Study On The Construction And Application Of A Phase Ⅰ Cardiac Rehabilitation Nursing Practical Program For Patients After Cardiac Resynchronization Therapy

Objective:To construct a phase I cardiac rehabilitation nursing practical program for patients after cardiac resynchronization therapy(CRT),and to explore the clinical application effect of this program in patients after CRT through preliminary application.Methods:Preliminarily formulate a phase I cardiac rehabilitation nursing practical program for patients after cardiac resynchronization therapy through literature review;the protocol was subjected to expert consultation using the Delphi method,and the final intervention protocol was developed based on the results of the consultation.Using a class experimental study method,27 patients who met the inclusion criteria and were admitted to the cardiovascular medicine department of a tertiary care hospital in Nanchang from November 2021 to May 2022 were used as the control group;27patients admitted from June 2022 to December 2022 were used as the experimental group.The control group was given conventional postoperative care methods,and the intervention group implemented interventions according to the Phase I cardiac rehabilitation nursing practice protocol.Using the 6-minute walk test(6MWT)distance,the Modified Barthel Index(BI)scale,and the Minnesota living with heart failure questionnaire(MLHFQ),the cardiac function,activity of daily living ability,the quality of life before and after the intervention were compared between the two groups,and the number of days of postoperative hospitalization was counted between the two groups.Results:(1)Construction of programsA total of two rounds of expert correspondence were completed.The positive coefficients of experts for the two rounds of expert correspondence were 95% and100%;the authority coefficients were 0.89 and 0.91;the coefficients of coordination(Kendall’s W)were 0.309 and 0.114(P<0.05);and the phase I cardiac rehabilitation nursing practical program for patients after cardiac resynchronization therapy contained 4 primary indicators and 46 secondary indicators.(2)Application of programs(1)54 cases were initially included in this study,and a total of 47 cases were included up to the end of the study,including 23 cases in the control group and 24 cases in the trial group,with a loss of follow-up rate of 12.96%.(2)There was no statistically significant difference in general information,cardiac function,ability to perform activities of daily living and quality of life between thetwo groups before the intervention(P>0.05).(3)Cardiac function: After the intervention,the 6MWT distance of the experimental group was longer than that of the pre-intervention and control groups(P< 0.05);the difference was not statistically significant when comparing the control group before and after the intervention(P>0.05).(4)Ability to perform activities of daily living: After the intervention,the BI scores of the experimental group were higher than those of the pre-intervention and control groups(P<0.05);compared with the control group before and after the intervention,there was no statistically significant difference(P>0.05).(5)Quality of life: The difference in MLHFQ scores between the two groups before the intervention was not statistically significant(P>0.05).One month after hospital discharge,the experimental group had lower scores in the total MLHFQ score and each dimension(somatic domain,emotional domain,and other domains)than the pre-intervention and control groups(P<0.05);The control group showed no statistically significant differences in MLHFQ scores and total scores in emotional and other domains except for the physical domain(P=0.020)compared to before intervention(P>0.05).(6)Postoperative hospitalization days: the difference between the number of postoperative hospitalization days of patients after the intervention and the control group was statistically significant(P<0.05).Conclusions:(1)The phase I cardiac rehabilitation nursing practical program for patients after cardiac resynchronization therapy constructed using the Delphi method is scientific and reliable,and the protocol is practical and feasible.(2)The application of the Phase I cardiac rehabilitation nursing practical program can facilitate the recovery of cardiac function,improve the ability to perform activities of daily living and quality of life,and shorten the number of postoperative hospital days for patients after cardiac resynchronization therapy.