The effects of discharge planning intervention for CHD elderly patients on CHD health related behaviors

目的:检验连续护理干预模式对改善冠 心病(CHD)老年患者(≥60岁)CHD相关健康行为依从性的效果。方法:采用随机对照设计,200名住院患者随机进入实验组和对照组。医院和社区护士 对实验组患者实施出院前和出院后为期1个月的连续护理干预。结果:在出院后2天、4周、12周饮食及日常生活行为依从性,出院后4周、12周服药依从性, 出院后12周体育锻炼依从性方面,实验组患者较对照组有统计学差异(P<0.05)。结论:连续护理干预能有效改善老年CHD患者CHD相关健康行 为。 ||Objective: To test the effects of an original discharge planning and follow-up support program during the transitional period of care for chronic heart dis- ease (CHD) in elderly patients. Method: This study used a randomized controlled trial to compare the effectiveness of a discharge planning protocol developed specifically for elderly Chinese hospitalized CHD patients with routine care. The patients in both study group (100) and control group (100) received routine care. Patients in the study group received a discharge planning program which included assessment, health education and consultation, discharge plan, patient referral by hospital nurses before discharge; continuing intervention of continued education and consultation during the follow-up by community nurses after discharge. Results: Control features were: demographic factors, health and functional status. Compared with the control group, self-reported adherence to diet and health-related daily behavior at 2 days, 4 weeks and 12 weeks post- discharge; medication adherence at 4 weeks and 12 weeks post-discharge; and physical exercise at 12 weeks post-discharge were all significantly higher in the study group (P<0.05). Conclusions: Study findings demonstrate that the discharge planning and follow-up support program may benefit the elderly CHD patients by en- hancing CHD related knowledge and health behavior.