作者：黎景徽1 ，钟美容2 ，韦丽华3

单位：

1.415099湖南省常德市第一中医医院护理部　2.530011广西壮族自治区南宁市，广西中医药大学附属瑞康 医院护理部　3.530011广西壮族自治区南宁市，广西中医药大学附属瑞康医院心脏康复中心

Units：

1.Nursing Department, Changde First Hospital of Traditional Chinese Medicine, Changde 415099, China 2.Nursing Department, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China 3.Heart Rehabilitation Centre, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China

关键词：

冠心病；老年人；经皮冠状动脉介入治疗；二元疾病管理理论；心脏康复；居家

Keywords：

Coronary disease; Aged; Percutaneous coronary intervention; Dyadic illness management theory; Cardiac rehabilitation; Home

CLC：

R 541.4

DOI：

10.12114/j.issn.1008-5971.2024.00.104

Funds：

广西壮族自治区卫生健康委员会自筹经费科研课题（Z20201491）；广西壮族自治区中医药管理局适宜技术开发与推 广项目课题（GZSY23-42）

摘要：

目的　探讨二元疾病管理理论在接受PCI的老年冠心病患者居家心脏康复中的应用效果。方法　本研 究时间为2023年1—3月。为了避免沾染，采用抛硬币法将广西中医药大学附属瑞康医院心内科两个病区随机分为试验 组和对照组，其中心内科二区为对照组、心内科一区为试验组；再根据便利抽样法在两个病区分别选取42例接受PCI 的老年冠心病患者作为研究对象。对照组患者接受常规居家心脏康复，试验组患者接受基于二元疾病管理理论的居家 心脏康复。比较两组患者干预12周后实际有氧运动完成率、实际抗阻运动完成率和运动依从性，干预前及干预12周后 运动功能指标（峰值摄氧量、无氧阈）、自我管理能力〔冠心病自我管理行为评定量表（CSMS）各维度评分及其总 分〕及配偶的健康促进行为（中文版健康促进生活方式量表评分）。结果　干预12周后，试验组患者实际有氧运动 完成率和实际抗阻运动完成率均高于对照组（P＜0.05）。试验组患者运动依从性优于对照组（P＜0.05）。干预12周 后，试验组患者峰值摄氧量和无氧阈大于对照组，日常生活管理、疾病医学管理、情绪认知管理评分及CSMS总分高 于对照组（P＜0.05）。干预12周后，试验组患者配偶中文版健康促进生活方式量表评分高于对照组（P＜0.05）。结 论　将二元疾病管理理论用于接受PCI的老年冠心病患者的居家心脏康复中，可有效增加其运动次数，提高其运动依 从性、运动功能、自我管理行为水平及其配偶的健康促进行为水平。

Abstract：

Objective To explore the application effect of dyadic illness management theory in home-based cardiac rehabilitation of elderly coronary heart disease patients undergoing PCI. Methods The study period was from January to March 2023. In order to avoid contamination, the two wards of the Department of Cardiology of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine were randomly divided into experimental group and control group by coin tossing method. The second wards of the Department of Cardiology was the control group and the first wards of the Department of Cardiology was the experimental group. According to the convenience sampling method, 42 elderly patients with coronary heart disease who received PCI in the two wards were selected as the research subjects, respectively. Patients in the control group received routine home-based cardiac rehabilitation, and patients in the experimental group received home-based cardiac rehabilitation based on dyadic illness management theory. The actual aerobic exercise completion rate, actual resistance exercise completion rate and exercise compliance were compared between the two groups at 12 weeks after intervention. The motor function indexes (peak oxygen uptake, anaerobic domain) , self-management ability [each dimension score and total score of Coronary Heart Disease Self-Management Behavior Rating Scale (CSMS) ] and spouse's health promotion behavior (Chinese Version of Health Promoting Lifestyle Scale score) were compared between the two groups before intervention and at 12 weeks after intervention. Results At 12 weeks after intervention, the actual aerobic exercise completion rate and actual resistance exercise completion rate in the experimental group were higher than those in the control group (P < 0.05) . The exercise compliance in the experimental group was better than that in the control group (P < 0.05) . At 12 weeks after intervention, the peak oxygen uptake and anaerobic threshold in the experimental group were bigger than those in the control group, and the scores of daily life management, disease medical management, emotional cognitive management and CSMS total score were higher than those in the control group (P < 0.05) . At 12 weeks after intervention, the Chinese Version of Health Promoting Lifestyle Scale score of spouse in the experimental group was higher than that in the control group (P < 0.05) . Conclusion Dyadic illness management theory in home-based cardiac rehabilitation of elderly coronary heart disease patients undergoing PCI can effectively increase the patients' exercise frequency, improve their exercise compliance, motor function, self-management behavior level and health promotion behavior level of their spouses.

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