文章摘要
张静,霍仙娜,焦傲,等.专科团队式个体化健康管理对冠心病病人健康素养、心脏康复的影响[J].安徽医药,2021,25(12):2441-2445.
专科团队式个体化健康管理对冠心病病人健康素养、心脏康复的影响
Effects of specialist team-based individualized health management on health literacy and cardiac rehabilitation in patients with coronary heart disease
  
DOI:10.3969/j.issn.1009-6469.2021.12.025
中文关键词: 冠心病  精准医学  团队资源管理,卫生保健  团队式个体化健康管理  健康素养  心脏康复
英文关键词: Coronary heart disease  Precision medicine  Crew resource management, healthcare  Team-based individualized health management  Health literacy  Cardiac rehabilitation
基金项目:2018年河南省医学科技攻关计划项目( 2018020860,2018020865)
作者单位
张静 郑州市第七人民医院心血管内科三病区河南郑州 450000 
霍仙娜 郑州市第七人民医院心血管内科三病区河南郑州 450000 
焦傲 郑州市第七人民医院心血管内科三病区河南郑州 450000 
胡云霞 郑州市第七人民医院心血管内科三病区河南郑州 450000 
陈亚娟 郑州市第七人民医院心血管内科三病区河南郑州 450000 
韩菲菲 郑州市第七人民医院心血管内科三病区河南郑州 450000 
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中文摘要:
      目的探讨专科团队式个体化健康管理对冠心病病人健康素养、心脏康复的影响。方法选取 2017年 4月至 2018年 4月郑州市第七人民医院收治的冠心病 126例,按随机数字表法分为管理组和常规组,各 63例。常规组进行常规管理,在常规管理基础上,管理组进行专科团队式个体化健康管理,干预 24个月,比较两组干预前后健康素养(信息获取能力、交流互动能力、改善健康意愿、经济支持意愿)、心功能[左心室射血分数( LVEF)、脑钠肽、 6 min步行试验( 6MWT)]以及生存质量(心绞痛发作情况、心绞痛稳定状态、活动受限程度、疾病认识度、疗效满意度)的变化情况。结果共失访 7例:管理组 5例,常规组 2例。干预后,管理组信息获取能力、交流互动能力、改善健康意愿以及经济支持意愿评分[( 28.96±4.36)分、(40.02±6.81)分、(19.75±2.84)分和( 9.12±1.25)分]明显高于常规组[( 21.53±3.29)分、(35.69±5.63)分、(17.31±2.67)分和( 6.96±1.02)分]( P<0.05);管理组 LVEF、6MWT水平[( 50.84±6.88)%、(361.56±37.32)m]明显高于常规组[( 46.90±7.27)%、(307.81±34.95)m]( P< 0.05),脑钠肽水平( 118.63±19.46)ng/L明显低于常规组( 290.28±26.57)ng/L(P<0.05);管理组心绞痛发作情况、心绞痛稳定状态、活动受限程度、疾病认识度以及疗效满意度评分[(8.87±0.61)分、(2.85±0.53)分、(37.84±6.03)分、(9.05±0.86)分和( 14.83±1.74)分]明显高于常规组[(8.46±0.55)分、(2.54±0.46)分、(33.11±5.84)分、(8.62±0.71)分和( 13.61±1.58)分]( P<0.05);管理组心绞痛、心力衰竭、心律失常、心肌梗死冠心病相关不良事件总发生率( 17.24%)明显低于常规组( 37.70%)(P<0.05)。结论专科团队式个体化健康管理可显著提升冠心病病人健康素养水平,促进病人心脏康复,改善病人预后。
英文摘要:
      Objective To explore the effects of specialist team-based individualized health management on health literacy and cardi. ac rehabilitation in patients with coronary heart disease.Methods A total of 126 patients with coronary heart disease treated in The7th People′s Hospital of Zhengzhou between April 2017 and April 2018 were selected and randomized into management group and rou.tine group, with 63 cases in each group. The patients in routine group were given routine management while the patients in managementgroup were given specialist team-based individualized health management on the basis of routine management, and they were inter.vened for 24 months. Health literacy (information acquisition ability, communication and interaction ability, willingness to improvehealth, financial support willingness), cardiac function [left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), 6 minwalking test (6MWT)] and quality of life (angina pectoris episodes, steady state of angina pectoris, activity limitation, disease aware.ness, efficacy satisfaction) were compared between the two groups before and after intervention.Results Totally 7 patients were lost to follow-up, including 5 cases in management group and 2 cases in routine group. After intervention, the scores of information acquisitionability, communication and interaction ability, willingness to improve health and financial support willingness [(28.96±4.36) points,(40.02±6.81) points, (19.75±2.84) points and (9.12±1.25) points] in management group were significantly higher than those [(21.53±3.29) points, (35.69±5.63) points, (17.31±2.67) points and (6.96±1.02) points] in routine group (P<0.05). The levels of LVEF and6MWT [(50.84±6.88)%, (361.56±37.32) m] in management group were significantly higher than those [(46.90±7.27)%, (307.81±34.95)m] in routine group (P<0.05) while the BNP level was significantly lower in management group than in routine group [(118.63±19.46) ng/L vs. (290.28±26.57) ng/L, P<0.05]. The scores of angina pectoris episodes, steady state of angina pectoris, activity limitation, dis.ease awareness and efficacy satisfaction [(8.87±0.61) points, (2.85±0.53) points, (37.84±6.03) points, (9.05±0.86) points and (14.83±1.74) points] in management group were significantly higher than those [(8.46±0.55) points, ( 2.54±0.46) points, (33.11±5.84) points,(8.62±0.71) points and (13.61±1.58) points] in routine group (P<0.05). The total incidence rate of coronary heart disease-related ad. verse events including angina pectoris, heart failure, arrhythmia and myocardial infarction in management group was significantly lowerthan that in routine group (17.24% vs. 37.70%, P<0.05).Conclusion Specialist team-based individualized health management can sig.nificantly improve the health literacy promote the cardiac rehabilitation and improve the prognosis of patients with coronary heart dis.ease.
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