| objectiveTo construct a intervention programme based on health promotion model and to explore the effect of cardiopulmonary rehabilitation comprehensive intervention based on health promotion model to the quality of life,cardiopulmonary function,health promotion lifestyle,the average hospital stay and the readmission rate within 3 months of the elderly patients with chronic heart failure.So as to provide a reference for the clinic application.Method?1?Evidence-based resource,such as relevant consensus,clinical practice guidelines,and systematic evaluation in the field,had been reviewed in literatre evaluation method.Semi-structured interview had been understood the rehabilitation needs of the patients with chronic heart failure.this intervention programme for the chronic heart failure was formulated after expert consultation.?2?104 elderly patients with chronic heart failure met the included criteria and treated in department of cardiovascular medicine,a third Class A Hospital in Hunan province from March 2018 to March 2019 were selected as the investigative object.The patients were randomly assigned to the control group?52cases?and intervention group?52cases?.Conventional nursing guidance were carried out in the two group,while the cardiopulmonary rehabilitation comprehensive intervention based on health promotion model was carried out in the intervention group.After intervention 3 months,Compared the score of MLHFQ,HPLP-II,cardiopulmonary function.and analyse the average hospital stay and the readmission in 3 months.?3?SPSS25.0 statistical software was used to analyse the statistical data.The Mean±standard deviation was used to describe the statistical interpretation met normal distribution.The statistical interpretation of the enumeration data used the frequency and percentage.Comparison between two groups used t test,approximate t test,c2 test and Wilcoxon rank-sum test.Result?1?The two-round familiarity degree coefficient Cs were 0.863 and0.872,and the judgment coefficient Ca respectively were 0.769 and 0.773.the expert authority degree Cr were 0.816 and 0.823 respectively.The kendall's W were 0.692 and 0.765.the variable coefficient were 0.023 and 0.021.?2?There were no significant differences between the two groups in the general demographic information and clinical data before intervention?P>0.05?.?3?Baseline data:at baseline,there were no differences between two groups included the quality of life,cardio-pulmonary function index,and the score of HPLP-II?P>0.05?.?4?The quality of life:?1?after intervention,the total score of intervention group was?39.70±10.06?,which was significantly lower than that in the control group?54.51±11.59?.the score of physical domain,emotional field,and other domain respectively were?20.53±3.45?,?4.84±2.56?,and?13.70±4.05?,Which had improved than pre-operation and the control group?P<0.05?.?2?There was no statistical significance in total and all dimensions score of control group than before intervention?P>0.05?.?5?The cardiopulmonary function:?1?After intervention,The VO2peak?19.90±2.89?,AT?72.89±16.04?and 6MWD?380.49±61.40?of the intervention group were better than per-operation and the control group?P<0.05?;?2?The VE/VCO2slop?28.20±4.26?,NT-proBNP?466.85±70.02?and Brog score?3.00±1.26?were lower than that?P<0.05?.The LVEF?47.45±7.53?of intervention was no significant difference with the control group and before intervention?3?The above indicators of the control group were no significant difference with before intervention?P>0.05?.?6?The health promotion lifestyle:?1?After intervention,the HPLP-I I total score?125.32±21.13?,health responsibility dimension?24.55±2.67?,st ress management dimension?22.98±2.96?,exercise training dimension?23.18±4.15?,and interpersonal relation dimension?21.67±4.20?of interventio n group,which were significantly higher than the control group and pre-operation?P<0.05?.?2?There was no statistical significance compared w ith the control group and before intervention in the sore of nutritious di et dimension?17.88±3.20?and self-actualization dimension?14.06±3.95??P>0.05?.?3?The differences were no statistical significance in the control group compared with pre-operation?P>0.05?.?7?The average hospital stay and readmission rate:The average hospital stay and readmission rate of intervention group were?10.27±2.42?d and13.46%.the control group respectively were?15.36±2.58?d and 42.31%.The difference was statistically significant?P<0.05?.ConclusionThe cardiopulmonary rehabilitation comprehensive intervention based on health promotion model can improve the quality of life,strengthen the cardiopulmonary function,improve the the healthy lifestyle level,shorten the average hospital stay and reduce the readmission rate within 3 months after intervention of the elderly patients with chronic heart failure. |
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