Study on humanistic nursing based on Watson's caring theory in perioperative period of percutaneous coronary intervention in ST-segment elevation myocardial infarction patients with hypertension (基于Watson关怀理论的人性化护理在合并高血压的STEMI患者PCI围手术期中的应用)

Abstract

Objective To explore the application effect of humanistic nursing based on Watson’s care theory in patients with acute ST segment elevation myocardial infarction (STEMI) combined with hypertension during the perioperative period of percutaneous coronary intervention (PCI). Methods A total of 180 STEMI patients with hypertension admitted to hospital from May 2017 to May 2020 were randomly divided into two groups, who met the indications of PCI and were scheduled to undergo the operation. The control group was given routine nursing care during the perioperative period of PCI, while the research group implemented humanistic nursing based on Watson’s care theory on the basis of the above. The changes of negative emotion before and after nursing, the compliance degree of diagnosis and treatment during nursing, the changes of blood pressure and heart rate during vital signs monitoring, the success rate of PCI operation, the length of hospital stay during hospitalization and postoperative complications were compared between the two groups. Results After nursing intervention, the scores of anxiety and depression evaluation were decreased compared with those before treatment (P 0. 05), and small changes in systolic and diastolic blood pressures and heart rate were found in the study group compared with those in the control group (P 0. 05). There were 3 cases of nosocomial infection, 2 cases of stent thrombosis and 1 case of coronary artery spasm reported in the control group. Conclusion The implementation of humanistic nursing based on Watson’s caring theory in the perioperative period is potentially effective to alleviate patient negative emotions, improve the treatment compliance , and reduce the risk associated with variation of blood pressure and heart rate and other complications after PCI (目的 探讨基于Watson关怀理论的人性化护理在合并高血压的急性ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入治疗(PCI)围手术期中的应用效果。方法 选取医院2017年5月—2020年5月收治的180例合并高血压的STEMI患者, 采用随机数字表分为2组, 均符合PCI指征且拟行择期PCI手术。对照组在PCI围手术期实施常规护理, 研究组在对照组基础上实施基于Watson关怀理论的人性化护理。对比2组患者护理前后负性情绪变化, 评价护理期间诊疗配合度, 监测生命体征监护期间患者血压、心率变化, 统计PCI手术成功率、住院时间和术后并发症。结果 实施护理干预后, 2组焦虑、抑郁评分均较干预前降低, 且研究组评分低于对照组(P＜0. 01)。研究组护理期间诊疗配合度优于对照组(P＜0. 05)。2组生命体征监护时间差异无统计学意义(P＞0. 05), 研究组生命体征监护期间收缩压、舒张压、心率变化量低于对照组的(P＜0. 01)。2组PCI手术成功率、住院时间差异无统计学意义(P＞0. 05)。研究组术后住院期间无并发症, 对照组有3例院内感染、2例支架内血栓形成、1例冠脉痉挛。结论 在合并高血压的STEMI患者PCI围手术期实施基于Watson关怀理论的人性化护理, 可以缓解患者负性情绪, 提高配合度, 对控制血压和心率变化、减少PCI术后并发症风险具有积极意义。