作者：周苗，郭晓岚

单位：

710038 陕西省西安市，空军军医大学第二附属医院心血管内科 通信作者：郭晓岚，E-mail：guox6464@126.com

Units：

Department of Cardiovascular Internal Medicine, the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038, China Corresponding author: GUO Xiaolan, E-mail: guox6464@126.com

关键词：

心肌梗死; 认知行为疗法; 双心护理; 焦虑;

Keywords：

Myocardial infarction; Cognitive behavioral therapy; Double heart nursing; Anxiety

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.006

Funds：

摘要：

背景急性心肌梗死(AMI)患者较易出现焦虑、恐惧情绪,进而诱发"双心疾病"。因此,双心护理对AMI患者至关重要。认知行为疗法是目前临床改善患者心理健康的首选心理疗法。目的探讨以认知行为疗法为主的双心护理在AMI术后焦虑患者中的应用效果,以期为改善AMI患者的身心健康提供参考。方法选取2020年2月至2021年2月空军军医大学第二附属医院心血管内科收治的经皮冠状动脉介入治疗(PCI)后焦虑的AMI患者100例,按照住院顺序分为对照组和干预组,各50例。对照组患者采用常规护理模式,干预组患者在对照组基础上接受以认知行为疗法为主的双心护理。比较两组患者干预前后焦虑自评量表(SAS)评分、阿森斯失眠量表(AIS)评分、心功能指标[N末端脑钠肽前体(NT-proBNP)、左心室射血分数(LVEF)]、6 min步行距离(6MWD)及护理满意度。结果两组患者干预前SAS评分、AIS评分、NT-proBNP水平、LVEF、6MWD比较,差异无统计学意义(P> 0.05)。干预组患者干预后SAS评分、AIS评分、NT-proBNP水平低于对照组,LVEF高于对照组,6MWD长于对照组,护理满意度优于对照组(P <0.05)。结论以认知行为疗法为主的双心护理可有效缓解AMI术后焦虑患者的焦虑情绪,改善心功能,进而提高睡眠质量、运动耐量及护理满意度。

Abstract：

【Abstract】　Background Patients with acute myocardial infarction (AMI) are more prone to anxiety and fear, whichin turn induce "double heart disease". Therefore, dual heart nursing is very important for patients with AMI. Cognitive behavioraltherapy is currently the preferred psychological therapy for clinical improvement of patients' mental health. Objective Toexplore the application effect of double heart nursing based on cognitive behavioral therapy in postoperative anxiety patientswith AMI, in order to provide reference for improving the physical and mental health of AMI patients. Methods A total of 100cases of AMI patients with anxiety after percutaneous coronary intervention (PCI) admitted to the Department of CardiovascularInternal Medicine, the Second Affiliated Hospital of Air Force Military Medical University from February 2020 to February 2021were selected, and they were divided into the control group and the intervention group according to the order of hospitalization, 50cases in each group. Patients in the control group adopted the conventional nursing model, and patients in the intervention groupreceived double heart nursing based on cognitive behavioral therapy on the basis of the control group. Self-rating Anxiety Scale(SAS) score, Athens Insomnia Scale (AIS) score, cardiac function indicators [N-terminal pro-brain natriuretic peptide (NT-proBNP)level, left ventricular ejection fraction (LVEF) ] , 6 minutes walking distance (6MWD) before and after intervention and nursingsatisfaction were compared between the two groups. Results There was no significant difference in SAS score, AIS score, NT-proBNP level, LVEF, and 6MWD before intervention between the two groups (P > 0.05) ; SAS score, AIS score, and NT-proBNPlevel of the intervention group were lower than those of the control group, LVEF was higher than that of the control group, and 6MWD waslonger than that of the control group, the nursing satisfaction was better than that of the control group (P < 0.05) .Conclusion Doubleheart nursing based on cognitive behavioral therapy can effectively relieve the anxiety of postoperative anxiety patients with AMI,improve the cardiac function, and promote the sleep quality, exercise tolerance and nursing satisfaction.

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