【摘要】 目的 探讨基于患者健康参与模型的结构化教育对心肌梗死患者心血管健康指数的影响,为提升患者的心血管健康水平提供指导。方法 选取2021年8月—12月在南昌市某三级甲等医院就诊的120例心肌梗死患者,将2个院区的患者分别设为试验组与对照组。对照组采用常规教育模式,试验组接受结构化教育课程干预,基于患者健康参与模型,将课程划分为迷惘期、觉醒期、依赖期、自我实现期4个阶段,内容包括4个主题、5个模块。在干预后6个月、12个月使用收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、身体质量指数(body mass index,BMI)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、吸烟率评估两组患者的心血管健康指数,比较两组患者的冠心病自我管理量表(coronary self-management scale,CSMS)得分和心肌梗死多维度评估量表(myocardial infarction dimensional assessment scale,MIDAS)得分。结果 在干预后6个月、干预后12个月试验组的SBP、DBP、LDL-C、吸烟率均低于对照组,在干预后12个月试验组的BMI低于对照组,CSMS得分和MIDAS得分比较,差异均具有统计学意义(P<0.05)。重复测量方差分析结果显示,DBP、SBP、LDL-C、CSMS得分、MIDAS得分的时间效应、组间效应及交互效应差异均具有统计学意义(P<0.05)。结论 基于患者健康参与模型的结构化教育可以有效增强患者的自我管理信念,提高其心血管健康水平和生活质量。更多还原

【Abstract】 Objective To explore the effects of structured education based on the Patient Health Engagement model on the cardiovascular health index in patients with myocardial infarction, and to provide guidance for improving patients′cardiovascular health.Methods A total of 120 patients with myocardial infarction treated at a Grade A tertiary hospital in Nanchang between August and December 2021 were selected. Patients from two hospital campuses were assigned to the experimental group and the control group,respectively. The control group received routine education,while the experimental group received a structured education curriculum intervention based on the Patient Health Engagement model. The program was divided into four stages:blackout,arousal,adhesion,and eudaimonic project,and included four themes and five modules. At 6 and 12 months after the intervention,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and smoking rate were measured to assess the cardiovascular health index. The coronary self-management scale(CSMS) and the myocardial infarction dimensional assessment scale(MIDAS) were used to compare self-management ability and quality of life between the two groups.Results At 6 and 12 months after the intervention,SBP,DBP,LDL-C,and smoking rate in the experimental group were lower than those in the control group,and BMI in the experimental group was lower than that in the control group at 12 months. Differences in CSMS and MIDAS scores between the two groups were statistically significant(P<0.05). Repeated-measures ANOVA showed significant time effects,group effects,and interaction effects for DBP,SBP,LDL-C,CSMS scores,and MIDAS scores(P<0.05).Conclusion Structured education based on the Patient Health Engagement model can effectively enhance patients′ self-management beliefs and improve cardiovascular health and quality of life.更多还原