Article(id=1322168051634647786, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322167989802217791, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.04.015, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1735574400000, receivedDateStr=2024-12-31, revisedDate=1769702400000, revisedDateStr=2026-01-30, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159028204, onlineDateStr=2026-10-28, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159028204, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159028204, creator=13701087609, updateTime=1793159028204, updator=13701087609, issue=Issue{id=1322167989802217791, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='4', pageStart='529', pageEnd='704', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159013461, creator='13701087609', updateTime=1793159013461, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=633, endPage=638, ext={EN=ArticleExt(id=1322168051924054763, articleId=1322168051634647786, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application of video education program based on timing theory in young and middle-aged patients with coronary heart disease undergoing PCI, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the application effect of video education program based on the timing theory in young and middle-aged patients with coronary heart disease undergoing PCI.

Methods

A total of 93 young and middle-aged patients with coronary heart disease undergoing PCI who were hospitalized in the department of cardiovascular medicine of the First Affiliated Hospital of Henan University of Chinese Medicine from January to August 2024 were selected as the research subjects.They were divided into an observation group of 47 cases and a control group of 46 cases according to the order of admission.The control group received conventional health education,while the observation group implemented a video health education program based on the timing theory.The scores of the Coronary Artery Disease Self-management Scale(CSMS),the China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases(CQQC),satisfaction with health education and the incidence of cardiovascular negative related events were compared between two groups of patients before the intervention and 3 months after the intervention.

Results

A total of 92 patients completed the intervention,with 46 cases in the observation group and 46 cases in the control group.After 3 months of intervention,the scores of CSMS and CQQC in the observation group were higher than those in the control group,the satisfaction with health education was higher than that in the control group,and the incidence of cardiovascular negatively related events was lower than that in the control group.The differences were all statistically significant(P<0.05).

Conclusions

The video education program based on the timing theory was helpful for young and middle-aged patients with coronary heart disease undergoing PCI to establish and maintain healthy behaviors,improve self-management ability,reduce the incidence of cardiovascular negatively related events,and thereby improve the quality of life.

, authors=Rongxin TANG, Shu LIU, Leiyuan REN, Xincan LIU, Ming LI, Yan ZHANG, Qiong SUN, Xianan WANG, authorsList=Rongxin TANG, Shu LIU, Leiyuan REN, Xincan LIU, Ming LI, Yan ZHANG, Qiong SUN, Xianan WANG, authorCompany=null, correspAuthors=Shu LIU, authorNote=null, correspAuthorsNote=
LIU Shu, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168052796469996, articleId=1322168051634647786, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

探讨基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用效果。

方法

选取2024年1月—8月在河南中医药大学第一附属医院心血管内科住院的93例中青年冠心病PCI病人作为研究对象,按照入院的先后顺序将其分成观察组47例和对照组46例。对照组实施常规健康教育,观察组实施基于时机理论的视频健康教育方案。比较两组病人干预前、干预3个月后冠心病自我管理行为量表(CSMS)得分、中国心血管病病人生活质量评定问卷(CQQC)得分、健康教育满意度和心血管负性相关事件发生率。

结果

共92例病人完成干预,观察组和对照组各46例。干预3个月后,观察组CSMS及CQQC得分高于对照组,健康教育满意度高于对照组,心血管负性相关事件发生率低于对照组,差异均有统计学意义(P<0.05)。

结论

基于时机理论的视频教育方案有助于中青年冠心病PCI病人建立并维持健康行为,提升自我管理能力,降低心血管负性相关事件的发生率,从而改善生活质量。

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唐荣欣,本科

, correspAuthorsNote=
刘姝,E-mail:
LIU Shu, E-mail:
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articleTitle=科普微视频健康教育对老年恶性肿瘤患者健康素质的影响, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322530025115603450, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, xref=1, ext=[AuthorCompanyExt(id=1322530025123992059, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, companyId=1322530025115603450, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Henan University of Chinese Medicine, Collaborative Innovation Center of Prevention and Treatment of Major Diseases by Chinese and Western Medicine, Henan Province, Henan 450000 China), AuthorCompanyExt(id=1322530025132380668, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, companyId=1322530025115603450, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1河南中医药大学第一附属医院(心脏中心),中西医防治重大疾病河南省协同创新中心,河南 450000)])], figs=[ArticleFig(id=1322530027959341617, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 1, caption=

