李金銮　柏亚妹　孙秋　魏凤莲

[摘要] 目的 考察基于微信平臺的管理模式对急性冠脉综合征患者疾病不确定感和焦虑抑郁情绪的改善效果。 方法 将2017年6—12月我院诊治的80例急性冠脉综合征患者随机分为观察组和对照组，每组各40例，对照组采用常规健康教育模式，观察组在对照组基础上联合应用微信平台健康教育模式，均干预12周，比较两组干预前后的疾病不确定感评分、抑郁自评量表（SDS）评分和焦虑自评量表（SAS）的评价结果。 结果 干预前，两组患者复杂性、不明确性和疾病不确定感评分比较，差异无统计学意义（P>0.05）;经干预后，两组患者复杂性、不明确性和疾病不确定感评分均显著降低，且观察组显著低于对照组（P<0.05）;干预前，两组患者SDS评分和SAS评分比较，差异无统计学意义（P>0.05）;经干预后，两组患者SDS和SAS评分均显著降低，且观察组显著低于对照组（P<0.05）。 结论 微信平台的健康管理模式能改善急性冠脉综合征患者的疾病不确定感、焦虑和抑郁程度。

[关键词] 急性冠脉综合征;疾病不确定感;微信;焦虑抑郁

[中图分类号] R47          [文献标识码] B          [文章编号] 1673-9701（2021）04-0176-04

Effect of patient management model based on Wechat platform on improving the uncertainty of disease and anxiety and depression of patients with acute coronary syndrome

LI Jinluan1   BO Yamei1   SUN Qiu2   WEI Fenglian2

1.College of Nursing， Nanjing University of Chinese Medicine， Jiangsu   210029， China; 2.Department of Cardiology， Nanjing Chest Hospital， Jiangsu   210029， China

[Abstract] Objective To investigate the effect of the patient management mode based on Wechat platform on improving the uncertainty of disease and anxiety and depression of patients with acute coronary syndrome. Methods A total of 80 patients with acute coronary syndrome diagnosed and treated in our hospital from June to December 2017 were randomly divided into the observation group（n=40） and the control group（n=40）. The control group adopted the conventional health education mode， and the observation group received the Wechat-based health education mode on the basis of the control group. All patients were intervened for 12 weeks. The scores of uncertainty in disease， self-rating depression scale（SDS） and self-rating anxiety scale（SAS） before and after intervention were compared between the two groups. Results Before intervention， there was no significant difference in the scores of complexity， uncertainty and disease uncertainty between the two groups（P>0.05）. After intervention， the scores of complexity， uncertainty and uncertainty of disease in the two groups were significantly reduced， and the observation group was significantly lower than the control group（P<0.05）. Before intervention， there was no significant difference between SDS score and SAS score between the two groups（P>0.05）. After intervention， the scores of SDS and SAS in both groups were significantly decreased， and the observation group was significantly lower than the control group（P<0.05）. Conclusion Wechat-based health management model can improve the degree of uncertainty， anxiety and depression of patients with acute coronany syndrome.

[Key words] Acute coronary syndrome; Uncertainty in disease; Wechat; Anxiety and depression

急性冠脉综合征（Acute coronary syndrome，ACS）是冠状动脉粥样硬化性心脏病最为严重的发病形式，临床主要表现为间断性或持续性的胸骨后剧烈疼痛，呈烧灼感或紧缩压榨感，伴有呼吸困难、恶心、出汗、窒息感甚至晕厥等症状[1-2]。美国心理护理专家Mishel于1988年提出疾病不确定感理论，临床调查研究显示，疾病不确定感与患者的信息缺乏具有一定的相关性[3-4]。介入治疗在治疗ACS上效果较好，术后的健康教育也十分重要，传统的疾病健康教育方式消耗的人力物力较大，难以长期实施，因此亟需探讨新型的健康教育方式以改善ACS患者的疾病不确定感，本研究拟考察基于微信平台的管理模式对ACS患者疾病不确定感和焦虑抑郁情绪的改善效果，现报道如下。