医学研究与教育 ›› 2025, Vol. 42 ›› Issue (3): 44-54.DOI: 10.3969/j.issn.1674-490X.2025.03.007

• 护理学 • 上一篇    下一篇

基于跨理论模型冠心病二级预防同质化护理方案的构建

罗瑜1,蒋谷芬1,何花1,戴想荣1,熊向晖1,陈红涛2   

  1. 1.湖南中医药大学第二附属医院护理部, 湖南 长沙 410005;
    2.湖南中医药大学护理学院, 湖南 长沙 410208
  • 收稿日期:2025-02-21 出版日期:2025-06-25 发布日期:2025-06-25
  • 通讯作者: 蒋谷芬(1968—),女,湖南长沙人,主任护师,硕士,硕士生导师,主要从事中西医结合护理研究和医院管理。E-mail: 1337309254@qq.com
  • 作者简介:罗瑜(2000—),女,湖南衡阳人,护士,在读硕士,主要从事中西医结合护理研究。 E-mail: cutieui@163.com
  • 基金资助:
    湖南省中医药管理局委托课题(D2023011);湖南省临床医疗技术创新引导项目(S2021SFYLJS0687);湖南省中医药科研计划项目(C2022031);湖南省卫生健康委员会2023年度科研计划课题(D202314017293);湖南省自然科学基金项目(2025JJ80911)

  • Received:2025-02-21 Online:2025-06-25 Published:2025-06-25

摘要: 目的 基于跨理论模型,构建冠心病二级预防的同质化护理方案。方法 以跨理论模型为指导,在文献研究、病例回顾、半结构式访谈的基础上拟定护理方案初稿。采用目的抽样法,对湖南省、广东省、四川省、湖北省及重庆市5个省(直辖市)的20名心血管内科医疗和护理专家进行函询。根据专家建议及课题组成员讨论,对方案进行修订,形成正式稿。结果 两轮函询专家积极系数均为100%,专家积极性高。两轮函询条目重要性和可行性的肯德尔和谐系数分别为0.118、0.228和0.112、0.150(P<0.01)。最终构建的护理方案包括5个一级条目,15个二级条目,33个三级条目。结论 基于跨理论模型冠心病二级预防的同质化护理方案具有可靠性、科学性、实用性,且方案将中医护理融入其中,使中医护理成为冠心病患者居家康复的重要措施。该方案为提高冠心病患者的自我管理能力,改善负性情绪,促进疾病康复,提供新的思路与参考。

关键词: 跨理论模型, 冠心病, 二级预防, 同质化护理, 方案构建

Abstract: Objective To construct a homogeneous nursing program for secondary prevention of coronary heart disease based on the transtheoretical model. Methods Based on the transtheoretical model, literature research, case review and semi-structured interviews, the first draft of nursing plan was drawn up. A total of 20 medical and nursing experts of cardiovascular medicine from Hunan, Guangdong, Sichuan, Hubei and Chongqing were selected by purposive sampling method for consultation. According to the suggestions of experts and the discussion of research group members, the scheme was revised to form a formal scheme. Results The positive coefficient of the two rounds of expert consultation was 100%, and the enthusiasm of the experts was high. The Kendall harmony coefficients of the importance and feasibility of the two rounds of consultation were 0.118, 0.228 and 0.112, 0.150, respectively(P<0.01). The final nursing plan included 5 first-level items, 15 second-level items and 33 third-level items. Conclusion The homogeneity nursing program for secondary prevention of coronary heart disease based on the transtheoretical model is reliable, scientific and practical, and the program integrates TCM nursing into it, making TCM nursing an important measure for home rehabilitation of patients with coronary heart disease. This program provides new ideas and references for improving the self-management ability of patients with coronary heart disease, improving negative emotions and promoting disease rehabilitation.

Key words: transtheoretical model, coronary heart disease, secondary prevention, homogeneous nursing, construction of scheme

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