Effect of rehabilitation education on the quality of life of the patients in the convalescence stage of the acute myocardial infarction

背景:急性心肌梗死恢复期的患者依然存在复发的危险,而且生活状况较差.研究证明,此与患者未掌握适合心肌梗死恢复的生活方式有关.目的:采用康复教育的手段,帮助患者建立适合的生活方式,以期提高其生活质量.设计:以急性心肌梗死恢复期患者为研究对象的对比观察.单位:北京医科大学护理学院和两所大学医院.对象:病例均为1999-04/1999-11北京医科大学第二、三附属医院心内科住院患者.纳入标准:首次发病的急性心肌梗死患者,且自愿参加本研究.排除标准:非首次发病的心肌梗死患者.对照组为1999-04/1999-06入院且符合上述纳入条件的患者,共35例;试验组为1999-08/1999-11入院且符合上述纳入条件的患者,共40例.除去一般情况特殊且无条件匹配者及试验组中途失访的患者,最后纳入分析两组均为30例,对照组中男23例,女7例,平均(60±14)岁;试验组中男22例,女8例,平均(62±10)岁,两组患者年龄、性别差异无显著性意义.方法:以Neuman健康照顾系统模式为理论框架,对心肌梗死恢复期患者实施康复教育,即在试验组患者出院前采取集中授课和个别讲解并配合康复教育手册的形式提供康复教育,出院后3个月期间采用电话教育的形式进行督导,提供咨询,出院3个月时家访获得评价资料.主要观察指标:两组患者生活质量及各维度的比较.结果:试验组患者在总的生活质量得分以及躯体、心理、职责角色、健康意识等维度得分均显著高于对照组(t=11.03,3.26,3.62,2.05,15.48,P<0.05),而在社会维度方面二者差异无显著性意义(P>0.05).结论:健康教育可使急性心肌梗死恢复期患者的生活质量得到显著提高.BACKGROUND: There is still recrudescent risk in the convalescence stage of the acute myocardial infarction and the living condition is relatively poor. The study proved that it has relation to that the patients haven't mastered the scientific conformable life style for the myocardial infarction recovery.OBJECTIVE: Take the rehabilitation education to help the patients set up conformable life style so as to improve the quality of life.DESIGN: The patients in the convalescence stage of the acute myocardial infarction were chosen for the control study.SETTING: Nursing Institute of Beijing Medical University and two university hospitals.PARTICIPANTS: The cases were taken from the Cardiology Departm ents of the Second and Third Affiliated Hospital of Beijing Medical University from April 1999 to November 1999. Inclusive standard: the first onset of the acute myocardial infarction and voluntary for this study. Exclusive standard: not the first onset of the acute myocardial infarction. The control group contained 35 patients hospitalized from April 1999 to June 1999 conforming to the including standard. The experimental group contained 40 patients hospitalized from August 1999 to November 1999 conforming to the including standard. After eliminating the special unmatched cases and missed follow-up cases in the experimental group, the final 30 cases were respectively involved in the both groups. There were 23 male cases and 7 female cases in the control group with the mean age of(60 ± 14), and 22 male cases and 8 female cases in the experimental group with the mean age of(62 ± 10) . There was no significant difference in the age and sex in these two groups.METHODS: The Neuman health care system pattern was taken as the theoretical frame for the rehabilitation education of the patients in the convalescent stage of the acute myocardial infarction. That is the conver genceteaching and personal illustration accompanied the rehabilitation education hand books were adopted for the rehabilitation education in the experimental group before their leaving. Then the telephone education was taken for further direction and consultation during the first three months after being discharged. The evaluation information was obtained through the follow-up after the first three months.MAIN OUTCOME MEASURES: The quality of life and dimensions in the two groups.RESULTS: Compared with the control group, the scores of the quality of life, the dimensions of the body, the psychology, the duty role and the health consciousness in the experimental group were all significantly higher(t= 11.03,3.26,3.62,2.05,15.48, P < 0. 05), while there was no significant difference in the social degree( P > 0.05) .CONCLUSION: The rehabilitation education can significantly improve the quality of life of the patients in the convalescence stage of the acute myocardial infarction.北京医科大学校科研和教改项目07167-169