| Objectives:In the framework of the Omaha system and on the basis of relevant guidance support and expert consultation,a continuous nursing program for patients after coronary artery bypass grafting was formed.The main nursing problems of patients during the period of cardiac rehabilitation after discharge were analyzed and the follow-up intervention was carried out.To explore the influence of nursing scheme based on Omaha system on the continuous nursing effect of patients after coronary artery bypass grafting(CABG),and to provide reference basis for future nursing work.Methods:(1)Based on the American Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs and the Chinese Consensus of Experts on Secondary Prevention after Coronary Artery Bypass Transplantation(2016 Edition),semi-structured interviews and Delphi method were used to construct a continuing nursing program for patients after coronary artery bypass grafting based on Omaha system.(2)From January 2018 to June 2018,110 patients undergoing coronary artery bypass surgery in Yuhuangding Hospital of Yantai,affiliated to Qingdao University,were selected by convenience sampling.The patients in the control group were randomly divided into control group(n=55)and experimental group(n=55).The patients in the control group were followed up by routine follow-up program.The patients in the experimental group were given continuous nursing program based on Omaha system.Omaha outcome evaluation system and SF-36 were used to evaluate the improvement of cardiac rehabilitation health-related behavior and quality of life of patients in the two groups at one month and six months after discharge.(3)Statistical analysis is implemented by SPSS21.0 statistical software package.Statistical Description: Quantitative statistical analysis of the data obtained from expert inquiries,calculation of mean,standard deviation,coefficient of variation,percentage,etc.Demographic data of patients,effects of nursing intervention and quality of life,blood lipid control level,quantitative data using mean and standard deviation,qualitative data utilization or frequency distribution.Statistical inference: t-test was used for quantitative data group comparison,max-2 test was used for qualitative data group comparison,and P < 0.05 was set as statistical significance.Results:(1)At the end of the study,12 cases were lost to follow-up due to telephone failure,patient failure to cooperate with the assessment,death and other reasons.Finally,98 cases were enrolled in the group to complete the intervention and outcome evaluation,including 50 cases in the experimental group and 48 cases in the control group.(2)Before discharge,there was no significant difference in the levels of total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein between the two groups(P > 0.05).(3)Before discharge,there was no significant difference in health-related behaviors between the two groups(P > 0.05).(4)One month after discharge,there was no significant difference in health-related behavior level and quality of life between the two groups(P > 0.05).(5)Six months after discharge,the scores of 11 management items in three fields of physiology,health-related behavior and social psychology in the experimental group were higher than those in the control group(P < 0.05),the difference was statistically significant;the scores of quality of life in the experimental group were significantly higher than those in the control group(P < 0.05),and the difference was statistically significant.(6)One month after discharge,there was no significant difference in total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein between the two groups(P > 0.05).(7)Six months after discharge,there were significant differences in total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein between the two groups(P < 0.05).The level of blood lipid control in the experimental group was significantly better than that in the control group.(8)There was a significant difference in the quality of life between the first month after discharge and the sixth month after discharge(P < 0.05).The quality of life in the sixth month after discharge was significantly higher than that in the first month after discharge.(9)There was significant difference in blood lipid control level between one month after discharge and six months after discharge(P < 0.05).The blood lipid control level of six months after discharge was significantly better than that of one month after discharge.Conclusions:Continuous nursing intervention in patients after coronary artery bypass grafting using the Omaha system can help nurses assess their health needs more comprehensively and provide individual health education and guidance.Help the patients to solve the health problems in the process of cardiac rehabilitation,promote postoperative rehabilitation. |
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