王秀峰 罗卫华 丁燕 罗琳 周恩庭

摘 要 目的：探究社區微信延续性护理对冠心病PCI术后患者健康行为及生活质量的影响。方法：选取2018年1月—2018年12月常住上海花木社区并首次行冠心病PCI术后出院3个月内的122例患者，按单纯随机抽样法分为对照组和观察组各61例。观察组中有男性39例，占63.9%，女性22例，占36.1%；平均年龄（64.52±9.85）岁。对照组中有男性38例，占62.3%，女性23例，占37.7%；平均年龄（66.43±7.00）岁。对对照组患者实施常规健康教育，对观察组患者在对照组的基础上实施医院-社区-家庭三维联动机制下的社区微信延续性护理干预。干预1年后比较两组患者的健康行为、生活质量、术后事件发生率和再入院率。结果：干预后，观察组患者生活质量（SAQ）评分中的心绞痛发作频率、治疗满意度、疾病认知程度以及健康行为（HPLⅡ）评分均高于干预前，差异均有统计学意义（P<0.01）；对照组患者干预前后的SAQ评分及HPLⅡ评分差异无统计学意义（P>0.05）。干预后，观察组SAQ评分中的躯体活动受限程度、心绞痛发作频率、治疗满意度、疾病认知程度及健康行为（HPLⅡ）评分均高于对照组，差异均有统计学意义（P<0.01）。观察组的术后事件和再入院率均明显低于对照组（9.84%比39.34%，P<0.05；9.84%比32.79%，P<0.05）。结论：在医院-社区-家庭三维联动机制下，社区微信延续性护理对冠心病PCI术后患者的健康行为和生活质量提高效果明显，值得推广。

关键词 冠心病；经皮冠状动脉介入；延续性护理；健康行为；生活质量

中图分类号：R473 文献标志码：A 文章编号：1006-1533（2020）16-0050-04

Effect of community WeChat continuous nursing on health behavior and quality of life of patients with coronary heart disease after PCI

WANG Xiufeng1， LUO Weihua1， DING Yan1， LUO Lin1， ZHOU Enting2（1. Nursing Department of Huamu Community Health Service Center of Pudong New District， Shanghai 201204， China； 2. General Practice Team of Huamu Community Health Service Center of Pudong New District， Shanghai 201204， China）

ABSTRACT Objective： To explore the effect of community WeChat continuous nursing on the health behavior and quality of life of patients with coronary heart disease after percutaneous coronary intervention（PCI）. Methods： From January 2018 to December 2018 a total of 122 patients who were permanent residences in Huamu Community， Shanghai and underwent coronary artery disease for the first time within three months after PCI were divided into a control group with 61 cases and an observation group with 61 cases according to the simple random sampling method. The observation group had 39 males， accounting for 63.9%， and 22females， accounting for 36.1%； the average age was （64.52±9.85） years. The control group had 38 males， accounting for 62.3%， and 23females，accounting for 37.7%； the average age was （66.43±7.00） years. The control group received routine health education， and on the basis of the control group， the observation group implemented community WeChat continuous nursing intervention under the three-way linkage mechanism of hospital， community and family. After intervention for 1 year， health behavior， quality of life， postoperative cardiac event rate and readmission rate of the two groups were compared.

Results： After intervention， the angina attack frequency， treatment satisfaction， disease cognition and health behavior（HPLⅡ） scores in the quality of life（SAQ） score in the observation group were higher than those before intervention， and the differences were statistically significant（P<0.01）； there was no significant difference in SAQ score and HPL Ⅱ score before and after intervention in the control group（P>0.05）. After intervention， the SAQ score， the frequency of angina pectoris attack， the treatment satisfaction， the disease cognition and the HPLⅡ score（P<0.001） in the observation group were higher than those in the control group， and the difference was statistically significant（P<0.01）. The incidence of postoperative cardiac events and the readmission rate in the observation group were lower than those in the control group（9.84% vs. 39.34%， P<0.05； 9.84% vs. 32.79%， P<0.05）. Conclusion： Under the three-way linkage mechanism of hospital， community and family， the application of community WeChat continuous nursing in the improvement of patients with coronary heart disease after PCI has a significant effect and is worthy of promotion.

KEY WORDS coronary heart disease； percutaneous coronary intervention； continuity nursing； health behavior； quality of life

冠心病是临床常见的心血管疾病，是目前危害全球居民健康和生活质量的慢性疾病之一。经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）是通过植入心脏冠脉支架来扩张、疏通狭窄或闭塞的冠状动脉，改善心肌缺血、缺氧症状[1]，从而达到帮助患者治疗疾病、提高生活质量的目的，是治疗冠心病最直接、有效的手段之一。……