5A联合Teach-Back护理模式在冠脉介入术后患者中的应用效果分析

Analysis of the Application Effect of 5A Combined with Teach-Back Nursing Model in Patients after Coronary Intervention

摘要: 目的：探讨5A联合Teach-back护理模式对冠脉介入术(PCI)后患者自我管理能力、心功能及生活质量的影响。方法：采用回顾性病例对照试验设计，选取2023年6月至2024年5月延安市安塞区人民医院收治的50例PCI术后患者为对照组(常规护理)，选取2024年6月至2025年5月延安市安塞区人民医院收治的50例PCI术后患者为观察组(5A联合Teach-back护理模式)。干预后比较两组患者的自我管理能力(采用冠心病自我管理量表CSMS)、临床指标(血压、低密度脂蛋白)、左室射血分数(LVEF)。结果：行冠脉介入治疗(PCI)患者术后实施5A联合Teach-back护理模式的患者在随访护理干预3个月后其冠心病自我管理CSMS量表总分高于对照组，并在用药管理、健康监测、心理与社交3个维度显著高于对照组，差异具有统计学意义(P < 0.05)；行冠脉介入治疗(PCI)患者术后实施5A联合Teach-back护理模式的患者在随访护理干预3个月后其低密度脂蛋白(LDL-C)、血压(收缩压)低于对照组患者，观察组患者心功能明显改善，其LVEF由术前的(48.18 ± 6.62)%提升至术后3个月的(55.82 ± 6.93)%，优于对照组的(48.46 ± 7.24)%至(51.72 ± 8.79)%，差异具有统计学意义(P < 0.05)。结论：5A联合Teach-back护理模式能有效提升PCI术后患者的自我管理能力与生理指标控制，降低心血管事件风险，具有临床推广价值。

Abstract: Objective: The purpose is to explore the influence of the 5A combined with Teach-back nursing model on the self-management ability, cardiac function and quality of life of patients after coronary intervention (PCI). Methods: A retrospective case-control trial design was adopted. Fifty patients who underwent PCI and were admitted to Ansai District People’s Hospital of Yan’an City from June 2023 to May 2024 were selected as the control group (with conventional care). Fifty patients who underwent PCI and were admitted to Ansai District People’s Hospital of Yan’an City from June 2024 to May 2025 were selected as the observation group (5A combined with Teach-back nursing model). After the intervention, the self-management ability (using the Coronary Heart Disease Self-Management Scale CSMS), clinical indicators (blood pressure, low-density lipoprotein), and left ventricular ejection fraction (LVEF) of the two groups of patients were compared. Results: Patients who underwent coronary intervention (PCI) and implemented the 5A combined Teach-back nursing model after the operation had a higher total score of the CSMS scale for coronary heart disease self-management than the control group after 3 months of follow-up nursing intervention, and were significantly higher than the control group in the three dimensions of medication management, health monitoring, and psychology and social interaction. The difference was statistically significant (P < 0.05); after 3 months of follow-up nursing intervention, the low-density lipoprotein (LDL-C) and blood pressure (systolic blood pressure) of patients who underwent coronary intervention (PCI) and implemented the 5A combined Teach-back nursing model were lower than those of patients in the control group. The cardiac function of patients in the observation group was significantly improved. Its LVEF increased from (48.18 ± 6.62)% before the operation to (55.82 ± 6.93)% at 3 months after the operation, which was better than that of the control group from (48.46 ± 7.24)% to (51.72 ± 8.79)%, and the difference was statistically significant (P < 0.05). Conclusion: The 5A combined with Teach-back nursing model can effectively enhance the self-management ability and physiological index control of patients after PCI, reduce the risk of cardiovascular events, and has clinical promotion value.