基于保护动机理论的体质量管理联合分级活动对慢性充血性心力衰竭患者的效果

doi:10.3760/cma.j.issn.1007-1245.2023.20.025

摘要/Abstract

摘要：

目的　分析慢性充血性心力衰竭患者应用基于保护动机理论的体质量管理联合分级活动的效果。方法　选取2019年3月至2021年3月在连云港市第一人民医院心内科住院的慢性充血性心力衰竭患者90例进行随机对照试验。采用随机数字表法将其分为对照组和研究组，每组45例。对照组男27例，女18例，年龄（62.37±3.15）岁。研究组男31例，女14例，年龄（62.54±3.40）岁。对照组实施常规护理及分级活动干预，研究组在对照组基础上实施基于保护动机理论的体质量管理。比较干预前、干预1个月后两组血清指标水平、超声心动图指标、体质量管理能力及生活质量。应用明尼苏达心力衰竭生活质量问卷（Minnesota Living with Heart Failure Questionnaire，MLHFQ）对患者生活质量进行评估。采用t检验、χ²检验。结果　干预前，两组血清指标、心动图指标、体质量管理能力及生活质量等差异均无统计学意义（均P>0.05）。干预1个月后，研究组氨基末端pro脑钠肽（N-terminal probrain natriuretic peptide，NT-proBNP）、半乳糖凝集素-3（galectin-3，Gal-3）等血清指标水平低于对照组（3.17±0.71）ng/L比（4.98±0.67）ng/L、（6.37±1.24）ng/L比（9.27±2.15）ng/L，差异均有统计学意义（均P<0.05）；研究组左心室舒张末期内径（left ventricular end diastolic diameter，LVEDD）、心室收缩末期内径（left ventricular end systolic diameter，LVESD）低于对照组［（55.07±4.27）mm比（58.41±5.12）mm、（40.29±3.45）mm比（45.37±4.87）mm］，差异均有统计学意义（均P<0.05）；研究组左心室射血分数（left ventricular ejection fraction，LVEF）高于对照组［（52.19±7.67）%比（48.67±6.24）%］，差异有统计学意义（P<0.05）；研究组体质量检测、知识、信念、行为体质量管理能力评分和总分均优于对照组［（4.86±1.24）分比（1.98±0.68）分、（3.98±2.18）分比（2.25±1.17）分、（8.15±3.74）分比（5.67±3.15）分、（9.99±4.87）分比（6.49±3.04）分、（26.98±12.03）分比（16.39±8.04）分］，差异有统计学意义（均P<0.05）；研究组MLHFQ躯体领域、情绪领域、其他评分及总分均低于对照组（13.08±3.74）分比（16.48±5.37）分、（2.27±1.34）分比（4.29±2.11）分、（9.67±2.18）分比（11.04±3.16）分及（25.02±7.26）分比（31.81±10.64）分，差异有统计学意义（均P<0.05）。结论　在慢性充血性心力衰竭患者中应用基于保护动机理论的体质量管理联合分级活动，可提高患者活动耐力，促进心功能指标恢复，强化患者对体质量管理的重视，保证疾病顺利治疗，提高预后。

关键词:

慢性充血性心力衰竭, 保护动机理论, 体质量管理, 分级活动

Abstract:

Objective　To analyze the effect of weight management based on protective motivation theory combined with grading activities for patients with chronic congestive heart failure. Methods　From March 2019 to March 2021, 90 patients with chronic congestive heart failure hospitalized in Department of Cardiology, First People's Hospital of Lianyungang City were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 45 cases in each group. There were 27 males and 18 females in the control group; they were (62.37±3.15) years old. There were 31 males and 14 females in the study group; they were (62.54±3.40) years old. The control group took routine nursing and grading activities; in addition, the study group took the weight management based on the protective motivation theory. The levels of serum indicators, changes of echocardiogram indicators, weight management ability, and improvement of quality of life were compared between the two groups before and one month after the intervention. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate their quality of life. t and χ² tests were applied. Results　Before the intervention, there were no statistical differences in serum indicators, electrocardiogram indicators, weight management ability, and quality of life between the two groups (all P>0.05). One month after the intervention, the serum levels of N-terminal probrain natriuretic peptide (NT-proBNP) and galectin-3 in the study group were lower than those in the control group [(3.17±0.71) ng/L vs. (4.98±0.67) ng/L and (6.37±1.24) ng/L vs. (9.27±2.15) ng/L], with statistical differences (both P<0.05); the left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in the study group were lower than those in the control group [(55.07±4.27) mm vs. (58.41±5.12) mm and (40.29±3.45) mm vs. (45.37±4.87) mm], with statistical differences (both P<0.05); the left ventricular ejection fraction (LVEF) in the study group was significantly higher than that in the control group [(52.19±7.67)% vs. (48.67.6.24)%], with a statistical difference (P<0.05); the scores of body weight measurement, knowledge, belief, and behavior of the weight management ability and the total score in the study group were better than those in the control group [(4.86±1.24) vs. (1.98±0.68), (3.98±2.18) vs. (2.25±1.17), (8.15±3.74) vs. (5.67±3.15), (9.99±4.87) vs. (6.49±3.04), and (26.98±12.03) vs. (16.39±8.04)], with statistical differences (all P<0.05); the scores of physical domain, emotional domain, and other domain of MLHFQ and the total score in the study group were lower than those in the control group [(13.08±3.74) vs. (16.48±5.37), (2.27±1.34) vs. (4.29±2.11), (9.67±2.18) vs. (11.04±3.16), and (25.02±7.26) vs. (31.81±10.64)], with statistical differences (all P<0.05). Conclusion　The application of weight management combined with grading activities based on the protective motivation theory in patients with chronic congestive heart failure can improve their activity endurance, promote their recovery of cardiac function indicators, strengthen their attention to weight management, ensure the smooth treatment of diseases, and improve their prognosis.

Key words:

Chronic congestive heart failure, Protective motivation theory, Weight management, Grading activities

金茜吴红燕.

基于保护动机理论的体质量管理联合分级活动对慢性充血性心力衰竭患者的效果 [J]. 国际医药卫生导报, 2023, 29(20): 2941-2946.

Jin Qian, Wu Hongyan.

Effect of weight management based on protective motivation theory combined with grading activities for patients with chronic congestive heart failure [J]. International Medicine and Health Guidance News, 2023, 29(20): 2941-2946.

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