基于赋能理论的CCU免陪照护护理模式在首次冠心病PCI患者中的应用效果

Application Effect of CCU Unaccompanied Care Nursing Model Based on Empowerment Theory in Patients with First Coronary Heart Disease PCI

摘要: 背景：经皮冠状动脉介入治疗(PCI)作为心脏监护病房(CCU)处理冠心病的核心微创技术，能够有效重建心肌血运，从而优化心功能并提升临床结局。然而，多数PCI治疗患者因病情复杂需接受长期护理管理。常规“免陪照护”模式通过专业医疗团队替代家属照护，由经过系统培训的医护人员全面负责住院患者的诊疗、护理及生活照料，这一模式既响应了群众多元化的健康服务需求，其标准化推广与持续改进也成为医疗服务质量升级的重要趋势。基于此，本研究旨在评估赋能理论指导下的“免陪照护”护理方案对患者自我管理能力、出院准备度、照顾者负担及术后并发症发生率方面的应用效果。方法：选取符合纳排标准的本院CCU首次冠心病PCI患者124例作为研究对象，根据随机数字表法均分为对照组(60例，采用常规护理措施)与观察组(55例，基于赋能理论的“免陪照护”护理方案)，对照组实施常规护理，干预组实施本研究构建的干预方案，对比两组患者自我管理能力问卷(ESCA)、冠心病自我管理行为量表(CSMS)、一般自我效能感量表(GSES)、出院准备度量表、照顾者负担量表(CBI)、术后并发症(包括患肢异常肿胀、术后异常出血、拔管综合征等)的差异。结果：经过护理后，与对照组相比，观察组ESCA各项评分(健康知识水平、自我概念、自我责任感和自我护理技能)出院准备度得分均高于对照组(P < 0.05)，而CBI总评分、术后并发症(包括患肢异常肿胀、术后异常出血、拔管综合征等)发生率显著降低(P < 0.05)。结论：基于赋能理论的“免陪照护”护理方案能够显著提高患者的自我管理能力、出院准备度以及降低照顾者负担和术后并发症发生率，对促进患者良好预后可能具有较高的临床应用价值。

Abstract: Background: Percutaneous coronary intervention (PCI) is a core minimally invasive technique in the cardiac care unit (CCU) for treating coronary heart disease, which can effectively restore myocardial blood flow, thereby optimizing cardiac function and improving clinical outcomes. However, most PCI patients require long-term care management due to complex conditions. The conventional “no-visitor care” model, which replaces family care with professional medical teams, has been widely adopted. Trained medical staff are fully responsible for the diagnosis, treatment, care, and daily life of inpatients. This model not only meets the diverse health service demands of the public but also represents an important trend in the continuous improvement of medical service quality. Based on this, this study aims to evaluate the application effect of the “no-visitor care” nursing program guided by the empowerment theory on patients’ self-management ability, discharge readiness, caregiver burden, and the incidence of postoperative complications. Methods: A total of 124 patients with their first coronary heart disease PCI in the CCU of our hospital who met the inclusion and exclusion criteria were selected as the research subjects. They were randomly divided into a control group (60 cases, receiving conventional care) and an observation group (55 cases, receiving the “no-visitor care” nursing program based on the empowerment theory). The control group received conventional care, while the observation group received the intervention program designed in this study. The differences in the scores of the self-management ability questionnaire (ESCA), coronary heart disease self-management behavior scale (CSMS), general self-efficacy scale (GSES), discharge readiness scale, caregiver burden inventory (CBI), and the incidence of postoperative complications (including abnormal swelling of the affected limb, abnormal postoperative bleeding, and extubation syndrome) were compared between the two groups. Results: After the nursing intervention, compared with the control group, the observation group had significantly higher scores in all ESCA items (health knowledge level, self-concept, self-responsibility, and self-care skills) and discharge readiness (P < 0.05), while the total CBI score and the incidence of postoperative complications (including abnormal swelling of the affected limb, abnormal postoperative bleeding, and extubation syndrome) were significantly lower (P < 0.05). Conclusion: The “no-visitor care” nursing program based on the empowerment theory can significantly improve patients’ self-management ability and discharge readiness, reduce caregiver burden, and lower the incidence of postoperative complications, which may have high clinical application value in promoting good prognosis for patients.