Health education video program for PCI patients

, figureFileSmall=null, figureFileBig=null, tableContent=
时间时机阶段干预目的视频内容
院内干预诊断期引导正确认知,提高健康素养“劳模”心脏的工作日常;冠心病治疗方法及预后;冠心病病人家属必备技能
围术期激发内在动机,积极应对康复心脏介入术前攻略;神奇的心脏介入:揭秘手术全过程;3D动画演示心脏支架植入;心脏支架术后那些事(七步运动法、中医手指操、踝泵运动)
出院准备期掌握康复技能,提高自我能力心脏康复的理念、内容及获益;血压、心率、血糖的自我检测方法;需要定期监测的检验指标;识别心脏危险信号及急救
院外干预调整期调适心理、执行计划、积极康复运动康复秘笈;运动康复过程中暂停和降低运动强度的指征;冠心病病人必备服药宝典;非戒不可的烟;冠心病饮食“五宜五忌”;谁掌控了冠心病病人的情绪价值;不可小觑的体重
适应期有效管理、回归社会、定期复查PCI术后复查“查什么”;冠心病病人健康生活方式; “黄金4 min”——心肺复苏术;自动体外除颤器的藏匿之路和激活方式;养生·中医传统功法系列(八段锦、太极拳、心肺康复操)
), ArticleFig(id=1322530029595120178, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=CN, label=表1, caption=

PCI病人健康教育视频方案

, figureFileSmall=null, figureFileBig=null, tableContent=
时间时机阶段干预目的视频内容
院内干预诊断期引导正确认知,提高健康素养“劳模”心脏的工作日常;冠心病治疗方法及预后;冠心病病人家属必备技能
围术期激发内在动机,积极应对康复心脏介入术前攻略;神奇的心脏介入:揭秘手术全过程;3D动画演示心脏支架植入;心脏支架术后那些事(七步运动法、中医手指操、踝泵运动)
出院准备期掌握康复技能,提高自我能力心脏康复的理念、内容及获益;血压、心率、血糖的自我检测方法;需要定期监测的检验指标;识别心脏危险信号及急救
院外干预调整期调适心理、执行计划、积极康复运动康复秘笈;运动康复过程中暂停和降低运动强度的指征;冠心病病人必备服药宝典;非戒不可的烟;冠心病饮食“五宜五忌”;谁掌控了冠心病病人的情绪价值;不可小觑的体重
适应期有效管理、回归社会、定期复查PCI术后复查“查什么”;冠心病病人健康生活方式; “黄金4 min”——心肺复苏术;自动体外除颤器的藏匿之路和激活方式;养生·中医传统功法系列(八段锦、太极拳、心肺康复操)
), ArticleFig(id=1322530029670617651, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 2, caption=

Comparison of general information in two groups

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类观察组(n=46)对照组(n=46)统计值P
年龄(岁)49.89±7.0250.33±6.58t=-0.1160.767
性别(例)男3940χ2=0.1930.292
女76
文化程度(例)小学及以下117χ2=1.0210.361
初中1620
高中或中专1012
专科及以上97
婚姻状况(例)有配偶4139χ2=0.0470.764
无配偶57
工作状况(例)在职3632χ2=0.4250.172
不在职1014
居住地(例)农村1714χ2=0.3670.531
城市3132
家庭人均月收入(例)<3 000元1312χ2=0.5330.465
3 000~5 000元1716
>5 000元1618
合并其他慢性病(例)有2932χ2=0.1880.496
无1714
吸烟史(例)有2119χ2=0.4750.493
无1517
PCI放置支架数量(例)1枚2527χ2=0.3970.802
2枚1413
3枚及以上76
), ArticleFig(id=1322530029750309428, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=CN, label=表2, caption=

