社区护理干预对老年慢性心力衰竭患者自我护理能力的影响

目的探讨老年慢性心力衰竭患者自我护理能力以及社区干预的效果。方法选择2013年1～11月在温州医科大学附属第一医院治疗的≥60岁的心力衰竭患者103例,随机分为研究组（51例）和对照组（52例）。两组护理干预前采用欧洲心力衰竭自我护理行为量表对患者的自我护理能力进行评估。研究组在出院后给予社区护理干预,并进行定期随访。干预6个月后,比较两组的再住院率、再住院次数、再住院天数以及自我护理能力评分。结果干预前,不同病程、心功能分级的患者自我护理能力评分比较,差异均有高度统计学意义（P〈0.01）。干预后,对照组再住院率（59.6%）显著高于研究组（39.2%）,对照组再住院次数[（0.93±0.25）次]显著多于研究组[（0.48±0.12）次],对照组再住院天数[（14.89±3.17）d]显著多于研究组[（5.53±1.42）d],干预后研究组自我护理评分[（27.1±6.9）分]显著低于干预前和对照组,差异均有统计学意义（P〈0.05或P〈0.01）。结论老年慢性心力衰竭患者自我护理能力相对较弱,社区护理干预能够显著改善患者的自我护理能力。

Effect of community nursing intervention on self-care of elderly patients with chronic heart failure

Objective To analyze the effect of community nursing intervention on self-care of elderly patients with chronic heart failure. Methods From January to November 2013, in the First Affiliated Hospital of Wenzhou Medical University, 103 cases of ≥60 years age patients with heart failure were selected and divided into study group（51 cases）and control group（52 cases）. Before community nursing intervention, self-care of patients was surveyed with EHFScBS.Study group were given community nursing intervention after discharge and regularly followed-up. After 6 months, EHFScBS of two groups were compared. Results Before the intervention, EHFScBS scores of different age and NYHA patients were compared, the differences were statistically significant（P 〈0.01）. After the intervention, readmission rates（59.6%）, readmission frequency [（0.93±0.25） times] and days of readmission [（14.89±3.17） d] in the control group were more than those in the study group [39.2%,（0.48±0.12） times,（5.53±1.42） d], EHFScBS of the study group [（27.1±6.9）points] were lower than those before the intervention and the control group, the differences were statistically significant（P 〈0.05 or P 〈0.01）. Conclusion Self-care ability of elderly patients with chronic heart failur is relatively weak, and community nursing intervention can improve self-care ability of elderly patients with chronic heart failure.