| Objective To improve the quality and level of care for patients with chronic heart failure in the region to provide theoretical and practical basis.Methods1.Self-care ability and quality of life of patients with chronic heart failure in this area:a total of 106 patients with chronic heart failure from October 2017 to April 2018 in a grade Ⅲ class a hospital in Wu xi city were selected by convenience sampling.The general situation questionnaire,the modified European heart failure self-care behavior scale and the Minnesota heart failure quality of life questionnaire were used to collect information to analyze the self-care behavior and quality of life of patients with chronic heart failure.2.Continuity care plan formulation of patients with chronic heart failure: according to the Omaha system,combining the physiological and pathological characteristics of patients with chronic heart failure,to continuity of care of patients with chronic heart failure assessment,intervention and evaluation plan,through expert consultation method,indexes and items for selection and modification,eventually forming the continuity of care of patients with chronic heart failure.3.Application of continuous care plan for patients with chronic heart failure: a total of100 patients with chronic heart failure admitted to a class a hospital in Wuxi from July2018 to July 2019 were randomly divided into two groups: the control group(50 cases)and the intervention group(50 cases).During the period of hospitalization,patients in the control group were nursed by the responsible nurse according to the nursing routine of chronic heart failure,including routine in-patient care,discharge guidance and post-discharge follow-up.Patients in the intervention group were given extended care for patients with chronic heart failure within the framework of Omaha system.By analyzing the patients’ main nursing problems during and after hospitalization,individualized care was implemented,and the improvement effect of nursing problems was evaluated from the aspects of cognition,behavior and status.The quality of life scale for heart failure was used to evaluate the quality of life of patients in both groups at admission and before discharge.Results1.The self-care ability and quality of life of patients with chronic heart failure in this region was investigated and the results showed that the self-care ability of patients with chronic heart failure in this region was poor and the quality of life was low.Low self-care ability is mainly manifested in the inability to contact the doctor/nurse actively when gaining weight,inability to maintain daily weight measurement,and inability to control fluid intake.Poor quality of life is mainly manifested in sexual difficulties,fatigue,fatigue,or lack of energy,physical activities or preferences more difficult to do.2.Formulation of continuous care plan for patients with chronic heart failure: after two rounds of expert consultation,the evaluation table of continuous care for patients with chronic heart failure was finally determined.The authoritative coefficients of the two rounds of consultation were 0.901 and 0.900,respectively.After consultation with 5experts,the corresponding intervention measures and effectiveness evaluation program were developed.Likert grade 5 score was used to score the nursing problems of patients with chronic heart failure from three aspects of cognition,behavior and status,and the scoring basis was proposed.3.Application of continuous care plan for patients with chronic heart failure: a total of100 patients with chronic heart failure admitted to a class a hospital in wuxi from July2018 to July 2019 were randomly divided into two groups: the control group(50 cases)and the intervention group(50 cases).During the period of hospitalization,patients in the control group were nursed by the responsible nurse according to the nursing routine of chronic heart failure,including routine in-patient care,discharge guidance and post-discharge follow-up.Patients in the intervention group were given extended care for patients with chronic heart failure within the framework of Omaha system.By analyzing the patients’ main nursing problems during and after hospitalization,individualized care was implemented,and the improvement effect of nursing problems was evaluated from the aspects of cognition,behavior and status.The quality of life scale for heart failure was used to evaluate the quality of life of patients in both groups at admission and before discharge.After discharge,patients in the intervention group mainly had 9 nursing problems including personal care,substance abuse,medication regimen,breathing,pain,circulation,mental health,nutrition and physical activity.Three months after discharge,the scores of patients with 8 other nursing problems,except personal care,were significantly higher than those 1 week after discharge(P<0.05).In terms of quality of life,there was no significant difference in the scores of each dimension of quality of life on admission between the intervention group and the control group(P<0.05).Before discharge,the scores of each dimension of quality of life in the two groups were significantly higher than those on admission(P<0.05),and the scores of each dimension of quality of life in the intervention group were significantly higher than those in the control group(P<0.05).Conclusion1.Due to regional,cultural and lifestyle differences,patients with chronic heart failure in this region have poor self-care ability and lower quality of life.2.The continuous care plan for patients with chronic heart failure developed based on Omaha system has good reliability and validity and can be applied to the clinical care of patients with chronic heart failure.3.Continuous nursing program based on Omaha system can effectively improve the nursing effect of patients with chronic heart failure in this region and improve their quality of life. |
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