多维度心身干预对瓣膜置换术后风湿性心脏病患者心理韧性及预后的影响

Impact of multidimensional psychosomatic intervention on psychological resilience and prognosis in patients with rheumatic heart disease after valve replacement surgery

  • 摘要:
    目的 探讨双心护理联合认知-行为-心理干预对瓣膜置换术后风湿性心脏病(RHD)患者心理韧性及预后的影响。
    方法 选取2023年3月—2024年3月190例瓣膜置换术后RHD患者资料, 2023年3—9月采用常规护理患者纳入常规护理组, 2023年10月—2024年3月采用双心护理联合认知-行为-心理多维度干预患者纳入联合护理组,每组95例。比较2组患者干预6个月后的心功能分级、干预前及干预6个月后的心理状态疾病进展恐惧心理量表(FoP-Q)、心理弹性量表(CD-RISC)、Herth希望量表(HHI), 以及干预6个月后的生活质量综合评定问卷(GQOLI-74)评分、干预6个月内的总不良事件发生率、服药依从率。
    结果 干预后,联合护理组心功能分级低于常规护理组,差异有统计学意义(P < 0.05)。干预后, 2组FoP-Q评分均降低,且联合护理组低于常规护理组; 2组CD-RISC、HHI评分均升高,且联合护理组评分高于常规护理组,差异有统计学意义(P < 0.05); 联合护理组GQOLI-74中的躯体功能、人际社交、物质生活、自我认知评分以及服药依从率均高于常规护理组,总不良事件发生率低于常规护理组,差异有统计学意义(P < 0.05)。
    结论 与常规护理相比,双心护理联合认知-行为-心理干预能更有效地缓解瓣膜置换术后RHD患者的疾病恐惧,提升心理韧性与希望水平,改善心功能与生活质量,提高服药依从性并降低不良事件风险。

     

    Abstract:
    Objective To investigate the impact of psycho-cardiological nursing combined with cognitive-behavioral-psychological intervention on psychological resilience and prognosis in patients with rheumatic heart disease (RHD) after valve replacement surgery.
    Methods The data of 190 RHD patients who underwent valve replacement surgery from March 2023 to March 2024 were selected. Patients who received conventional nursing from March to September 2023 were included in conventional nursing group, while those who received psycho-cardiological nursing combined with multidimensional cognitive-behavioral-psychological intervention from October 2023 to March 2024 were assigned to combined nursing group, with 95 cases in each group. The cardiac function grading after 6 months of intervention, psychological status before and 6 months after intervention Fear of Progression Questionnaire (FoP-Q), Connor-Davidson Resilience Scale (CD-RISC), Herth Hope Index (HHI), and the score of the Generic Quality of Life Inventory-74 (GQOLI-74) after 6 months of intervention, the overall incidence of adverse events within 6 months of intervention, and medication adherence rate were compared between the two groups.
    Results After the intervention, the cardiac function grade in the combined nursing group was significantly lower than that in the conventional nursing group, with a statistically significant difference (P < 0.05). After the intervention, The FoP-Q scores decreased in both groups, and the score in the combined nursing group was significantly lower than that in the conventional nursing group. The CD-RISC and HHI scores increased in both groups, and the scores in the combined nursing group were significantly higher than those in the conventional nursing group, with statistically significant differences (P < 0.05). The scores of physical function, interpersonal relationships, material life, and self-cognition in the GQOLI-74, as well as the medication adherence rate, were significantly higher in the combined nursing group than those in the conventional nursing group, while the overall incidence of adverse events was significantly lower, with statistically significant differences (P < 0.05).
    Conclusion Compared with conventional nursing, psycho-cardiological nursing combined with cognitive-behavioral-psychological intervention can more effectively alleviate disease fear, enhance psychological resilience and hope levels, improve cardiac function and quality of life, increase medication adherence, and reduce the risk of adverse events in RHD patients after valve replacement surgery.

     

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