Application of case management based on the transtheoretical model of change in cardiac rehabilitation for patients after PCI for myocardial infarction (基于跨理论模型的个案管理在心肌梗死经皮冠状动脉介入治疗术后患者心脏康复中的应用)

2025

中西医结合护理, Vol 11, Iss 5, Pp 11-18 (2025)

Objective To investigate the effect of case management based on the transtheoretical model of change (TTM) on the cardiac rehabilitation of patients after percutaneous coronary intervention (PCI) for myocardial infarction, in order to provide an effective rehabilitation management mode for clinical practice. Methods A total of 100 patients undergoing PCI for myocardial infarction were randomly divided into intervention group and control group, with 50 patients in each group. All patients received routine care after surgery, including condition observation, medication and general health education, and patients in the intervention group received TTM-based case management. A multidisciplinary team was established to develop and implement individualized rehabilitation interventions according to the stage of behavior change of patients. Primary indicators included cardiac function after surgery, quality of life, adverse cardiovascular events, health behaviors and medication adherence. Results Patients in the intervention group had better outcomes of left ventricular ejection fraction, heart rate, distance of 6-minute walking test compared with those in the control at 6 months after intervention (P＜0. 05). SF-36 scores for physical functioning, social functioning and emotional role in the intervention group were higher than those in the control group after intervention (P＜0. 05). The incidence of adverse cardiovascular events in the intervention group was lower than that in the control group (P＜0. 05). The score of knowledge-attitude-practice assessment and rate of good medication adherence in the intervention group were higher than those in the control group (P＜0. 05). Conclusion Case management based on TTM can effectively improve cardiac function and quality of life of patients after PCI for myocardial infarction, reduce the incidence of adverse cardiovascular events, and improve patients' psychological status and medical behavior. (目的 探讨基于跨理论模型(TTM)的个案管理对心肌梗死经皮冠状动脉介入治疗(PCI)术后患者心脏康复中的影响, 以期为临床提供一种有效的康复管理模式。方法 选取某三级甲等医院2023年5月—2024年5月收治的心肌梗死PCI术后患者100例, 采用随机数字表法分为干预组和对照组, 每组50例。对照组给予常规护理, 包括病情观察、药物治疗和常规健康教育; 干预组在常规护理基础上, 实施基于TTM的个案管理。组建多学科团队, 根据患者所处的行为改变阶段, 制定并实施个性化的康复干预措施等。观察指标包括心脏功能、生活质量、不良心血管事件、健康行为及服药依从性。结果 干预后6个月, 干预组左心室射血分数(LVEF)、心率、6分钟步行试验(6MWT)距离改善优于对照组, 差异有统计学意义(P＜0. 05)。干预组SF-36量表躯体功能、社会功能和情感功能评分高于对照组, 差异有统计学意义(P＜0. 05)。干预组不良心血管事件发生率低于对照组, 差异有统计学意义(P＜0. 05)。干预组“知信行”评分高于对照组, 服药依从性评价优于对照组, 差异有统计学意义(P＜0. 05)。结论 心肌梗死PCI术后患者心脏康复中, 实施基于TTM的个案管理在能有效改善患者的心脏功能和生活质量, 降低不良心血管事件的发生风险, 改善患者治疗依从性。)

article

Chinese

Journal of International Translational Medicine Limited, 2025.

myocardial infarction, percutaneous coronary intervention, transtheoretical model, case management, cardiac rehabilitation, 心肌梗死, 经皮冠状动脉介入治疗, 跨理论模型, 个案管理, 心脏康复, Nursing, RT1-120