| Objective1.By comparing the control group and the intervention on symptoms and quality of life of patients with chronic heart failure,to investigate the effect of palliative care on symptoms and quality of life of patients.2.By comparing the control group and the intervention on caregivers burden score,to investigate the effe care on the burden.MethodsThis study is an Randomized controlled trial.94 cases of heart failure patients admitted to the department of cardiovascular medicine of a third-grade a hospital in tianjin from July 2016 to July 2017 were selected as the research objects.According to the discharge time,each patient was numbered and randomly divided into a control group of 47 cases and an intervention group of 47 cases.Socio-demographic data and disease-related data of patients with chronic heart failure were collected.Before discharge,all patients and caregivers were given routine guidance for heart failure,and the intervention group was given palliative treatment on the basis of routine guidance.The Edmonton symptom assessment scale(ESAS),the Kansas city life quality table(KCCQ)respectively to evaluate two groups of patients before intervention,intervention after 3 months,6 months,12 months in patients with symptoms and quality of life,use care burden scale(ZBI)evaluation of two groups of caregivers before intervention,intervention after 3 months,6 months,12 months burden.The date was analyzed in SPSS21.0sofware.For categorical date,such as gender,patient and caregiver education level,cardiac function classification,residence, medical insurance status,care time,monthly income of the caregiver,caregiver relationship,and the gender of the caregiver.Measurement data included age,ESAS,KCCQ and ZBI scale scores,which were described with mean standard deviation.When comparing the two groups of patients,the counting data,including gender, education level,classification of cardiac function,residence,medical insurance status,care time,monthly income of caregivers,caregiver relationship,and caregiver gender,were tested by?~2 tests.Measurement data included scores of ESAS,KCCQ and ZBI scales,and repeated measurement was used.Result1.A total of 94 patients were included in this study,including 7 patients in the control group and 7 patients in the intervention group.Finally,40 patients in the control group,40 patients in the intervention group,and a total of 80 patients were statistically analyzed.2.When enrolled,the basic data of patients in the two groups,including age,gender,education level and cardiac function grading,showed no statistical difference(P>0.05),which was comparable.3.Patients in the intervention group were compared with those in the control group in terms of symptom management,quality of life and caregiver burden by using palliative care,and there were statistically significant differences(P<0.05).(1)ESAS scores of patients in the two groups in the three time periods before and after intervention showed that there was no statistical difference in ESAS scores between the two groups before intervention(P>0.05),which was comparable.There were statistically significant differences in scores at 3,6 and 12 months after intervention(P<0.05).When intervention factors were excluded,the time effect(P<0.05)indicated that the ESAS score was lower and lower with the extension of time.After the time factor was excluded,the grouping effect was statistically different between the two groups(P<0.05).There were interactions between two groups of patients in different time periods and different groups,with statistical differences(P<0.05),indicating that palliative treatment could improve the symptoms of patients.(2)KCCQ scores of patients in the two groups in the three time periods before and after the intervention showed that there was no statistical difference in KCCQ scores between the two groups before the intervention(P>0.05),which was comparable.There were statistically significant differences in scores at 3,6 and 12 months after intervention(P<0.05).The intervention factors were excluded,and the time effect(P<0.05)indicated that the KCCQ score was higher and higher with the extension of time.After the time factor was excluded,the grouping effect was statistically different between the two groups(P<0.05).There were interactions between two groups of patients in different time periods and different groups,with statistical differences(P<0.05),indicating that palliative care can improve the quality of life of patients.(3)The ZBI score of the caregivers of the two groups in the three time periods before and after the intervention showed that there was no statistical difference in the ZBI score of the caregivers of the two groups before the intervention(P>0.05),which was comparable.There were statistically significant differences in scores at 3,6 and 12months after intervention(P<0.05).When intervention factors were excluded,time effect(P<0.05)indicated that ZBI score was getting lower and lower with the extension of time.After the time factor was excluded,the grouping effect was statistically different between the two groups(P<0.05).There were interactions between two groups of patients in different time periods and different groups,with statistical differences(P<0.05),indicating that palliative care can reduce the burden of caregivers.Conclusion1.Palliative care can reduce the ESAS score of patients with chronic heart failure,indicating that palliative care can improve the symptoms of patients.2.Palliative care can improve the quality of life score of patients with chronic heart failure,indicating that the quality of palliative care can improve the quality of life of patients.3.Palliative care can reduce the caregiver burden score,indicating that palliative care can reduce the caregiver burden. |
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