两组一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类观察组(n=46)对照组(n=46)统计值P
年龄(岁)49.89±7.0250.33±6.58t=-0.1160.767
性别(例)男3940χ2=0.1930.292
女76
文化程度(例)小学及以下117χ2=1.0210.361
初中1620
高中或中专1012
专科及以上97
婚姻状况(例)有配偶4139χ2=0.0470.764
无配偶57
工作状况(例)在职3632χ2=0.4250.172
不在职1014
居住地(例)农村1714χ2=0.3670.531
城市3132
家庭人均月收入(例)<3 000元1312χ2=0.5330.465
3 000~5 000元1716
>5 000元1618
合并其他慢性病(例)有2932χ2=0.1880.496
无1714
吸烟史(例)有2119χ2=0.4750.493
无1517
PCI放置支架数量(例)1枚2527χ2=0.3970.802
2枚1413
3枚及以上76
), ArticleFig(id=1322530029821612597, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 3, caption=

Comparison of CSMS scores between two groups of patients(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预3个月后t值P
观察组4665.57±4.5879.85±5.18-14.010<0.001
对照组4663.93±3.8870.46±4.15-7.781<0.001
t值1.8419.599
P0.069<0.001
), ArticleFig(id=1322530029888721462, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=CN, label=表3, caption=

两组病人CSMS得分比较(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预3个月后t值P
观察组4665.57±4.5879.85±5.18-14.010<0.001
对照组4663.93±3.8870.46±4.15-7.781<0.001
t值1.8419.599
P0.069<0.001
), ArticleFig(id=1322530029960024631, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 4, caption=

Comparison of CQQC scores between two groups of patients(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预3个月后t值P
观察组4665.59±5.2980.20±6.06-12.320<0.001
对照组4663.89±4.2671.37±4.50-8.177<0.001
t值1.6937.930
P0.094<0.001
), ArticleFig(id=1322530030018744888, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=CN, label=表4, caption=

两组病人CQQC得分比较(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预3个月后t值P
观察组4665.59±5.2980.20±6.06-12.320<0.001
对照组4663.89±4.2671.37±4.50-8.177<0.001
t值1.6937.930
P0.094<0.001
), ArticleFig(id=1322530030094242361, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 5, caption=

Comparison of health education satisfaction between two groups of patients

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数很满意较满意一般不满意总满意
观察组4636(78.26)7(15.22)2(4.35)1(2.17)43(93.48)
对照组4617(36.96)15(32.61)11(23.91)3(6.52)32(69.56)
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两组病人健康教育满意度比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数很满意较满意一般不满意总满意
观察组4636(78.26)7(15.22)2(4.35)1(2.17)43(93.48)
对照组4617(36.96)15(32.61)11(23.91)3(6.52)32(69.56)
), ArticleFig(id=1322530030236848699, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=EN, label=Table 6, caption=

Comparison of the incidence of cardiovascular negative related events between two groups of patients

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组别例数心绞痛非计划再入院疾病加重合计
观察组463(6.52)1(2.17)1(2.17)5(10.87)
对照组469(19.56)5(10.87)3(6.52)17(36.95)
), ArticleFig(id=1322530030312346172, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168051634647786, language=CN, label=表6, caption=

两组病人心血管负性相关事件发生率比较

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组别例数心绞痛非计划再入院疾病加重合计
观察组463(6.52)1(2.17)1(2.17)5(10.87)
对照组469(19.56)5(10.87)3(6.52)17(36.95)
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基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用
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唐荣欣 , 刘姝 *, * , 任蕾元 , 刘新灿 , 李明 , 张岩 , 孙琼 , 王夏楠
护理研究 | 综合研究 2026,40(4): 633-638
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护理研究 |综合研究 2026 , 40 (4) : 633 -638
基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用
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唐荣欣, 刘姝*, * , 任蕾元, 刘新灿, 李明, 张岩, 孙琼, 王夏楠
作者信息
  • 1河南中医药大学第一附属医院(心脏中心),中西医防治重大疾病河南省协同创新中心,河南 450000
通讯作者:
刘姝,E-mail:
LIU Shu, E-mail:
作者简介:

