王美仙　章凤彩　王淑卿

[摘要] 目的 分析健康教育对心内科患者治疗的依从性及心理健康的影响。 方法 选取2013年4月～2014年4月淳安县第一人民医院心内科收治的154例患者，随机分为观察组和对照组。每组77例。对照组给予常规护理，观察组在常规护理的基础上，由专科护理人员进行健康宣教。观察并比较两组患者SAS评分和SDS评分的变化以及两组患者治疗的依从性。 结果 健康教育后，观察组平均SAS、SDS评分均显著低于健康教育前的平均评分（t=78.48，P<0.01；t=57.04，P<0.01）。治疗后对照组平均SAS、SDS评分均显著低于治疗前的平均评分（t=26.99，P<0.01；t=24.4，P<0.01）。治疗后观察组患者SAS评分和SDS评分明显低于对照组，两者差异有统计学意义（t=45.79，P<0.01；t=41.27，P<0.01）。观察组患者的总依从率显著高于对照组（χ2=37.762，P<0.01），且观察组的依从性也显著优于对照组（Z=-6.456，P<0.01）。 结论 健康教育能降低心内科患者焦虑、抑郁的情况，提高治疗依从性，值得在临床推广与应用。

[关键词] 健康宣教；SAS评分；SDS评分；治疗依从性

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2015）35-0147-03

[Abstract] Objective To explore the effect of health education on the compliance and mental health in patients of the Department of cardiology. Methods Selected 154 patients from the department of cardiology from April 2013 to April 2014 in the first people's hospital of Chunan county. These patients were randomly divided into the observation group and the control group. Normal nursing was given to the patients in the control group. Besides normal nursing， health education was conducted on the observation group. The SAS score， SDS score and the compliance were recorded and compared between those two groups. Results After health education， SAS score and SDS score of the patients in the observation group and the control group were significantly lower than before health education（t=78.48， P<0.01； t=57.04， P<0.01）， and the SAS score and SDS score of patients in control group were also significantly lower than before（t=26.99， P<0.01； t=24.4， P<0.01）. While， after health education， the SAS score and SDS score of the patients in the observation group were significantly lower than that of the patients in the control group（t=45.79， P<0.01； t=41.27， P<0.01）. The compliance rate of the observation group was significantly higher than that of the control group（χ2=37.762，P<0.01）， and the compliance of the patients in the observation group was significantly better than that of the control group（Z= -6.456， P<0.01）. Conclusion Health education can reduce the incidence of anxious or depression for patients in department of Cardiology， improve the treatment compliance. And it is worthy of promotion and application.

[Key words] Health education； SAS score； SDS score； Treatment compliance

治療依从性是指患者的行为（服药、饮食及改变其他生活方式）与临床医嘱的符合程度[1]。随着我国人民生活水平的提高、生活节奏的加快和生活方式的改变以及老龄化社会的到来，以冠心病为代表的慢性心血管疾病逐渐成为危害人民健康的主要疾病[2]。肥胖、吸烟、高脂血症、高血压、高脂高蛋白饮食、运动量少等均为冠心病的发生发展的重要危险因素[3]。此外，大量研究证实，情绪在心血管疾病的发生、发展中起着重要的作用[4]。心血管疾病多为慢性病，患者往往需要长期反复地住院治疗，在住院期间难免出现紧张、抑郁、焦虑等各种不良情绪，导致患者治疗的依从性降低，严重影响治疗效果[5]。本院于2013年4月～2014年4月选取154例患者在住院期间由专科护理人员进行相关疾病的健康宣教，取得较好的效果，患者治疗的依从性显著提高，现报道如下。

1 资料与方法