冠心病合并糖尿病患者经皮冠状动脉介入治疗术后共病随访模式的构建及应用效果研究
Construction and Application of Comorbidity Follow-up Model for Patients with Coronary Heart Disease Complicated with Diabetes after PCI
许洪梅 汤云昭 于翔 王青龙 宋洪娜 刘玉环
作者信息
摘要
背景 经皮冠状动脉介入治疗（PCI）术后患者因普遍缺乏疾病自我管理意识而影响预后，同时合并糖尿病的冠心病患者预后更差。建立慢病随访系统，对两种疾病进行协同管理是患者康复的关键。目的 基于慢病自我管理理论和 CICARE 沟通模式，构建冠心病合并糖尿病患者 PCI 术后随访模式，并探索应用效果。方法 2022 年 1—4 月通过文献回顾、半结构式访谈、专家函询构建冠心病合并糖尿病患者 PCI 术后共病随访模式。选取 2022 年 5 月—2022 年 12 月在天津医科大学朱宪彝纪念医院心血管科行 PCI 术的冠心病合并糖尿病患者为研究对象，采用随机数字表法将其分为两组，对照组（77 例）患者接受常规随访，试验组（78 例）患者接受共病随访模式，比较两组患者出院前和出院后 3 个月、6 个月冠心病自我管理行为量表（CSMS）得分和其余结局指标。结果 2 轮函询专家积极系数均为 100%，权威系数为 0.87，协调系数分别为 0.310 和 0.334（均 P<0.001）。构建的共病随访模式共 3 个维度，11个模块和 30 项内容。试验组和对照组完成随访患者各 64 例。组别与时间对患者 CSMS 得分存在交互作用（F交互=150.504，P 交互 <0.001），患者出院后 3 个月和 6 个月 CSMS 得分较出院前均升高（P<0.001），且试验组高于对照组（P<0.05）。出院后 6 个月试验组患者 BMI 低于对照组（P<0.05）。结论 构建的 PCI 术后共病随访模式科学有效，能改善冠心病合并糖尿病患者 PCI 术后患者的自我管理行为，并降低 BMI。Abstract
BackgroundThe lack of disease self-management awareness in patients after percutaneous coronary interventionPCIaffects the prognosisand the prognosis of patients with diabetes is worse. The establishment of chronic disease follow-up system and the collaborative management of the two diseases become the key to the rehabilitation of patients. ObjectiveTo construct a comorbidity follow-up model for patients with coronary heart disease complicated with diabetes after PCI based on the theory of chronic disease self-management and CICARE communication modeland to explore the application effect. MethodsFrom January to April 2022literature reviewsemi-structured interviews and expert correspondence were used to constructed a comorbidity follow-up model for patients with coronary heart disease complicated with diabetes after PCI. Patients with coronary heart disease complicated with diabetes who received PCI in the department of cardiology of Chu Hsien-I Memorial Hospital Tianjin Medical University from May 2022 to December 2022 were selected as research subjects. They were divided into two groups by using the random number table method. The control group77 casesreceived routine follow-upand the test group78 casesreceived comorbidity follow-up model. The scores of Coronary Heart Disease Self-Management Scale CSMSand other outcome indicators were compared between the two groups before discharge3 months and 6 months after discharge. ResultsThe positive coefficients of experts in the two rounds of expert correspondence were both 100%the authority coefficient was 0.87and the coordination coefficient was 0.310 and 0.334respectivelyall P<0.001. The comorbidity follow-up model included three dimensions11 modules and 30 contents. Finally64 patients in each group completed the follow-up. There was an interaction between group and time on the scores of CSMSF=150.504P<0.001. The scores of CSMS at 3 months and 6 months after discharge were higher than those before dischargeP<0.001and the scores of the test group were higher than those of the control groupP<0.05. After 6 monthsthe BMI of the test group was lower than that of the control groupP<0.05. ConclusionThe constructed comorbidity follow-up model after PCI was scientific and effective which can improve the self-management behavior of patients after PCI and reduce BMI. 关键词
冠心病/糖尿病/经皮冠状动脉介入治疗/自我管理能力引用本文复制引用
许洪梅,汤云昭,于翔,王青龙,宋洪娜,刘玉环.冠心病合并糖尿病患者经皮冠状动脉介入治疗术后共病随访模式的构建及应用效果研究[EB/OL].(2024-05-14)[2025-12-13].https://chinaxiv.org/abs/202405.00129.学科分类
临床医学/内科学
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