"Key words" coronary heart disease; Psychological nursing; health education
In the nursing work, the author taught the patients and their families the etiology, pathology, clinical manifestations, diagnosis, treatment and nursing knowledge of the disease, mobilized the patients and their families to actively participate in medical nursing activities, carefully analyzed the patients' psychological reaction after illness, and carried out targeted psychological nursing and health education [1], which improved the patients' self-care and health care ability and achieved good results. The report is as follows.
The clinical data of this group 1 98 cases are all inpatients who received income from September 2002 to September 2005, and all of them meet the diagnostic criteria of coronary heart disease [1]. There were 65 males and 33 females. Age 47~76 years old; There are 36 retirees and 62 retirees; 30 cases have college education or above, and 68 cases have technical secondary school education or below; There were 20 cases with medical history within 1 year, 52 cases with medical history above 1 year, and the remaining 26 cases were initial cases.
Methods Collect patients' health problems, evaluate patients' physical condition, psychological state, social background, education level, living habits and economic status, consult outpatient medical records, and make targeted nursing and health education plans.
Determine the way of health education, try to meet the needs of individualized patients, and guide them in various ways. Such as the combination of word cards and oral explanations; The combination of questioning and discussion; Combination of teaching and self-study.
3 Psychological Nursing and Health Education Content The psychological problems of patients with coronary heart disease can be induced by many reasons, such as social psychological stress, mental stress, smoking and drinking, mood swings, etc. Through clinical observation, the prominent psychological states of these patients are anxiety, anxiety, fear, denial and role disorder. [2]. According to the different psychology of patients, psychological nursing should be done well while treating and nursing.
3. 1 Psychological care and health education of anxiety Because of the circadian changes of arrhythmia in patients with coronary heart disease, patients often have anxiety about whether their disease can be cured, especially when arrhythmia occurs frequently, patients are anxious, uneasy [3], anxious, sleep less and depressed, which makes the original condition worse. For such patients, we should fully understand their personality, inform them about diseases, give them psychological counseling, stabilize their emotions, make them correctly understand nursing requirements, get rid of anxiety, eliminate doubts, and consciously cooperate with treatment and nursing.
3.2 Psychological care and health education of nervousness and fear. Fear often manifests itself as nervousness in clinic. Patients with coronary heart disease often take exams at night, and their symptoms get worse on big websites or at night. Some patients are nervous before going to bed at night, some patients are nervous and afraid when they see rescuing other patients, and some patients are nervous when they see some rescue instruments and oxygen inhalation devices, which makes their condition worse. In view of this mentality, patients contacted them with warm and cordial attitude after admission, actively introduced the environment of intensive care unit, and gained the trust of patients with steady and skillful operation. At the same time, the methods of suggestion, persuasion, demonstration and induction are used. Patients can learn to relax and divert attention, eliminate nervous psychological factors, make patients feel trust and security in medical staff, and enhance their confidence in overcoming diseases.
3.3 Anxiety Psychological Nursing and Health Education Anxiety is clinically manifested as anxiety about future events and their results. More common in patients in remission and recovery. These patients are worried about the recurrence of coronary heart disease and that their condition will not be treated and cared for by medical staff in time after discharge. Some patients are willing to be treated by the doctor who has been in charge of him, fearing that they will not understand the condition after changing doctors and delay treatment. In view of this psychology, we formulate measures to strengthen the publicity and education of disease knowledge, so that patients and their families can understand and master the pathogenesis of coronary heart disease, matters needing attention in treatment and rest, self-care and self-help. Explain to the patient before discharge, indicating that the patient's condition has improved. In remission period, as long as patients insist on treatment, follow up regularly, have a cheerful personality and find and avoid inducing factors, they can reduce or stop the attack.
3.4 Denial of psychological care and health education Some patients do not admit that they are sick or their condition is getting worse, and they are not prepared for the possible serious consequences. They believe that their bodies will resist all diseases or don't believe that their strong bodies will get sick at all. In view of this situation, it is necessary to actively and appropriately tell the patient about the condition and the doctor's diagnosis, so that the patient can understand the degree of the condition. Through a period of psychological counseling, let patients admit that they are sick, explain their illness at the same time, introduce the current research progress of coronary heart disease, and clearly point out that coronary heart disease is not an incurable disease, and avoidance can only be bad for them. At the same time, combined with some examples of curing coronary heart disease in our ward, please introduce your personal experience in the treatment of patients in remission, so as to enhance patients' confidence and make them recognize the disease and cooperate with the treatment.
3.5 Psychological Care and Health Education for Role Disorders Our most commonly used method is to introduce rehabilitation cases of similar patients, and create opportunities for patients to meet with the recovered people, so that they can have a direct dialogue and exchange information in two directions. Because the role of introducer and listener is the same, patients are psychologically easy to accept, and they can see that the disease can be recovered intuitively and vividly, which enhances their confidence in overcoming the disease.
3.6 To meet patients' demand for disease-related knowledge and psychologically explain the risk factors of coronary heart disease and a series of changes in its occurrence, development and prognosis. The inducement of angina pectoris, the use method, function and side effects of therapeutic drugs. Tell the patient the purpose and precautions of each examination, and feedback the examination results to the patient in time after the examination.
Results Through targeted psychological care and health education for patients with coronary heart disease, imparting self-care knowledge and skills to patients will help patients to actively participate, actively cooperate with treatment and nursing, control the development of illness, prevent complications, promote their functional recovery and mental health, and improve their quality of life. At the same time, patients and their families have trust in nurses, which shortens the distance between nurses and patients, deepens the feelings between nurses and patients, improves patients' health awareness and quality of life, and promotes the development of nursing discipline.