Abstract: Objective　To explore the application of outpatient collaborative nursing combined cognitive reconstruction intervention in reducing coronary heart disease readmission in the elderly. Methods　A total of 82 elderly patients with coronary heart disease were selected and regularly reviewed after outpatient treatment in Wuxi Second People's Hospital from July 2019 to July 2021. They were divided into an experimental group and a reference group by the parity grouping method, with 41 cases in each group. In the reference group, there were 18 males and 23 females, aged (69.07±5.62) years; there were 22 males and 19 females in the experimental group, aged (69.31±5.47) years. The reference group received cognitive reconstruction intervention, and the experimental group received outpatient collaborative nursing on the basis. The disease knowledge mastery, self-efficacy measurement scale [Exercise of Self-care Agency Scale (ESCA)], and Seattle Angina Questionnaire (SAQ) quality of life data were evaluated in the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The disease knowledge mastery rate of the experimental group was higher than that of the reference group [95.12% (39/41) vs. 80.49% (33/41)], with a statistically significant difference (χ²=4.100, P=0.043). After intervention, the scores of self-care skills [(36.21±2.82) points vs. (34.51±2.74) points], self-responsibility [(11.26±2.74) points vs. (9.52±2.65) points], self-concept [(25.36±2.63) points vs. (23.52±2.84) points], and health knowledge level [(48.29±2.67) points vs. (46.56±2.58) points] of self-efficacy in the experimental group were higher than those in the reference group, with statistically significant differences (all P<0.05). After intervention, the scores of physical activity [(24.89±2.59) points vs. (26.53±2.63) points], physical symptoms [(23.71±2.64) points vs. (25.46±2.84) points], emotional distress [(15.76±2.63) points vs. (17.45±2.88) points], and life satisfaction [(14.66±2.56) points vs. (16.35±2.64) points] of quality of life in the experimental group were lower than those in the reference group, with statistically significant differences (all P<0.05). The readmission rate of the experimental group was lower than that of the reference group [2.44% (1/41) vs. 14.63% (6/41)], with a statistically significant difference (χ²=3.905, P=0.048). Conclusion　Outpatient collaborative nursing combined with cognitive reconstruction intervention can effectively improve the degree of disease knowledge mastery in elderly patients with coronary heart disease, improve their self-efficacy and quality of life level, and reduce the readmission rate.

Key words: Outpatient collaborative nursing, Cognitive reconstruction intervention, Elderly coronary heart disease, Readmission, Self-efficacy, Disease knowledge mastery, Quality of life

摘要： 目的　探究门诊协同护理联合认知重构干预在减少老年冠心病患者再次入院中的应用。方法　选取2019年7月至2021年7月在无锡市第二人民医院门诊治疗后定期复查的老年冠心病患者82例，以奇偶分组法均分为参照组及试验组，每组41例。参照组男18例，女23例，年龄（69.07±5.62）岁；试验组男22例，女19例，年龄（69.31±5.47）岁。参照组行认知重构干预，试验组加用门诊协同护理。对两组疾病知识掌握、自我效能测定量表及西雅图心绞痛问卷生活质量数据进行测评。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　试验组疾病知识掌握率高于参照组［95.12%（39/41）比80.49%（33/41）］，差异有统计学意义（χ²=4.100，P=0.043）；干预后，试验组自我效能的自我护理技能评分［（36.21±2.82）分比（34.51±2.74）分］、自我责任感评分［（11.26±2.74）分比（9.52±2.65）分］、自我概念评分［（25.36±2.63）分比（23.52±2.84）分］及健康知识水平评分［（48.29±2.67）分比（46.56±2.58）分］均高于参照组，差异均有统计学意义（均P<0.05）；试验组生活质量的躯体活动评分［（24.89±2.59）分比（26.53±2.63）分］、躯体症状评分［（23.71±2.64）分比（25.46±2.84）分］、情绪困扰评分［（15.76±2.63）分比（17.45±2.88）分］及生活满意度评分［（14.66±2.56）分比（16.35±2.64）分］均低于参照组，差异均有统计学意义（均P<0.05）。试验组患者的再入院率低于参照组［2.44%（1/41）比14.63%（6/41）］，差异有统计学意义（χ²=3.905，P=0.048）。结论　门诊协同护理联合认知重构干预能够有效改善老年冠心病患者的疾病知识掌握程度，提高其自我效能及生活质量水平，降低患者的再入院率。

关键词: 门诊协同护理, 认知重构干预, 老年冠心病, 再次入院, 自我效能, 疾病知识掌握, 生活质量