Influence of problem-oriented nursing intervention on self-management ability and rehabilitation effect of patients with coronary heart disease after PCI / 中国实用护理杂志

ABSTRACT

Objective:To investigate the effect of problem-oriented nursing intervention in the self-management rehabilitation of patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 128 patients with coronary heart disease undergoing PCI operation in Changzhou Second People′s Hospital from January 2019 to January 2021 were selected and randomly divided into the observation group and the control group with 64 cases in each group. The control group was given routine self-management intervention, and the observation group was given problem-oriented self-management intervention. After 6 months of intervention, the indicators of self-management ability, cardiac function, and quality of life were compared between the two groups.Results:After 6 months of intervention, the observation group actually completed 58 cases, and the control group actually completed 62 cases. Before the intervention, there were no significant differences between the two groups in the scores of coronary self-management ability scale, cardiac function index and Seattle Angina Questionnaire ( P>0.05). Six months after intervention, the scores of disease knowledge management, symptom management, first aid management, daily life management, bad addiction management, treatment compliance, and self-management ability in the observation group were 16.34 ± 2.36, 13.36 ± 2.42, 12.26 ± 2.23, 17.45 ± 2.74, 16.52 ± 2.45, 12.16 ± 2.15, 103.54 ± 14.32, which were significant higher than those of in the control group, 14.32 ± 2.45, 12.45 ± 2.23, 10.75 ± 2.32, 16.05 ± 2.45, 15.24 ± 2.53, 10.36 ± 2.24, 94.09 ± 13.36 ( t=2.14-4.59, all P<0.05). After six months of intervention, the left ventricular end-systolic diameter (LVESD) and the left ventricular end-diastolic diameter(LVEDD) were (34.39 ± 6.75) mm and (52.60 ± 6.31) mm, which were significant lower than those of the control group, (38.56 ± 6.52) mm and (55.79 ± 5.74) mm ( t=3.52 and 2.90, both P<0.05). Left ventricular ejection fraction (LVEF) and left ventricular short-axis shortening rate (FS) in the observation group after 6 months intervention were (44.25 ± 3.65)% and (23.86 ± 2.41)%, which were significant higher than those of in the control group, (39.24 ± 3.52)% and (22.26 ± 2.51)%( t=7.65 and 3.56, both P<0.05). Six months after the intervention, the scores of the degree of body limitation, angina pectoris, stable angina pectoris attack degree, treatment satisfaction, disease cognition degree, quality of life score in the observation group were 73.09 ± 8.13, 68.21 ± 10.15, 74.10 ± 4.45, 79.36 ± 8.21, 76.53 ± 9.43, 72.26 ± 9.12, which were significant higher than those of in the control group, 64.15 ± 8.11, 59.38 ± 10.23, 63.51 ± 5.23, 62.45 ± 8.16, 67.68 ± 9.20, 63.44 ± 8.65 ( t=4.74-11.91, all P<0.05). Conclusion:Problem-oriented nursing intervention is helpful to promote the development of self-management ability of patients with coronary heart disease after PCI, promote the recovery of postoperative cardiac function, and improve the quality of life of patients.