唐荣欣,本科

Application of video education program based on timing theory in young and middle-aged patients with coronary heart disease undergoing PCI
Rongxin TANG, Shu LIU , Leiyuan REN, Xincan LIU, Ming LI, Yan ZHANG, Qiong SUN, Xianan WANG
Affiliations
  • 1The First Affiliated Hospital of Henan University of Chinese Medicine, Collaborative Innovation Center of Prevention and Treatment of Major Diseases by Chinese and Western Medicine, Henan Province, Henan 450000 China
  • Corresponding Author:
    LIU Shu, E-mail:
出版时间: 2026-02-25 doi: 10.12102/j.issn.1009-6493.2026.04.015
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目的

探讨基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用效果。

方法

选取2024年1月—8月在河南中医药大学第一附属医院心血管内科住院的93例中青年冠心病PCI病人作为研究对象,按照入院的先后顺序将其分成观察组47例和对照组46例。对照组实施常规健康教育,观察组实施基于时机理论的视频健康教育方案。比较两组病人干预前、干预3个月后冠心病自我管理行为量表(CSMS)得分、中国心血管病病人生活质量评定问卷(CQQC)得分、健康教育满意度和心血管负性相关事件发生率。

结果

共92例病人完成干预,观察组和对照组各46例。干预3个月后,观察组CSMS及CQQC得分高于对照组,健康教育满意度高于对照组,心血管负性相关事件发生率低于对照组,差异均有统计学意义(P<0.05)。

结论

基于时机理论的视频教育方案有助于中青年冠心病PCI病人建立并维持健康行为,提升自我管理能力,降低心血管负性相关事件的发生率,从而改善生活质量。

冠心病  /  中青年  /  经皮冠状动脉介入治疗  /  时机理论  /  视频教育  /  护理
Objective

To explore the application effect of video education program based on the timing theory in young and middle-aged patients with coronary heart disease undergoing PCI.

Methods

A total of 93 young and middle-aged patients with coronary heart disease undergoing PCI who were hospitalized in the department of cardiovascular medicine of the First Affiliated Hospital of Henan University of Chinese Medicine from January to August 2024 were selected as the research subjects.They were divided into an observation group of 47 cases and a control group of 46 cases according to the order of admission.The control group received conventional health education,while the observation group implemented a video health education program based on the timing theory.The scores of the Coronary Artery Disease Self-management Scale(CSMS),the China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases(CQQC),satisfaction with health education and the incidence of cardiovascular negative related events were compared between two groups of patients before the intervention and 3 months after the intervention.

Results

A total of 92 patients completed the intervention,with 46 cases in the observation group and 46 cases in the control group.After 3 months of intervention,the scores of CSMS and CQQC in the observation group were higher than those in the control group,the satisfaction with health education was higher than that in the control group,and the incidence of cardiovascular negatively related events was lower than that in the control group.The differences were all statistically significant(P<0.05).

Conclusions

The video education program based on the timing theory was helpful for young and middle-aged patients with coronary heart disease undergoing PCI to establish and maintain healthy behaviors,improve self-management ability,reduce the incidence of cardiovascular negatively related events,and thereby improve the quality of life.

