创新扩散理论结合多学科协作在重症肺炎合并心力衰竭患者中的应用

Application of diffusion of innovation theory combined with multidisciplinary collaboration in patients with severe pneumonia complicated by heart failure

  • 摘要:
    目的 探讨创新扩散理论结合多学科协作护理在重症肺炎合并心力衰竭患者干预中的效果。
    方法 选取2021年4月—2024年4月收治的120例重症肺炎并发心力衰竭患者为研究对象,根据随机黑白球方式分为观察组(n=60)和对照组(n=60)。对照组接受常规护理干预,观察组在对照组基础上采用创新扩散理论结合多学科协作护理的干预模式。比较2组康复情况(肺部炎症控制时间、咳嗽咳痰消失时间、住院时间)以及干预后心功能情况左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)。采用明尼苏达心力衰竭生活质量问卷(MLHFQ)调查2组生活质量; 采用心力衰竭自我护理指数量表(SCHFI)评估患者自我护理行为。比较2组并发症发生情况,并分析成本效益(患者医疗费用和再入院情况)。
    结果 观察组咳嗽和咳痰消失时间、肺部炎症控制时间以及住院时间短于对照组,差异有统计学意义(P < 0.05)。干预后, 2组LVEF均较干预前升高,且观察组高于对照组,差异有统计学意义(P < 0.05); LVESV均较干预前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。干预后, 2组MLHFQ中的生理、情感、社会功能评分与干预前比较均下降,且观察组上述维度评分低于对照组,差异有统计学意义(P < 0.05)。干预后,2组SCHFI中自我护理维持、自我护理管理和自我护理信心3个维度评分均升高,观察组上述维度评分高于对照组,差异有统计学意义(P < 0.05)。2组并发症发生情况比较,差异无统计学意义(P>0.05)。
    结论 创新扩散理论与多学科协作护理模式可加速重症肺炎合并心力衰竭患者的康复进程,改善生活质量,并有效提高其自我护理能力。

     

    Abstract:
    Objective To explore the effectiveness of the diffusion of innovation theory in combination with multidisciplinary nursing collaboration in intervention for patients with severe pneumonia complicated by heart failure.
    Methods A total of 120 patients with severe pneumonia complicated by heart failure admitted between April 2021 and April 2024 were enrolled and randomly divided into observation group (n=60) and control group (n=60) using a random black-and-white ball method. The control group received conventional nursing intervention, while the observation group received an intervention model combining the diffusion of innovations theory with multidisciplinary collaboration on top of the conventional nursing. Rehabilitation outcomes (time to control of pulmonary inflammation, time to resolution of cough and expectoration, length of hospital stay) and post-intervention cardiac functionleft ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV)were compared between the two groups. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess quality of life, and the Self-Care Heart Failure Index (SCHFI) was used to evaluate self-care behaviors. Complications were compared between the two groups, and cost-effectiveness was analyzed (patient medical expenses and re-hospitalization rates).
    Results The observation group had shorter time to resolution of cough and expectoration, control of pulmonary inflammation, and length of hospital stay compared with the control group, with statistically significant differences (P < 0.05). After intervention, LVEF increased in both groups compared with pre-intervention levels, and was higher in the observation group than in the control group, with a statistically significant difference (P < 0.05); ESV decreased in both groups compared with pre-intervention levels, and was lower in the observation group than in the control group, with a statistically significant difference (P < 0.05). After intervention, physiological, emotional, and social functioning scores in the MLHFQ decreased in both groups compared with pre-intervention levels, and were lower in the observation group than in the control group, with statistically significant differences (P < 0.05). After intervention, scores for self-care maintenance, self-care management, and self-care confidence in the SCHFI increased in both groups, and were higher in the observation group than in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05).
    Conclusion The combination of the diffusion of innovations theory and multidisciplinary collaboration nursing model can accelerate the rehabilitation process in patients with severe pneumonia complicated by heart failure, improve their quality of life, and effectively enhance their self-care abilities.

     

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