Abstract:

Objective　To study the effect of nursing intervention based on the behaviour change wheel (BCW) theory on volume management in patients with chronic heart failure (CHF). Methods　This was a prospective, randomized, controlled, and single-center study. A total of 86 CHF patients admitted to the Department of Geriatric Medicine, Henan Provincial People's Hospital from April 2023 to November 2023 were selected as the study objects. The patients were divided into a control group and an experimental group by the random number table method. The experimental group screened 43 cases, excluded 3 cases, and finally included 40 cases in the analysis; the control group screened 43 cases, excluded 2 cases, and finally included 41 cases in the analysis. There were 14 males and 27 females in the control group, aged (60.17±5.22) years, with a height of (165.10±7.45) cm and body weight of (69.41±13.28) kg. There were 18 males and 22 females in the experimental group, aged (58.33±4.50) years, with a height of (166.65±10.72) cm and body weight of (68.12±13.31) kg. The control group received routine nursing intervention, and the experimental group received nursing intervention based on the BCW theory on the basis of the control group. Both groups received four interventions during hospitalization (on the first day after admission, on the second day after admission, on the third day after admission, and before discharge), and once a week in the first month after discharge, a total of four times. The two groups were followed up by telephone one month after the end of intervention. The qualitied rates of dry weight of the two groups were compared 1 month and 2 months after discharge, and the weight management ability, self-management ability, and quality of life of the two groups were compared before intervention and 1 month and 2 months after discharge. Independent sample t test, paired t test, and χ² test were used. Results　At 1 month and 2 months after discharge, the qualitied rate of dry weight of the experimental group [85.00% (34/40) and 72.50% (29/40)] was higher than that of the control group [63.41% (26/41) and 48.78% (20/41)] (both P<0.05). At 1 month and 2 months after discharge, the scores of weight management ability [(36.93±1.50) points and (35.17±2.07) points], self-management ability [(75.34±1.53) points and (73.95±1.16) points] of the experimental group were higher than those of the control group [(30.03±0.84) points, (27.13±0.83) points, (67.40±1.43) points, and (64.03±1.14) points] (all P<0.05); the quality of life score of the experimental group [(63.85±6.35) points and (62.68±4.57) points] was lower than that of the control group [(83.45±5.44) points and (89.80±5.10) points] (both P<0.05). Conclusion　In CHF patients, the application of nursing intervention based on the BCW theory can improve the qualitied rate of dry weight, weight management ability, self-management ability, and quality of life.

Key words:

Chronic heart failure, Behaviour change wheel theory, Volume management, Self-management, Quality of life

摘要：

目的　研究基于行为改变轮（BCW）理论的护理干预对慢性心力衰竭（CHF）患者容量管理的效果。方法　本研究为前瞻性、随机、对照、单中心研究。选取2023年4月至2023年11月河南省人民医院老年医学科收治的86例CHF患者作为研究对象。采用随机数字表法，将患者分为对照组和试验组。试验组筛选43例，剔除3例，最终纳入分析40例；对照组筛选43例，剔除2例，最终纳入分析41例。对照组男14例，女27例；年龄（60.17±5.22）岁；身高（165.10±7.45）cm；体重（69.41±13.28）kg。试验组男18例，女22例；年龄（58.33±4.50）岁；身高（166.65±10.72）cm；体重（68.12±13.31）kg。对照组采用常规护理干预，试验组在对照组基础上采用基于BCW理论的护理干预。两组住院期间干预4次（入院第1天、入院第2天、入院第3天、出院前）；出院后第1个月每周1次，共4次。两组干预完成后1个月行电话随访。比较两组出院后1个月、2个月干体质量达标情况，比较两组干预前、出院后1个月、2个月体重管理能力、自我管理能力以及生活质量。采用独立样本t检验、配对t检验和χ²检验。结果　出院后1个月、2个月，试验组干体质量达标率［85.00%（34/40）、72.50%（29/40）］均高于对照组［63.41%（26/41）、48.78%（20/41）］（均P<0.05）；试验组体重管理能力［（36.93±1.50）分、（35.17±2.07）分］、自我管理能力［（75.34±1.53）分、（73.95±1.16）分］评分均高于对照组［（30.03±0.84）分、（27.13±0.83）分、（67.40±1.43）分、（64.03±1.14）分］（均P<0.05）；试验组生活质量评分［（63.85±6.35）分、（62.68±4.57）分］均低于对照组［（83.45±5.44）分、（89.80±5.10）分］（均P<0.05）。结论　在CHF患者中，应用基于BCW理论的护理干预，可提高患者干体质量达标率、体重管理能力以及自我管理能力，改善生活质量。

关键词:

慢性心力衰竭, 行为改变轮理论, 容量管理, 自我管理, 生活质量