coronary heart disease  /  young and middle-aged people  /  percutaneous coronary intervention  /  timing theory  /  video education  /  nursing
唐荣欣, 刘姝, 任蕾元, 刘新灿, 李明, 张岩, 孙琼, 王夏楠. 基于时机理论的视频教育方案在中青年冠心病PCI病人中的应用. 护理研究, 2026 , 40 (4) : 633 -638 . DOI: 10.12102/j.issn.1009-6493.2026.04.015
Rongxin TANG, Shu LIU, Leiyuan REN, Xincan LIU, Ming LI, Yan ZHANG, Qiong SUN, Xianan WANG. Application of video education program based on timing theory in young and middle-aged patients with coronary heart disease undergoing PCI[J]. Chinese Nursing Research, 2026 , 40 (4) : 633 -638 . DOI: 10.12102/j.issn.1009-6493.2026.04.015
冠心病(coronary heart disease,CHD)是心血管疾病中最常见的危重疾病之一,其发病率和死亡率持续上升,且发病年龄呈年轻化趋势[1],中青年冠心病病人占比约56.5%[2]。经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)是目前治疗冠心病的有效方法,可迅速开通血管、恢复心肌细胞灌注,但PCI并不能逆转冠状动脉粥样硬化的生物学进程,也不能消除冠心病的相关危险因素[3]。有研究表明,PCI术后因缺乏适时适用的健康指导,以致病人遵医依从性下降、自我管理能力较差[4],易发生支架内再狭窄及其他心血管不良事件,术后1年内非计划入院率高达20%~40%[5]。健康教育是临床护理工作的重要组成部分,《促进以病人为中心的学习》指南中指出,健康教育工作应以病人为中心,尊重其需求、想法与价值观,通过提供相关护理信息、工具与支持,促进病人主动参与至自身护理工作中,增强健康意识,规范健康行为[6]。目前,随着人口素质的提升和医疗模式的转变,PCI病人住院周期日渐缩短,现行的教育模式已不能满足其对于健康信息的需求[7]。因此,选择可行有效的健康教育形式势在必行。基于时机理论的健康教育模式,将疾病过程分为诊断期、稳定期、准备期、调整期及适应期5个阶段[8],强调依据疾病发展的不同阶段,给予相应的健康教育和支持需求,促进病人疾病恢复及回归社会。互联网+时代背景下,短视频的受众众多,是实现科普传播的重要主体和传播中介[9]。短视频通过其动态化、多维度、多模态符号的呈现方式,有助于加深病人对疾病的认知和理解,增强健康行为改变的动机,进而促进护理计划的实施,已被广泛应用于多种慢性病病人的健康教育中,且取得了良好效果[10-11]。基于此,本研究尝试探索基于时机理论的阶段式视频教育方案在中青年冠心病PCI病人中的应用效果,以期为临床健康教育创新形式提供参考。
选取2024年1月—8月在河南中医药大学第一附属医院心血管内科住院的中青年冠心病PCI病人作为研究对象。纳入标准:符合冠心病诊断标准[12],且首次行PCI;年龄18~59岁[13];意识清楚,无交流及沟通障碍;熟练使用智能手机,愿意配合本研究。排除标准:合并严重的心脑肾等其他器官病变或恶性肿瘤者;伴有明显精神障碍或认知功能缺陷者。脱落标准:因各种原因导致中途失访者。本研究经医院医学伦理委员会审批(审批号:2025HL-068),所有病人均签署知情同意书。样本量确定采用两独立样本均数比较公式:n1=n2=2[(μα+μβ)σ/δ]2。取α=0.05,β=0.10,双侧检验。查阅文献[14]得出,μα=1.96,μβ=1.28,σ=3.90,δ=3.20,并考虑20%样本流失率,最后确定总样本量为93例,按照入院的先后顺序将其分成观察组47例和对照组46例。
对照组实施常规PCI病人健康教育,即入院时由责任护士告知病人疾病相关知识;术前介绍手术流程及相关注意事项;口头描述手术方式及麻醉方式;术后根据病人病情,以讲解加动作示范的形式介绍早期术肢体位、功能锻炼方式及术后护理知识;同时,发放科室自制《经皮冠状动脉介入治疗康复手册》供病人学习。出院时指导病人关注科室微信公众号,讲解居家心脏康复知识(运动、用药、戒烟、饮食、心理调适)和疾病危险因素等,嘱定期复查。每个月电话随访1次,连续随访3个月。观察组实施时机理论指导下的视频教育方案,具体如下。
