Effect of Family-centered Care on Quality of Life in Patients Underwent Heart Valve Replacement
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摘要:
目的 针对患者在实施心脏瓣膜置换术后进行生存质量研究。 方法 在昆明医科大学第一附属医院心脏外科在2018年7月至2019年7月间，实施过第1次心脏机械瓣膜置换术的患者中选取200例，且患者在手术后行抗凝治疗（进口华法林）。对纳入的病例进行随机分组，其中对照组100例，实验组100例。实验组病例均采用FCC护理服务，且为责任制护理，即病患均有对应的专职责任护士，其自入院到后期家庭护理均有该护士全权负责，对照组则沿用目前的常规方法进行护理。并对患者进行术后护理效果评价，评价时间为术后的3、6以及12个月，评价指标包括服药的依从性和患者的生存质量。 结果 术后3个月内，2组患者在服药的依从性和术后生存质量评价结果中，差异无统计学意义（P > 0.05），但在6个月和12个月内的评价结果中，与对照组比较，实验组服药的依从性和术后生存质量，均显著增高，差异有统计学意义（P < 0.05）。 结论 对接受心脏瓣膜置换术的患者而言，FCC能使其在术后具有更高的服药依从性，并降低相应并发症的发生率，使其具有更高的生存质量。 Abstract:objective To explore the post-operative quality of life in cardiac valve replacement patients. Method A total of 200 patients who had undergone the first mechanical heart valve replacement within 1 year （July 2018 to July 2019） in the Department of Cardiology of The First Affiliated Hospital of Kunming Medical University were selected, and the patients received anticoagulant therapy （warfarin）after surgery. The included cases were randomly divided into the control group （100 cases） and the experimental group （100 cases）. All patients in the experimental group received FCC; that is, all patients had an assigned full-time nurse who was fully responsible for their home care from admission to later stage. The control group received routine nursing care. The patients were evaluated for postoperative nursing effect at 3, 6 and 12 months after surgery, and the evaluation indicators included medication compliance and patients’ quality of life. Results There was no statistically significant difference （P > 0.05） between the two groups in medication compliance and postoperative survival quality at 3 months after surgery; but in 6 months and 12 months, compared with the control group, experimental group’ s medication adherence and postoperative quality of life, were significantly increased （P < 0.05）. Conclusion For patients undergoing heart valve replacement, FCC is associated with a higher postoperative medication compliance and a lower incidence of complications, leading to a higher quality of life. -
表 1 2组一般资料对比结果[
$\bar x\pm s$ /n（%）]Table 1. List of basic data comparison results [
$\bar x\pm s $ /n（%）]项目 对照组（n = 100） 实验组（n = 100） t/χ2 P 年龄（岁） 46.20 ± 16.65 45.50 ± 16.68 0.297 0.767 性别 男 58（58.00） 59（59.00） 0.021 0.886 女 42（42.00） 41（41.00） 
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表 2 2组服药依从性得分比较[（
$\bar x\pm s$ ），分]Table 2. Comparison of medication compliance between the two groups[（
$\bar x\pm s $ ），score]时间点 对照组 实验组 t P 3个月 12.07 ± 2.42 12.07 ± 2.42 5.041 0.000 6个月 10.40 ± 3.04 10.40 ± 3.04 5.041 0.001 12个月 8.12 ± 1.05 8.12 ± 1.05 5.041 0.000
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表 3 2组生存质量得分比较[（
$\bar x\pm s$ ），分]Table 3. Comparison of medication compliance between the two groups[（
$ \bar x\pm s$ ），score]时间点 对照组 实验组 t P 3个月 123.67 ± 4.82 123.67 ± 4.82 13.330 0.000 6个月 125.70 ± 5.24 125.70 ± 5.24 13.330 0.000 12个月 102.52 ± 4.75 102.52 ± 4.75 46.019 0.000
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