持续心理护理对心力衰竭患者心功能及生活质量的影响

目的探讨持续心理护理对心力衰竭患者心功能和生活质量的影响。方法便利抽样法选取2009-2011年解放军第154中心医院心血管内科住院的心力衰竭患者164例为研究对象,同一心功能等级患者按住院先后分为对照组和观察组。观察组患者出院后每月给予随访检查及心理护理,持续半年;对照组患者给予常规随访检查。两组患者分别在出院时和出院半年后采用明尼苏达心力衰竭生活质量问卷(Minnesota living heart failure questionnaire,MLHFQ)测量其生活质量,并比较出院后半年内两组患者每月测得的血脑钠肽前体(pro-brain natriuretic peptide,pro-BNP)的浓度。结果同一心功能级别的两组患者在出院第4、5、6个月,观察组患者的血pro-BNP浓度均明显低于相应心功能级别的对照组患者,差异有统计学意义(P<0.05或P<0.01)。出院时,同一心功能等级的两组患者在MLHFQ问卷中的躯体领域、情绪领域的评分及总评分方面的差异均无统计学意义(均P>0.05);但在出院第6个月,同一心功能等级的患者中,观察组患者的MLHFQ问卷中的躯体领域、情绪领域的评分及总评分均低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论持续的心理护理可有效改善心力衰竭患者的心功能和生活质量。

Effect of Continuous Psychological Nursing on Cardiac Function and Life Quality of Patients with Heart Failure

Objective To explore the effect of continuous psychological care on cardiac function and quality of life for patients with heart failure. Methods Sixty-four patients with heart failure were divided into three levels of class II, III and IV according to the cardiac function, with 18 to 25 patients in each level. After that, patients in each level were divided into the control group and the experimental group, and both of the two groups were given the same routine care during hospitalization. After discharged, patients in the experimental group were continuously given psychological care once a month for half a year. Quality of life （QOL） the patients in two groups were measured using Minnesota Heart Failure Quality of Life Questionnaire（MHFQ） before discharge and six months after discharge. Meanwhile, the concentration of pro-brain natriuretic peptide （pro-BNP） in blood were tested every month in half a year after discharge. Results For patients with cardiac function of class II, III, and IV, the concentration of pro-BNP of the experimental group was significantly lower than that of the control group（P~0.05 or 0.01） 4,5 and 6 months after discharge. The score of the two groups in the physical field, emotional field and total score were not statistically significant when discharge; while the corresponding score of experimental group were significantly lower than those of the control group （P 〈 0. 05 or 0. 01） six months after discharge. Conclusion Continuous psychological nursing can effectively improve the cardiac function and the QOL of patients with heart failure.