视频健康教育小组包括病区主任、护士长、研究者及心内科医生、责任护士、护理硕士研究生、科普助理共7名成员。研究者负责构建视频方案、实施和视频推送及后台监控;心内科医生负责病人病情及治疗工作;主任和护士长负责方案指导和视频审核;科普助理负责视频的录制和剪辑;责任护士负责微信群管理和协助实施及随访;护理硕士研究生负责数据收集及资料分析。
以时机理论疾病阶段划分为参考,结合中青年冠心病PCI 病人的疾病特征、治疗特点及康复过程,最终确定5个阶段[9]:诊断期(从明确诊断至术前1 d)、围术期(术日至术后病情稳定)、出院准备期(即将结束治疗至出院)、调整期(PCI术后1个月)及适应期(PCI术后3个月)。根据PCI疾病发展不同阶段需求的相关性,与临床常见的护理与康复过程中存在的问题,筛选整合后梳理出健康教育需求信息39条。经小组成员集中讨论,并在咨询相关专家、查阅前期研究[15-17]、参照临床指南与共识[18-19]及证据总结[20]的基础上,反复进行设计与修改,并录制课程,最终制作成23个视频内容,见表1。
1)统一封面,健康知识视频时长控制在5 min内,运动跟练视频可同步在30~35 min,适当融入配音和背景乐;2)视频呈现形式以自主拍摄和制作动画为主;3)特征:有趣幽默、贴近生活,具有启发性和知识性,同时满足对新鲜性和时效性的需求;4)内容力求全面、生动、精简、通俗、重点突出;5)健康知识类视频均需进行相应备注,简明扼要告知学习要求和重点事项;6)运动部分制作为跟练视频,需包括休息间歇、节奏口令、背景音乐及注意事项讲解。
由研究者本人及研究小组经过统一培训的责任护士实施。1)住院期间责任护士按照疾病分期通过护患通推送视频,指导病人采用床旁智慧暖屏进行视频观看,每天2次或3次,每次10~15 min,观看完毕系统自动退出学习列表。观看结束后,对有疑问之处进行细致解答,适当反问以了解病人对视频内容的掌握情况。结合病人自身运动耐力,由心脏康复师开具运动处方,根据处方内容在院内进行一对一培训指导,确保其能够掌握运动方式,每周练习3次以上,每次热身+运动处方+放松共45 min。每日完成后,及时在健康教育实施表单上做记录。2)出院时将病人纳入视频教育微信群,关注微信健康教育小程序,并介绍其所含功能(视频的查收、观看以及打卡形式)。发放自我行为管理日历表,讲解记录方法和上传方式。3)出院后通过微信小程序进行视频推送。健康知识视频设定为每周一、周三、周五11∶00由微信小程序平台推送2条或3条,并发送观看提醒;运动跟练视频可于每周全天任意时间进入微信小程序,选择当日推送的与自己相对应的运动视频进行跟练。每周四之前完成3次,系统不会发送短信提醒;未完成者平台将在周四至周日11∶00进行运动跟练提醒。4)效果跟踪:研究者通过定期查看线上视频观看率、提问和考察的方式了解病人对健康教育信息的执行、掌握和运动锻炼情况,从而确定其完成质量。微信小程序设有后台视频播放监控,观看当日视频课程时长90%以上即认为其完成,同时在其手机端微信小程序日历中显示当日打卡。自身行为管理表需病人每天上传至微信群。病人出院后,运动完成情况除了后台监控跟练视频完成情况外,还会在每周随访时由责任护士与病人视频连线进行指导,及时督导和纠正。
责任护士在病人出院后每周电话随访1次,干预时间为3个月。对于教育效果不佳的病人则积极沟通,查找原因并解决,以达到预期的教育目标。
CSMS包括一般生活、症状、急救、疾病知识、治疗依从性、情绪认知以及不良嗜好7个维度,共27个条目,采用Likert 5级评分法,量表总分为27~135分[21]。得分越高,说明自我管理能力越强,量表的Cronbach's α系数为0.913。
CQQC包括体力状况、病情、医疗情况、一般生活功能、工作状况及社会心理功能6个维度,共28个条目。问卷总分为280分,得分越高,说明生活质量越高[22],问卷总的Cronbach's α系数为0.910。
采用科室自制健康教育满意度问卷进行满意度评价,分为很满意、较满意、一般和不满意4个等级。很满意和较满意均为病人对健康教育形式满意。
心血管负性相关事件包括心绞痛、非计划再入院、疾病加重[23]。
分别于两组病人术前1 d进行一般资料收集,发放CSMS和CQQC调查问卷。干预3个月时电话联系病人约定门诊复查时间,收集病人CSMS、CQQC、健康教育满意度问卷,统计心血管负性事件发生情况。要求病人独立填写问卷,填写完毕当场回收。未能按时到门诊复查者,由研究者本人通过电话随访的形式对调查问卷条目逐一询问后填写。回收的问卷和结果由双人核对并录入。
