammatory cytokine levels, and improves mental health and social functioning. These findings underscore the importance of behavior change theory-based nursing interventions in optimizing postoperative recovery.
本研究探讨以行为改变理论为指导的护理干预对接受体外循环心脏手术患者心脏功能恢复及生活质量的影响。
选取2021年2月至2023年5月在我院心内科计划行体外循环手术的120例患者。根据研究方案,患者术后随机分为对照组(n = 60)和观察组(n = 60)。对照组接受常规护理,观察组接受基于行为改变理论的护理干预,包括健康教育、心理支持和行为激励。所有患者均获得知情同意。从临床记录中收集患者的一般资料。采用超声心动图评估心脏功能。护理后评估室壁运动评分指数(WMSI)和6分钟步行距离(6MWD)。通过酶联免疫吸附测定法(ELISA)检测血清炎症细胞因子TNF-α、IL-6和IL-10水平。采用世界卫生组织生活质量简表(WHOQOL-BREF)评估生活质量,分别采用汉密尔顿焦虑量表(HAM-A)和汉密尔顿抑郁量表(HAM-D)评估焦虑和抑郁水平。
两组患者的基线临床特征和生化数据具有可比性(P > 0.05)。与对照组相比,观察组左心室射血分数(LVEF)显著更高(P < 0.05),而左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)均显著更低(P < 0.05)。此外,观察组的WMSI评分显著更低,6MWD更长(P < 0.05)。关于炎症标志物,观察组TNF-α和IL-6水平显著降低,而IL-10水平与对照组相比显著升高(P < 0.05)。在生活质量方面,观察组在身体健康、心理健康、社会关系和环境因素方面的得分显著更高(P < 0.05)。此外,观察组的焦虑和抑郁水平显著更低,HAM-A和HAM-D评分降低证明了这一点(P < 0.05)。
以行为改变理论为指导的护理显著改善了接受体外循环心脏手术患者的心脏功能和整体生活质量。这种方法提高了LVEF,减小了左心室内径,降低了炎症细胞因子水平,改善了心理健康和社会功能。这些发现强调了基于行为改变理论的护理干预在优化术后恢复中的重要性。