基于“互联网+”运动康复护理在慢性心力衰竭患者中的应用

doi:10.3760/cma.j.cn441417-20241121-11007

摘要/Abstract

摘要：

目的　探讨基于“互联网+”运动康复护理在慢性心力衰竭（CHF）患者中的应用价值。方法　选取2022年5月至2024年5月郑州市第七人民医院收治的78例CHF患者作为研究对象。根据护理方式，将患者分为对照组（39例）和观察组（39例）。对照组男22例，女17例；年龄50～68（61.94±2.25）岁；病程2～16（9.94±3.63）年；心功能分级：Ⅰ级10例，Ⅱ级15例，Ⅲ级14例。观察组男23例，女16例；年龄52～70（61.98±2.22）岁；病程1～17（9.52±3.82）年；心功能分级：Ⅰ级12例，Ⅱ级16例，Ⅲ级11例。对照组采用常规护理，观察组采用基于“互联网+”运动康复护理。两组均持续护理12周。比较两组运动依从性（郑州市第七人民医院自制的运动依从性调查表）、6 min步行距离、心功能［左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）］、生活质量［明尼苏达心力衰竭生命质量问卷（MLHFQ）］及护理满意度（纽卡斯尔护理满意度量表）。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　护理后，观察组运动依从性调查表中各维度（按时运动、运动频率、运动时长）评分均高于对照组［（85.53±3.62）分比（79.98±3.54）分、（86.26±4.24）分比（78.86±3.93）分、（85.57±2.64）分比（79.69±2.53）分］（均P<0.05）；观察组6 min步行距离长于对照组［（546.63±20.94）m比（489.75±20.56）m］（P<0.05）；观察组LVEDD、LVESD均小于对照组，LVEF高于对照组（均P<0.05）；观察组MLHFQ各维度（情绪领域、身体领域、其他领域）评分均低于对照组［（9.39±1.18）分比（12.54±1.22）分、（19.89±2.26）分比（22.35±2.28）分、（15.54±1.35）分比（19.93±1.76）分］（均P<0.05）；观察组护理总满意度高于对照组［94.87%（37/39）比79.49%（31/39）］（P<0.05）。结论　基于“互联网+”运动康复护理可提高CHF患者运动依从性，增强运动耐力，促进心功能恢复，改善生活质量，提高护理满意度

关键词:

慢性心力衰竭, 互联网+, 运动康复护理, 运动依从性, 6 min步行距离, 生活质量

Abstract:

Objective　To explore the application value of "Internet +" exercise rehabilitation nursing in patients with chronic heart failure (CHF). Methods　A total of 78 patients with CHF who were admitted to the Seventh People's Hospital of Zhengzhou from May 2022 to May 2024 were selected as the research subjects. According to the nursing methods, the patients were divided into the control group (39 cases) and the observation group (39 cases). There were 22 males and 17 females in the control group, aged 50-68 (61.94±2.25) years, course of the disease 2-16 (9.94±3.63) years, cardiac function classification: 10 cases at grade Ⅰ, 15 cases at grade Ⅱ, and 14 cases at grade Ⅲ. There were 23 males and 16 females in the observation group, aged 52-70 (61.98±2.22) years, course of the disease 1-17 (9.52±3.82) years, cardiac function classification: 12 cases at grade Ⅰ, 16 cases at grade Ⅱ, and 11 cases at grade Ⅲ. The control group took routine nursing, the observation group took "Internet +" exercise rehabilitation nursing, both groups were continuously nursing observation for 12 weeks. Compare the two groups in terms of exercise compliance (the self-developed exercise compliance questionnaire of the 7th People's Hospital of Zhengzhou), 6 min walking distance, cardiac function [left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF)], quality of life [Minnesota living with heart failure questionnaire (MLHFQ)], and nursing satisfaction (Newcastle satisfaction with nursing scale). Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After the nursing intervention, the scores of each dimension (timely exercise, exercise frequency, exercise duration) in the exercise compliance questionnaire of the observation group were all higher than those of the control group [(85.53±3.62) points vs. (79.98±3.54) points, (86.26±4.24) points vs. (78.86±3.93) points, (85.57±2.64) points vs. (79.69±2.53) points] (all P<0.05); The 6 min walking distance of the observation group was longer than that of the control group [(546.63±20.94) m vs. (489.75±20.56) m] (P<0.05); the LVEDD and LVESD values in the observation group were lower than those in the control group, while the LVEF was higher than that in the control group (all P<0.05); the scores of each dimension (emotional domain, physical domain, and other domains) of the MLHFQ in the observation group were all lower than those in the control group [(9.39±1.18) points vs. (12.54±1.22) points, (19.89±2.26) points vs. (22.35±2.28) points, (15.54±1.35) points vs. (19.93±1.76) points] (all P<0.05); the overall satisfaction rate of nursing in the observation group was higher than that in the control group [94.87% (37/39) vs. 79.49% (31/39)] (P<0.05). Conclusion　Exercise rehabilitation nursing based on "Internet +" can enhance the exercise compliance of patients with CHF, increase exercise endurance, promote the recovery of cardiac function, improve the quality of life, and increase the satisfaction of nursing.

Key words:

Chronic heart failure, Internet +, Sports rehabilitation nursing, Exercise compliance, 6 min walking distance, Quality of life

叶晓慧韩金桃王迈瑞.

基于“互联网+”运动康复护理在慢性心力衰竭患者中的应用 [J]. 国际医药卫生导报, 2025, 31(11): 1796-1800.

