| Background With the rapid development of China’s aging society,the incidence of cardiovascular diseases in the elderly has increased.Hypertension,as the most common cardiovascular disease,has a high incidence.Elderly patients with hypertension often have psychological problems such as anxiety and depression,and at the same time these psychological problems can lead to poor treatment and care of hypertension.Psychocardiology is a discipline that studies the relationship between heart diseases and psychological diseases,and its application to clinical patients can improve the physical and mental health of patients and improve the quality of life,and has achieved certain research results in the treatment of coronary heart disease and heart failure,while the effect of psychocardiology care needs to be further studied.Therefore,this study constructs a psychocardiology nursing program according to the characteristics of elderly hypertension disease and patients’ characteristics,so that the symptoms of elderly hypertensive patients can be effectively controlled,the level of disease cognition of patients can be improved,the psychological condition can be improved,and the quality of life of patients can be improved.Objective The purpose of this study was to construct a psychocardiology care program for elderly hypertensive patients in the community and evaluate the effect of its application in order to improve patients’ self-management ability,maintain stable blood pressure,reduce the degree of anxiety and depression,and improve their quality of life.Methods 1.Subjects Eighty-eight elderly hypertensive patients who met the inclusion criteria and were discharged from the cardiology department of a tertiary care hospital in Xinxiang were selected as the study subjects.According to the number of hospitalization number single and double were divided into control group and observation group of 44 each.2.Psychocardiology care program construction In the Chinese database,we used（old adult or Senile）and hypertension and community nursing and（bicentric nursing or bicentric medicine）and（anxious or/and depressed）and quality of life,and in the English database,we used（old adult or Senile）and hypertension and community nursing and（anxious or/and depressed）as keywords or subject terms for literature search,and the content of bicentric nursing program was analyzed through the study of related domestic and foreign literature.In-depth interviews were conducted with 13 elderly inpatients with hypertension and themes were refined.Based on the results of the literature study and qualitative study,a preliminary dual-hearted care program for elderly hypertensive patients was developed.Sixteen experts who met the inclusion criteria were selected to validate the dual-hearted care program for elderly hypertensive patients.Modifications were made according to the experts’ opinions and suggestions,and the finalized community-based dual-hearted care program for elderly hypertensive patients was formed.3.Effect evaluation（1）Intervention methods Patients in both groups received the same treatment and care during hospitalization.After discharge: the control group was issued a prescription for hypertension health education at the time of discharge and received routine chronic disease health education provided by the community health service center after discharge;the observation group took a 3-month intervention according to the psychocardiology care program for elderly hypertensive patients on the basis of the control group.During the intervention period,health education was provided to patients three times a week through telephone follow-up,We Chat group,We Chat app and other online methods.In the first month,the patients were given offline health education in batches every week,measure their own blood pressure and record it,and given education on hypertension-related knowledge;in the other times,the patients were supervised to learn related knowledge through online,and one-on-one guidance was given for existing problems.（2）Data collection and evaluation tools The self-management ability,anxiety and depression,quality of life and blood pressure of patients in both groups were assessed at discharge and after the intervention using the Self-Management Behavior Assessment Scale for Hypertensive Patients,the Hospital Anxiety and Depression Scale and the SF-36 Quality of Life Evaluation Scale.Data analysis was performed by Spss 21.0 statistical software.Results 1.Psychocardiology care program The content of double-hearted care program consisted of nine dimensions,including rational diet,good living habits,functional exercise,cognitive behavior,emotional management,meaning of life,social value,family relationship,and social relationship.2.Comparison of patients’ self-management behaviors between the two groups After the intervention,patients in the observation group were more effective in self-management ability（t=-11.125）and each dimension of condition monitoring（t=-6.659）,medication management（t=-8.966）,diet management（t=-2.944）,exercise management（t=-9.141）,work and rest management（t=-18.445）,and emotional management（t=-3.881）compared with the control group,and the differences were all statistically significant（P < 0.05）.3.Comparison of anxiety and depression between the two groups After the intervention,the differences were statistically significant when comparing the degree of anxiety and depression in the observation group with the control group（t anxiety = 5.124,t depression = 6.512,P < 0.05）.4.Comparison of quality of life of patients in both groups Quality of life of patients in the observation group after intervention（t=3.012）and each dimension of physical function（t=2.347）,physical function（t=2.535）,somatic pain（t=2.145）,general health status（t=3.125）,energy（t=2.412）,social function（t=2.034）,emotional function（t= 3.512）,and mental health（t=4.125）were statistically significant（p<0.05）compared with the control group.5.Comparison of blood pressure in the two groups The differences in systolic and diastolic blood pressure in the observation group after the intervention were statistically significant when compared with the control group,（t systolic blood pressure = 19.852,t diastolic blood pressure = 11.235,P < 0.05）.Conclusions Constructing a dual-hearted care program for elderly hypertensive patients in the community,which could improve the patients’ self-management ability,improve their anxiety and depression,thereby improving their blood pressure and stabilizing it,and improve their quality of life. |
