| Objective: This study is according to the clinical features of elderlycoronary heart disease, to understand the general living conditions of thevarious factors of subjective well-being of elderly patients with coronary arterydisease, on the basis of routine clinical treatment, comprehensive nursingintervention to correct the unhealthy lifestyles and habits and anxiety,improve self-care awareness and ability to reduce clinical metabolic markers toimprove the quality of life and happiness.Methods:121cases of elderly patients with coronary heart disease will beselected in accordance with international alphabet is divided into three groups,including the control group,1patient died, lost to follow patients afterdischarge and one cases of illness in intervention group Ⅰ two cases lost tofollow after dischargetwo cases of illness in the comprehensive interventiongroup Ⅱ one cases of death, lost to follow-one cases after discharge, threecases of changes in conditions, the exclusion of these12cases, and finally intothe group of109cases,37cases in the control group received drug treatmentand routine care, integratedthe intervention group Ⅰ,36cases to the daily lifein the control group on the basis of intervention, comprehensive interventiongroup Ⅱ,36cases in the families of the same period in education on the basisof the consolidated group Ⅰ. State Anxiety Inventory and well-being scale forpatients assessment to understand the effect of psychological interventionbefore and after the intervention, three groups of patients for a period of6months follow-up, observed and recorded before the intervention, three monthsafter the intervention, after intervention six months and three groups of patientswith body mass index, fasting blood glucose, blood pressure, blood lipid changes. Behavioral change theory as a framework, throughout the entirenursing interventions.Results: The three groups of patients before the intervention, body massindex, systolic blood pressure, diastolic blood pressure, fasting glucose, totalcholesterol, triglycerides, LDL, HDL, age, gender, and subjective sense ofhappiness and anxiety by statistical analysis (P>0.05), statistically nosignificant difference was comparable.1. Marital status, number of children, of living, accompanied by staff onthe subjective well-being of elderly patients with coronary artery disease hadno effect, no significant difference (P>0.05); gender, age, income, educationlevel, payment method, occupation, family relationships statistically significantdifferences in subjective well-being of elderly patients with coronary arterydisease (P<0.05).2. Stepwise regression analysis, family relationships, age, occupation,subjective well-being of elderly patients with coronary artery disease had agreater influence, family relationships, age60-69(cadres and workers)occupations in elderly patients with coronary artery disease higher sense ofhappiness.3. Three groups of patients in the subjective sense of happiness in thedischarge, P=0.28(P>0.05), no significant differences.3months after theintervention, at6months, three groups were compared in patients withsubjective well-being, all (P<0.05), significant difference.3months and6months of subjective well-being compared with the control group scoredeclined, the integrated intervention group Ⅰ and comprehensive interventionII group have risen, two in the intervention group than the control group (P<0.05), there are significant difference. Three groups after the intervention of three months, six months before theSWB and the intervention itself paired comparison, three groups of patientswith subjective well-being of all (P<0.05), significant difference.4. Three groups of patients discharged from the hospital, three months andsix months, the anxiety, all(P<0.05), significant difference. Discharge, theintegrated intervention Ⅱ group and control group comparison(P<0.05), thereare significant differences;3months, the intervention group and control groupcomparison (P<0.05), there are significant with the difference, better integratedintervention Ⅱ group than comprehensive intervention Ⅰ group (P<0.05),significant difference; six months, the intervention group than the controlgroup(P<0.05), significant difference.Three groups after the intervention,3months,6months of anxiety andpre-intervention paired comparison, three groups of patients with anxiety(P<0.05), significant difference.5. In the intervention three months, six months and three groups ofpatients with body mass index, triglycerides(P>0.05), no significant difference.3months after the intervention, three groups of total cholesterol, fasting bloodglucose, high density lipoprotein, low density lipoprotein (P>0.05), nosignificant differences, and systolic blood pressure, diastolic blood pressure(P<0.05), significant difference in the intervention group priority in the controlgroup(P<0.05), significant difference between the two intervention groups wasno significant difference (P>0.05).6months after the intervention, totalcholesterol, fasting glucose, HDL, LDL, systolic and diastolic blood pressure(P<0.05), significant difference. Intervention group compared with controlgroup(P<0.05), significant difference in the blood pressure intervention IIgroup was better than intervention group Ⅰ(P<0.05), significant difference.Three groups of patients with various clinical metabolic indicators andintervention after the intervention itself paired comparison, in the three months later, the control group, diastolic blood pressure, body mass index, fastingblood glucose before and intervention(P<0.05), significant difference, the restof the (P>0.05), no significant difference, after six months, only diastolic bloodpressure, fasting blood glucose and Before the intervention, comparison(P<0.05), a significant difference, the rest of the(P>0.05), no significantdifferences, body mass index of6months later than three months after therebound. Comprehensive intervention group Ⅰ: diastolic blood pressure tointervene in the three and six months and before the intervention comparison(P>0.05) difference, and total cholesterol in the intervention three monthsbefore the intervention,(P>0.05), no significant differences intervention after6months, P=0.007, there are significant differences in the remaining threemonths after the intervention, six months and intervention (P<0.05), significantdifference.Comprehensive intervention II group:3months after theintervention and intervention before, only diastolic blood pressure (P>0.05), nosignificant difference in the rest of the before intervention (P<0.05), significantdifference in the intervention after6months Before the intervention, all clinicalmetabolic markers(P<0.05), significant differences.6. Three groups of three months and six months after the intervention thenumber of patients hospitalized with recurrence compared by χ2test(P>0.05)no significant difference not statistically significant. Three months afterthe intervention, the comprehensive intervention group Ⅰ patients, three casesadmitted to hospital (8.33%), the integrated intervention group Ⅱ four casesadmission (11.11%) patients in the control group four cases admitted tohospital (10.81%); six months after the intervention, comprehensive interv-ention group Ⅰ patients hospitalized six cases (16.67%), the integrated interv-ention group Ⅱ five cases admission (13.89%) patients in the control group,13patients admitted to hospital (35.14%). Conclusion:In this study, the clinical features of elderly patients withcoronary artery disease, to identify the general living conditions of the variousfactors which impact on SWB, the use of integrated care intervention on elderlycoronary heart disease specific care and guidance, behavior change theorythroughout care interventions, we can draw the following conclusions:1. Lower subjective well-being of elderly patients with coronary arterydisease, gender, age, income, education level, payment method, occupation,family relationships on subjective well-being of the elderly patients withcoronary artery disease affect.2. Integrated care intervention can improve the subjective well-being ofelderly patients with coronary heart disease, reduce their anxiety.3. Comprehensive nursing intervention in elderly patients with coronaryartery disease fasting plasma glucose was significantly decreased bloodpressure and blood lipids and other clinical indicators.4. The comprehensive nursing intervention can improve the social supportof elderly coronary heart disease, reduce relapse and hospitalization rates.5. The integrated care intervention process is simple and feasible inelderly care in the future, provide a reliable and practical value. |
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