【摘要】 目的 探讨基于自我效能理论的功能锻炼对风湿性心脏病患者术后的康复效果。方法 选择2019年6月至2022年6月于江苏省人民医院心脏大血管二病区收治的风湿性心脏病接受心脏瓣膜置换术治疗的患者110例，作为研究对象。采用随机数字表法分为对照组和研究组，每组各55例。对照组患者术后接受常规护理干预。研究组在对照组的基础上，从术后第4周起开展为期4周的基于自我效能的功能锻炼指导。术后8周，根据美国纽约心脏病协会（NYHA）分级标准，对患者进行心功能分级。并对患者干预前（术后1周）、干预后（术后8周）进行生存质量与心理资源水平的评价。结果 术后8周研究组患者的心功能分级与对照组比较，差异有统计学意义（P<0.05）。研究组干预后的运动、疲乏、自理、睡眠、食欲、疼痛评分均明显高于对照组干预后（P<0.05）。经干预后，研究组的自我效能、韧性水平、乐观水平、希望水平评分均明显高于对照组（P<0.05）。结论 基于自我效能理论指导的功能锻炼可显著改善风湿性心脏病患者心脏瓣膜置换术后的心功能、生活质量和心理水平，值得临床推广应用。更多还原

【Abstract】 Objective To discuss the rehabilitation effect of functional exercise based on self-efficacy theory in patients with rheumatic heart disease(RHD) after surgery. Methods RHD patients(n=110) received cardiac valve replacement were chosen from the Second Area of Department of Cardiovascular Medicine in People’s Hospital of Jiangsu Province from June 2019 to June 2022. The patients were divided into control group and study group(each n=55) by using random digital table method. The control group was given routine nursing intervention,and study group was additionally given functional exercise guide based on self-efficacy for 4 weeks after surgery for 4 weeks. The heart function was graded according to the classification criteria of New York Heart Association(NYHA)in 2 groups after surgery for 8 weeks. The quality of life(QOL) and level of psychological resources were reviewed in 2 groups before intervention(1 week after surgery) and after intervention(8 weeks after surgery). Results The difference in NYHA grade had statistical significance between study group and control group 8 weeks after surgery(P<0.05). The scores of sport, fatigue, self-care, sleep, appetite and pain were significantly higher in study group than those in control group after intervention(P<0.05). The scores of self-efficacy, resilience, optimism and hope were significantly higher in study group than those in control group after intervention(P<0.05). Conclusion The functional exercise based on self-efficacy theory can significantly improve heart function, QOL and psychological level in RHD patients received cardiac valve replacement, which is worthy of clinical promotion and application.更多还原