ESPCS干预对慢性心力衰竭患者心脏康复的影响

doi:10.3969/j.issn.2095-9400.2019.08.014

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摘要目的：运用讲解-模拟-练习-沟通-支持（ESPCS）模式对心力衰竭患者心脏康复健康宣教进行干预，探讨ESPCS模式对心力衰竭患者心脏康复的影响。方法：将2017年10月至2018年11月收治的152例心力衰竭患者根据随机数字表法分成观察组和对照组，每组各76例。对照组实行常规护理指导，观察组在常规护理指导的基础上采用ESPCS模式，为患者量身定制健康教育计划；比较2组患者心力衰竭相关知识（HFKT）和自我护理技能（SCHFI）的掌握程度以及患者的心脏超声心动图中左心室射血分数（LVEF）和左心室舒张末内径（LVEDd）及再住院率。结果：慢性心衰患者HFKT和SCHFI得分低。实施护理前，对照组和观察组患者的HFKT得分、SCHFI得分差异均无统计学意义（P＞0.05），2组患者LVEF和LVEDd比较，差异亦无统计学意义（P＞0.05）。在出院时和出院后1个月调查2组患者的HFKT得分和SCHFI得分，观察组均明显高于对照组（P＜0.05）。出院后1个月观察组患者因心脏相关原因的再住院率为1.32%，明显低于对照组的13.16%，且复查心脏彩超显示LVEF和LVEDd较对照组改善明显。结论：ESPCS模式能更好地支持患者心脏康复的健康宣教，从而帮助患者理解出院指导，掌握心衰疾病相关知识，进行有效的自我护理。

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	叶灵晓
	汪莉莉
	王燕敏
	张丽萍

关键词 ：讲解-模拟-练习-沟通-支持, 心力衰竭, 心脏康复, 患者教育, 自我管理

Abstract：Objective: To explore the effect of ESPCS (explain-simulate-practice-communication-support) on the cardiac rehabilitation of patients with chronic heart failure (CHF) through the intervention of ESPCS model. Methods: There were totally 152 CHF selected from the hospital between Oct. 2017 and Nov. 2018, who were divided as the observation group and the control group with 76 cases in each. The control group received routine nursing guidance, while health education plan was customized for CHF in the observation group by establishing ESPCS model. The heart failure knowledge test (HFKT) and the self-care of heart failure index (SCHFI), as well as the situation of the left ventricular ejective fraction (LVEF), left ventricular diastolic diamein (LVEDd) and the rate of re-hospitalization were compared. Results: Low scores of HFKT and SCHIFI in patients with CHF were observed. Before the implementation, there was no significant difference between LVEF and LVEDd. After the implementation, the HFKT scores and SCHFI scores in two groups were investigated respectively twice in a month after discharge. The scores of the observation group were significantly higher than the control group (P<0.05). The number of CHF hospitalized for heart-related reasons was significantly lower in the observation group (1 patient) than that in the control group (10 patients). Meanwhile the LVEF and LVEDd was significantly improved compared with that in the control group one month after discharge. Conclusion: ESPCS model can support the health education of patients’ cardiac rehabilitation, so that patients with CHF better understand discharge guidance and achieve more effective self care by learning relevant knowledge.

Key words： explain-simulate-practice-communication-support chronic heart failure cardiac rehabilitation education self-care

通讯作者: 张丽萍，主任护师，硕士生导师，Email：zlp80090@126.com。

作者简介: 叶灵晓（1983-），女，浙江宁波人，主管护师，在职硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2019.08.014 或 https://xb.wmu.edu.cn/CN/Y2019/V49/I8/614

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