心脏机械瓣膜置换术后早期患者对华法林抗凝认知现状及其影响因素分析

目的：调查心脏机械瓣膜置换术后早期患者对华法林抗凝认知情况,并探讨其影响因素,为制定有针对性的华法林抗凝临床健康教育方案提供依据。方法：采用自行设计的华法林抗凝认知情况调查表,以及Zung焦虑自评量表、Zung抑郁自评量表和社会支持评定量表,以门诊复诊和电话随访的方式对115例心脏机械瓣膜置换术后服用华法林进行抗凝治疗的患者进行问卷调查。结果：患者抗凝认知得分为4～15（9.34±2.91）分,认知程度差者占40.0%,认知程度一般者占34.8%,认知程度好者占25.2%;认知程度主要影响因素为社会支持度、抑郁程度和现居住地。结论：患者抗凝认知程度尚待提高,护理人员应加强对患者进行华法林抗凝相关知识的宣教,特别是对于社会支持较差、有抑郁倾向或抑郁症状以及现居农村的患者。

The cognitive status of anticoagulant and its related factors in patients with mechanical heart valve replacement

Objective： To investigate the cognitive status and its related factors of warfarin anti coagulant in patients undergoing mechani cal heart valve replacement.Methods： Atotalof115patients with mechanical heart valve replacement were investigated with a selfdesigned questionnaire about the cognitive status of anticoagulation by warfarin, Self-rating anxiety scale（SAS）, Self-rating depressive scale（SDS）, and Social Support Rating Scale （SSRS）.They were interviewed at outpatient appointment or called by telephone to complete the questionnaires. Results： The score of cognitive status of anticoagulation by warfarin was ranged 4~15 （9.34±2.91）; 40.0% were unsatisfactory; 34.8% were common; and 25.2% were satisfactory. Social support, depression, and place of residency were significantly correlated with cognitive status of anticoagulation. Conclusion： The level of cognitive status of anticoagulation by warfarin in patients undergoing mechanical heart valve replacement needs to be improved. Nursing staff should enhance health education of the patients, especially the patients with poor social support,depression,and living in the rural area.