| ObjectiveThe present study aims to provide clinical application reference of continuous nursing in postoperative patients with intracoronary stenting, and to explore the influence of telephone guidance as continuous nursing on lifestyle, life quality and compliance behavior of postoperative patients with intracoronary stenting.MethodsThe subjects were hospitalized patients treated with intracoronary stenting in a cardiology department of a Grade-? Zhengzhou cardiovascular Hospital during Jan.2014 to Jan.2015. A total of 230 subjects were included in the study and then randomly divided into a control group and an intervention group with 115 patients in each group. Via statistical analysis (P>0.05), there was no significant difference between two groups in general condition and degree of illness. First of all, we established personal documents to each subject, including personal basic information, operation situation, discharged medical advices, and regular follow-up visits. During the stay-time in hospital, we gave same kinds of nursing care to patients in two groups and issued brochure named Postoperative Guide of Coronary Intervention. When they discharged from hospital, we issued brochure named Personal Medication Card and guided patients and their family members. We advised patients to take medications, do proper exercise and regular review by strictly complying with the brochures and discharged medical advices, and asked their family members to supervise and keep records. After discharged, the control group only received routine telephone guidance once without any other continuous nursing intervention on the 3rd day. Except routine telephone guidance, the intervention group also received continuous nursing after discharged. The main way of this continuous nursing was regular telephone guidance (once a week in the first month, then biweekly in the followed two months). Each telephone guidance lasted 20 minutes at least, including contents as patients' diet (food variety, appetite, salinity control, cooking oil control,), smoking controlling (smoking quitting), medication taking (medicine name, dose, directions for use, observation of defecate color, skin and mucosa bleeding or not), physical exercise (exercise type, amount of exercise, heart rate variation when exercising), review (on schedule or not, normal or not), psychological status (any abnormal), re-hospitalized or not, etc. Then we gave targeted guidance to patients according to the follow-up communication. On discharged day,3 months and 6 months after discharged, investigation and comparative analysis about lifestyle, life quality, compliance behavior, medication compliance and re-hospitalization in the patients of both two groups were performed. The methods of investigation included recording of patients' basic information, discharged medical advices, and regular review by using Patient's Personal Registration Form when they discharged, evaluating patients' lifestyle by HPLP-? and measuring patients' life quality by MOS-SF36, collecting medication taking, regular review and other conditions by patient's compliance behavior questionnaire form, and doing statistical analysis by SPSS 17.0, measuring data by (x±s), comparing two groups by using intergroup analysis and T test, counting data by using chi-square test, the difference has statistical significance when P<0.05.Results(1)There is no statistical difference between two groups of patients in sex ratio, and history of smoking, hypertension, diabetes, obesity as well as vasculopathy, P>0.05; (2) Scores of health-related lifestyle in both groups are in medium level, while the scores of health responsibility and interpersonal relationship are lower; (3) There is no significant difference between two groups in lifestyle indicators such as exercise, nutrition, stress, self-fulfillment, P=0.17; (4) After 3 months and 6 months continuous nursing, the score of health lifestyle in intervention group is higher than the score of the control group, P=0.016. The score of intervention group raises obviously, especially in nutrition, interpersonal support, health responsibility and self-fulfillment; (5) At 6 months after discharged, there is no significant difference between two groups of patients in physiological function, pain, general health, emotional, psychological and vitality, P> 0.05; The score of the intervention group is higher than the control group in the aspects of health condition, emotion, mental health and life force, with obvious difference, P<0.05; (6) There is no statistical difference between two groups of patients in compliance behavior before continuous nursing, P> 0.05; The compliance rate of patients at 6 months after discharged in the intervention group is higher than those in the control group, P< 0.05; (7) There is no statistical difference between two groups of patients in medicine compliance before continuous nursing, P> 0.05; The medicine compliance of patients at 3 months after discharged in the intervention group (80.87%) is higher than those in the control group (70.43%), P< 0.05; The medicine compliance of patients at 6 months after discharged in the intervention group (82.61%) is still higher than those in the control group (62.61%), P <0.05, the difference has statistical significance; (8) At 6 months after discharged, the re-hospitalized rate in the control group is 6.9%,0.9% in the intervention group, P=0.018. The difference of re-hospitalized rate between two groups has statistical significance.ConclusionTo postoperative patients with intracoronary stenting, this mode of telephone guidance as continuous nursing can improve the health lifestyle, compliance behavior and other kinds of self-management skills, and also can decrease the re-hospitalized rate. |
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