| ObjectiveThe purpose of this study is to construct a nursing program based on nursing staff to promote the development of home cardiac rehabilitation for patients after valvular heart disease surgery,and to evaluate the effect of the preliminary application.Methods1.Construction of home cardiac rehabilitation nursing program for patients after valvular heart disease surgeryThe core contents of nursing for home cardiac rehabilitation of patients after valvular heart disease surgery were defined by the literature research method,and the basic framework of home cardiac rehabilitation nursing plan was formulated based on the discussion of the research group,so as to provide the basis for the design of the first round of expert letter questionnaire.After two rounds of expert letter consultation,the core contents and forms of nursing program of home cardiac rehabilitation after valvular heart disease were determined.2.Effect evaluation of home cardiac rehabilitation nursing program for patients with valvular heart disease after surgeryPatients were enrolled from January 2022 to June 2022 were randomly divided into control group and intervention group with 43 patients in each group.Patients in the control group were provided with strict perioperative nursing during hospitalization.Patients in the intervention group were provided with perioperative nursing under the premise of receiving perioperative nursing for valvular heart disease.The nursing program of home cardiac rehabilitation for patients with valvular heart disease after discharge will be implemented for 6 consecutive months,and the application effect of this program will be preliminarily evaluated.Results1.Construction of home cardiac rehabilitation nursing scheme for patients with valvular heart disease after operationThrough literature analysis and expert group discussion,the core contents of nursing for home cardiac rehabilitation of patients with valvular heart disease after surgery were extracted,including 5 aspects,including exercise rehabilitation,medication guidance,nutrition consultation,psychological support,and sleep management.According to the draft of expert letter consultation designed for its core content,two rounds of expert letter consultation were conducted.The Kendall harmony coefficient of the first round was0.257,and that of the second round was 0.303.The response rate of the first round of expert letter consultation was 93.33%,and 100% in the second round,and the authority coefficient of the letter consultation was 0.87,indicating that the letter consultation results had strong reliability.Based on the expert letter consultation,the specific contents of nursing staff guidance in the nursing program of home cardiac rehabilitation for patients with heart valvular disease after surgery are formed.Through the preliminary trial of 21 discharged patients with valvular heart disease after operation in a tertiary Class A general hospital in Qingdao,the patients and their families indicated that the intervention program can effectively guide home cardiac rehabilitation.2.Effect evaluation of home cardiac rehabilitation nursing program for patients with valvular heart disease after surgeryThe effects of nursing program of home cardiac rehabilitation were evaluated from the aspects of cardiac function,nutritional status,psychological status,medication compliance,sleep quality and so on.In terms of cardiac function,left ventricular ejection fraction and 6MWT showed significant improvement at 1,3,and 6 months after intervention.Repeated measures of left ventricular ejection fraction analysis of variance showed that there were statistically significant differences in the intergroup effect(F=15.272,P<0.001),intra group effect(F=83.645,P<0.001)and interaction effect(F=26.372,P<0.001)of left ventricular ejection fraction between the two groups.The nutritional status did not improve significantly after 1 month,but improved significantly after 3 months and 6 months.In terms of psychological status,anxiety did not show obvious improvement after 1 month,but showed obvious improvement after 3 months and 6 months,and depression showed obvious improvement after 3 years.In terms of medication compliance,there was significant improvement after 3 periods.Sleep quality did not improve significantly after 1 month,but improved significantly after 3 months and6 months.Conclusion1.Based on the guidance of nursing staff,the nursing program of home cardiac rehabilitation for patients after valvular heart disease is constructed from the aspects of exercise rehabilitation,medication guidance,nutritional consultation,psychological support,sleep management,and daily life guidance.The construction process is scientific,which can effectively guide patients and be recognized by patients.2.After 6 months of intervention,the cardiac function,nutritional status,psychological status,medication compliance and sleep quality of patients after heart valvular disease surgery were improved to varying degrees,and the effect became more and more obvious with the extension of time. |
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