Ye Xiaohui, Han Jintao, Wang Mairui.

Application of "Internet +" exercise rehabilitation nursing in patients with chronic heart failure [J]. International Medicine and Health Guidance News, 2025, 31(11): 1796-1800.

参考文献

[1]兰云霞,易梦思,王晓明,等.基于恐惧-回避模型的康复护理方案在老年慢性心力衰竭患者中的应用[J].护理学杂志,2024,39(11):96-100.DOI:10.3870/j.issn.1001-4152. 2024.11.096.

[2]俞剑东,郁艳梅,张佳.协同康复护理对慢性心力衰竭患者自我护理能力和生活质量的影响[J].现代中西医结合杂志,2023,32(9):1295-1299.DOI:10.3969/j.issn.1008-8849. 2023.09.027.

[3]杜凌凌,刘艳梅,王亚楠,等.基于Cox健康行为互动模式在冠心病慢性心力衰竭患者康复护理中的应用[J].临床与病理杂志,2023,43(6):1274-1280.DOI:10.11817/j.issn. 2095-6959.2023.222587.

[4]祖东亮,张双,王楠.协同康复护理干预对慢性心力衰竭患者自护能力和生活质量的影响[J].中华全科医学,2022,20(1):169-171,174.DOI:10.16766/j.cnki.issn. 1674-4152.002304.

[5]中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性心力衰竭基层诊疗指南(2019年)[J].中华全科医师杂志,2019,18(10):936-947.DOI:10.3760/cma.j.issn. 1671-7368.2019.10.008.

[6]张前,范爱莉.藏文版明尼苏达心力衰竭生活质量问卷(MLHFQ)在心力衰竭患者的应用[J].基础医学与临床,2019,39(11):1612-1617.DOI:10.3969/j.issn.1001-6325. 2019.11.019.

[7]牛洪艳,倪静玉,张玲,等.护理满意度量表在临床住院病人中应用的信效度研究[J].护理研究,2016,30(3):287-290.DOI:10.3969/j.issn.1009-6493.2016.03.009.

[8]刘蕾蕾,王琎,史英梅,等.医院-社区-家庭三元联动延续性护理模式在慢性心力衰竭患者中的应用[J].中华现代护理杂志,2023,29(12):1639-1643.DOI:10.3760/cma.j.cn115682-20220805-03800.

[9]朱锋,苏严琳,朱丽萍.基于跨理论模型的护理模式对慢性心力衰竭患者用药依从性及生活质量的影响[J].国际护理学杂志,2022,41(3):529-533.DOI:10.3760/cma.j.cn221370-20200605-00138.

[10]李玉,陈可英,周黎辉.基于时机理论的步行运动法在老年慢性心力衰竭患者中的应用[J].解放军护理杂志,2021,38(6):72-75.DOI:10.3969/j.issn.1008-9993.2021.06.019.

[11]崔慧,张祖惠.自我效能感和应对方式对慢性心力衰竭患者自我护理行为的影响研究[J].贵州医药,2022,46(8):1322-1323.DOI:10.3969/j.issn.1000-744X.2022.08.092.

[12]李霞,杨蕊,陈飞飞.远程网络延续护理改善慢性心力衰竭患者心功能和生活质量的研究[J].中国护理管理,2021,21(3):414-419.DOI:10.3969/j.issn.1672-1756. 2021.03.018.

[13]杨学青,郭宇飞,刘慧娟,等.基于信息-动机-行为技巧模型的慢性心力衰竭患者护理干预效果评价[J].中国健康教育,2024,40(8):758-761.DOI:10.16168/j.cnki.issn.1002- 9982. 2024.08.016.

[14]董永蓉.基于授权理论的延续性护理对老年慢性心力衰竭病人心功能和躯体功能的影响[J].护理研究,2021,35(18):3336-3339.DOI:10.12102/j.issn.1009-6493.2021.18.027.

[15]陈艺香,李芳,刘薇,等.HtoH连续护理策略对老年慢性心力衰竭患者的影响[J].国际护理学杂志,2024,43(5):774-778.DOI:10.3760/cma.j.cn221370-20220610-00182.

[16]陈山霞,张俊梅,谢赫男.基于行为改变轮理论的护理干预对慢性心力衰竭患者容量管理效果的研究[J].国际医药卫生导报,2024,30(22):3852-3856.DOI:10.3760/cma.j.issn.1007-1245.2024.22.033.

[17]于甜栖,孙国珍,高敏,等.慢性心力衰竭患者运动康复参与护理干预方案的构建[J].中华护理杂志,2023,58(4):414-420.DOI:10.3761/j.issn.0254-1769.2023.04.004.

[18]张曦,孙敏,胡媛,等.过渡期护理干预在慢性心力衰竭患者家庭照顾者中的应用效果研究[J].护理管理杂志,2023,23(8):608-612.DOI:10.3969/j.issn.1671- 315x. 2023.08.003.

[19]Fürst P, Schultz T, Strang P. Specialized palliative care for patients with chronic heart failure at end of life: transfers, emergency department visits, and hospital deaths[J]. J Palliat Med, 2023, 26(6):798-806. DOI: 10.1089/jpm.2022.0292.

[20]杨凤玲,梁林丽,李婷婷,等.智慧护理信息系统应用于慢性心力衰竭急性发作患者出院后延续性干预效果评价[J].国际医药卫生导报,2022,28(1):82-85.DOI:10.3760/cma.j.issn.1007-1245.2022.01.020.