基于Orem模式运动康复护理对慢性心衰患者心功能及生活质量的影响

摘要

目的 探讨基于Orem模式运动康复护理对慢性心衰患者心功能及生活质量的影响.方法 选择100例CHF患者随机分为对照组和观察组各50例.两组患者住院后均遵医嘱实施药物等治疗.对照组常规护理,观察组在对照组的基础上,根据心功能分级,确定运动方案及运动量,实施基于Orem自理模式的运动康复护理.观察干预14d(T1)、出院当天(T2)两组的日常生活自理能力、LVEF、静息心率;出院后12个月评价生活质量.结果 与对照组相比,观察组T1、T2时射血分数、生活自理能力、步行距离增加幅度更显著(P＜0.01),心率下降更明显(P＜0.01).出院后1年,观察组和对照组生活质量评分依次为(42.5±8.2)、(57.6±10.5),观察组生活质量水平明显高于入院时及对照组(P＜0.01).结论 基于Orem自理模式的运动康复护理显著改善慢性心衰患者的生理与心理功能,有效减慢心率,降低心室重构的风险,延缓病情恶化,提高患者的生存质量,方案简单易行,重复性好且接近日常生活,具有较高的临床可行性及应用价值.%Objective To investigate the influence of exercise rehabilitation nursing based on Orem model on cardiac function and the quality of life of patients with chronic heart failure (CHF).Methods 100 patients with CHF were randomly divided into control group and observation group with 50 cases in each group.The patients of two groups received prescribed drug treatment.Control group received routine nursing care;on the basis of control group,observation group received exercise rehabilitation nursing based on Orem self-care model (formulating plan and amount of exercise according to the grade of cardiac function).Observed daily life self-care ability,LVEF,resting heart rate of the two groups 14 d after the intervention (T1) and on the day of discharge (T2);evaluated the quality of life 12 months after discharge.Results Compared with control group,ejection fraetion,living self-care ability,walking distance of the observation group at T1 and T2 increased more significantly (P＜0.01),heart rate decreased more significantly (P＜0.01).12 months after discharge,the score of quality of life in observation group and control group were (42.5±8.2) and (57.6± 10.5),life quality level of observation group was obviously higher than that on admission and that of control group (P＜0.01).Conclusions Exercise rehabilitation nursing based on Orem self-care model can significantly improve physiological and psychological function in patients with chronic heart failure,effectively slow heart rate,reduce the risk of ventricular remodeling,delay the deterioration,improve the quality of life in patients,simple,with good repeatability,close to daily life,with high feasibility and clinical application value.