采用SPSS 26.0进行数据分析。定性资料用例数、百分比(%)表示,采用χ2检验。符合正态分布的定量资料以均数±标准差(x±s)表示,采用t检验;不符合正态分布的定量资料以中位数(四分位数)[M(P25,P75)]表示,采用Mann-Whitney U秩和检验。以P<0.05为差异有统计学意义。
两组共92例病人完成干预,其中观察组46例(因失访脱落1例),对照组46例。两组病人一般资料比较,差异均无统计学意义(P>0.05),见表2。
研究表明,视频教育在意识清楚、具有决策能力的成年个体中具有较好的应用效果[24]。本研究结果显示,干预后两组CSMS得分均有所提高,且观察组得分[(79.85±5.18)分]高于对照组[(70.46±4.15)分],差异有统计学意义(P<0.001),证实了视频教育有助于中青年冠心病PCI病人自我管理能力的提升,这与崔英兰[25]研究结果一致。根据时机理论的疾病分期制定的视频教育方案内容,贯穿了PCI病人疾病康复的全过程,住院期间帮助病人建立正确的疾病认知,塑造正确的疾病管理理念,引导病人自我管理意识的形成;出院时帮助病人制订自我管理计划,强化了病人的参与程度;出院后督导落实自我管理计划实施,重视病人的启发及赋能的持续合作过程,使其主动参与疾病管理,并积极调节心理应对,不断改善自身行为而实现自我管理,促进疾病康复。
因受疾病的影响,PCI病人的生活质量明显低于正常人群[26]。本研究结果显示,干预后观察组CQQC得分[(80.20±6.06)分]高于对照组[(71.37±4.50)分],差异有统计学意义(P<0.001),说明本研究采用的视频教育形式是行之有效的。以疾病为导向的健康教育往往忽略了不同疾病阶段病人的需求,通常会导致护理信息提供和接收的偏差[27],并在一定程度上削弱了健康教育的有效性。而视频教育形式顺应大数据时代要求,具有便捷性、广泛性、低成本等特点[28]。结合专业医护团队,以病人为中心,最大限度满足了病人不同阶段的健康管理需求,以搭建学习体系的方式在疾病的相应周期内通过视频展现提供有效知识信息、满足病人健康需求,保证其知识获取的连续性和系统性,使病人感受到专业、连贯的护理指导[9],从而帮助病人建立健康的生活方式,提高生活质量。
本研究结果显示,干预后观察组的健康教育满意度(93.48%)高于对照组(69.57%)。本研究的视频教育方案整合了PCI病人疾病发展5个阶段的健康教育内容,在专业人员指导下进行制作,充分保证了内容的科学性、真实性、可学习性,使专业知识向“泛知识”和“轻量化知识”转化,更具有分享性与传播性[29]。反馈环节加强了护理人员与病人之间的沟通,满足病人的情感支持需求,因而病人满意度更高。本研究结果还显示,干预后观察组心血管不良事件发生率(10.87%)明显低于对照组(36.95%),这与观察组病人出院后持续学习疾病相关知识有关。疾病的正确认知促进了病人对心血管风险因素的识别,避免了因健康教育不到位而导致的认知偏差等问题。通过跟练视频,有效提高了病人运动的自主性和依从性,同时改善心脏功能、强化体能,降低心肌耗氧量,从而降低了病人心血管不良事件的发生率。
基于时机理论的视频教育能够提升病人的自我管理能力,提高生活质量,改善健康结局,在病人健康教育中具有较高的满意度,同时在一定程度上提高了工作效率。护理人员应在科学的方法学框架指导下,以病人为中心,进一步探讨其在不同疾病病人教育中的可行性和有效性,促进健康教育模式的变革,提高护理服务质量。但由于本研究是单中心研究,且样本量较少,干预时间较短,其长期效益有待进一步探索。

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doi: 10.12102/j.issn.1009-6493.2026.04.015
  • 接收时间:2024-12-31
  • 首发时间:2026-10-28
  • 出版时间:2026-02-25
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  • 收稿日期:2024-12-31
  • 修回日期:2026-01-30
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    1河南中医药大学第一附属医院(心脏中心),中西医防治重大疾病河南省协同创新中心,河南 450000

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刘姝,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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