林金珠?林娜?吴云娟?邹丽芳

【摘要】 目的：探討保护动机理论对择期冠脉支架植入术后患者用药依从性的应用效果。方法：选择2018年1月-2019年6月在笔者所在医院接受择期冠脉支架植入术的70例冠心病患者，依据随机数字表法分为两组，每组35例，对照组采用常规护理，观察组采用保护动机理论护理，比较两组服药依从性、自我护理能力评分、血脂水平、凝血功能指标。结果：观察组服药总依从率高于对照组，观察组自我护理能力评分高于对照组，差异均有统计学意义（P<0.05）。观察组总胆固醇、甘油三酯、低密度脂蛋白胆固醇、脂蛋白a水平均低于对照组，观察组凝血酶时间、凝血酶原时间、活化部分凝血活酶时间均长于对照组，差异均有统计学意义（P<0.05）。结论：保护动机理论护理可提高择期冠脉支架植入术患者的服药依从性和自我护理能力，有利于控制其血脂水平，增强抗凝功能。

【关键词】 冠心病 冠脉支架植入术 保护动机理论 护理 用药依从性

doi：10.14033/j.cnki.cfmr.2020.21.033 文献标识码 B 文章编号 1674-6805（2020）21-00-03

Application of Protective Motivation Theory in Medication Compliance of Patients Undergoing Elective Coronary Stent Implantation/LIN Jinzhu， LIN Na， WU Yunjuan， ZOU Lifang. //Chinese and Foreign Medical Research， 2020， 18（21）： -81

[Abstract] Objective： To explore the application effect of protective motivation theory on medication compliance of patients undergoing elective coronary stent implantation. Method： From January 2018 to June 2019， 70 patients with coronary heart disease who undergoing elective coronary stent implantation in our hospital were divided into two groups according to the method of random number table， 35 cases in each group. The control group was treated with routine nursing， and the observation group was treated with protective motivation theory nursing. The drug dependence， self-care ability score， blood lipid level and coagulation function index of the two groups were compared. Result： The total compliance rate in the observation group was higher than that in the control group， and the score of self-care ability in the observation group was higher than that in the control group， the differences were statistically significant （P<0.05）. The levels of total cholesterol， triglyceride， low-density lipoprotein cholesterol and lipoprotein a in the observation group were all lower than those in the control group， the thrombin time， prothrombin time and activated partial thrombin time in the observation group were all longer than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The theory of protective motivation nursing can improve the compliance of medication and self-care ability of patients with selective coronary stent implantation， help to control their blood lipid level and enhance the anticoagulant function.

[Key words] Coronary heart disease Coronary stent implantation Theory of protective motivation Nursing Medication compliance

First-authors address： Fujian Provincial Hospital， Fuzhou 350001， China

冠心病属于临床常见的慢性心血管疾病，其病程漫长，病情迁延不愈[1]。冠脉支架植入是一种介入治疗手段，对冠心病具有良好的疗效[2]，在治疗后患者需长时间服药以控制病情，部分患者由于服药疗程长而易出现不按医嘱服药、擅自中断服药等服药依从性差现象，不利于其病情控制，故还需对其采取护理措施进行干预。保护动机理论主要是指认知调节过程中的威胁评估和应对评估解释行为改变的过程，对形成保护动机的威胁因素进行评估，根据威胁因素实施针对性护理干预措施，其护理方案的针对性强[3]。本研究旨在探讨冠脉支架植入术患者通过保护动机理论护理对服药依从性的改善作用，具体如下。

1 资料与方法

1.1 一般资料

采用便利抽样法连续性纳入2018年1月-2019年6月我院行择期冠脉支架植入术的70例冠心病患者。……