基于循证理念的延续护理干预对老年心血管疾病患者介入术后远期心脏康复效果的作用机制与路径研究

Research on the Mechanism and Pathway of Extended Nursing Intervention Based on Evidence-Based Concept on the Long Term Cardiac Rehabilitation Effect of Interventional Surgery in Elderly Cardiovascular Disease Patients

摘要: 目的：探究基于循证理念的延续护理模式对老年心血管疾病患者介入术后远期心脏康复的多维影响，剖析其在改善心功能、提升生活质量、强化自我管理能力及降低不良事件风险中的作用机制。方法：采用前瞻性随机对照研究设计，纳入2024年3月~2025年5月于我院接受心血管介入术的186例老年患者，随机分为观察组与对照组。对照组实施常规护理，观察组基于循证医学证据构建延续护理方案，涵盖远程监测、个性化康复指导、心理干预及家庭支持协同等措施。通过6个月干预周期，运用心脏超声测量左心室射血分数(LVEF)、6分钟步行试验评估心功能；采用SF-36量表、老年心血管疾病自我管理量表(SCAHD-SMS)分别评价生活质量与自我管理能力；统计再住院率及并发症发生率。运用SPSS 26.0软件进行独立样本t检验、χ²检验，分析组间差异。结果：观察组LVEF较对照组显著提升(P < 0.001)，6分钟步行距离增加(P < 0.001)；SF-36量表生理功能、情感职能等8个维度评分均高于对照组(P < 0.05)，自我管理能力总分提升幅度达23.6% (P < 0.001)；再住院率降低42.8%，并发症发生率下降37.1%。结论：循证理念驱动的延续护理可通过精准干预路径，有效改善老年心血管介入术后患者的远期心脏康复效果，促进机体功能恢复，增强自我管理效能，减少医疗资源重复消耗，为优化老年心血管病康复护理策略提供科学依据。

Abstract: Objective: To explore the multidimensional effects of evidence-based continuous care models on long-term cardiac rehabilitation in elderly patients after cardiovascular interventional procedures, analyzing their mechanisms in improving cardiac function, enhancing quality of life, strengthening self-management abilities, and reducing adverse event risks. Methods: A prospective randomized controlled study design was employed, enrolling 186 elderly patients undergoing cardiovascular interventional procedures at our hospital from March 2024 to May 2025. Participants were randomly divided into an observation group and a control group. The control group received conventional care, while the observation group implemented a continuous care plan based on evidence-based medicine, encompassing remote monitoring, personalized rehabilitation guidance, psychological intervention, and family support coordination. Over a 6-month intervention period, left ventricular ejection fraction (LVEF) was measured via echocardiography, and 6-minute walking tests assessed cardiac function. Quality of life and self-management abilities were evaluated using the SF-36 scale and the Self-Management of Chronic Heart Disease in the Elderly Scale (SCAHD-SMS), respectively. Rates of rehospitalization and complication occurrence were recorded. Independent samples t-tests and χ² tests were conducted using SPSS 26.0 software to analyze intergroup differences. Results: The observation group showed significantly higher LVEF (P < 0.001) and increased 6-minute walking distance (P < 0.001) compared to the control group. SF-36 scale scores in eight dimensions, including physical function and emotional role, were higher in the observation group (P < 0.05), with a 23.6% improvement in self-management ability total scores (P < 0.001). The rehospitalization rate decreased by 42.8%, and complication occurrence dropped by 37.1%. Conclusion: Evidence-based continuous care can effectively improve long-term cardiac rehabilitation outcomes in elderly patients after cardiovascular interventional procedures through precise intervention pathways, promoting functional recovery, enhancing self-management efficacy, reducing redundant medical resource consumption, and providing a scientific basis for optimizing rehabilitation nursing strategies for elderly cardiovascular diseases.