Health Education for Elderly Patients with Coronary Heart Disease —— Talking about Health Education for Patients with Coronary Heart Disease
The methods and experiences of health education were reviewed and summarized. Nurses should first make clear the purpose and function of health education, flexibly use the methods of health education, get to know patients with different education levels and diseases and their families, and give them help, so as to reduce the morbidity and mortality of patients.
Keywords coronary heart disease; health education
Coronary heart disease is a common psychosomatic disease. Due to social, psychological, personality and biological factors, coronary atherosclerosis leads to coronary artery stenosis, which in turn leads to myocardial hypoxia and ischemia, leading to angina pectoris, myocardial infarction and heart failure. Surveys at home and abroad show that coronary heart disease is threatening human life and has become one of the three major death diseases in China. The disease mostly occurs after 40 ~ 50 years old, and the prevalence rate is 3% ~ 5%, which has an upward trend in recent years. There are many researches on coronary heart disease, especially behavioral medicine, which has been paid attention to in the process of comprehensive prevention and treatment of coronary heart disease. Research shows that health education for patients with coronary heart disease can achieve twice the result with half the effort.
Clinical data of 1
During the two years from 2005 10 to 2007/2,65438+,* * 98 patients were given health education, including 5 males, 47 females, aged 48-70 years, with an average of 60.5 years, 45 primary school students and 33 middle school students. Family members of patients 100, including 32 males and 68 females, aged 23-60, with an average of 4 1 year, 26 junior high school students, 43 senior high school students, 3 technical secondary schools and 3 universities1person.
2 Health education
2. 1 Health education during hospitalization
2. 1. 1 Psychological guidance: The occurrence and development of coronary heart disease are closely related to stress. External stressors such as physical, chemical, physiological and social factors often act on the body for a long time, which will produce a state of mental and physical urgency and lead to the occurrence of diseases. Therefore, the patient's environment should be quiet and comfortable, reduce all kinds of noise, keep the patient in a comfortable mood and stable mood, give full explanation and comfort, and avoid others talking about things that annoy and excite the patient.
2. 1.2 dietary guidance: the diet should be light and easy to digest, low in fat and salt, and should not be full. It is advisable to eat less and eat more meals, avoid irritating food and drinks, ban alcohol, give a diet high in fiber and vitamins, drink more water and supply more fresh vegetables to maintain adequate nutrition and protect blood vessels. Foods with high saturated fat and cholesterol, such as lard, butter, animal offal, egg yolk, roe and other foods that easily lead to arteriosclerosis, should be properly restricted and should not be overdone. Eating less and eating more is to avoid overeating and increase the burden on the heart.
2. 1.3 rest instruction: critically ill patients should rest in bed, be placed in ECG intensive care unit, keep the ward quiet, and all daily life should be solved with the help of nurses, so as to avoid unnecessary turning over, restrict visits and prevent mood swings. After the condition is stable, encourage patients to stay in bed and do physical activities to prevent thrombosis of lower limbs. With the help of nurses, gradually increase the amount of activities, from getting up, standing, walking slowly, walking indoors, and gradually increase medical gymnastics until walking in the hospital. You are allowed to meet people, read newspapers and watch TV, but you should avoid excessive fatigue. Patients in convalescence can resume their original daily activities and gradually increase activities such as walking.
2. 1.4 Instructions for medication: Nitroglycerin is the first choice for coronary heart disease, and the patient should be told to take it under the tongue and not to swallow it. After using vasodilators, blood pressure should be measured regularly to avoid syncope caused by postural hypotension. Patients should get up slowly, lie flat for a while when dizzy, and receive oxygen when necessary. When using anticoagulants, pay attention to whether there are bleeding spots and ecchymosis on the body and observe whether there is bleeding. For the application? Beta blockers should not be missed or stopped at will, because food will delay the absorption of drugs, so they should be taken before meals, and the intravenous infusion speed should not be adjusted at will and should be strictly controlled by nurses.
2. 1.5 Life instruction: In order to keep defecation unobstructed, patients should eat more fruits, vegetables and foods rich in cellulose, and develop daily defecation habits. For constipation, you can gently knead along the direction of colon deformation. If the stool remains unsolved for several days, laxatives or low-pressure warm water enema can be given. Those who are ineffective can wear gloves to lubricate their fingers and gently pull out the stool.
2.2 Health education after discharge
2.2. 1 Make an activity plan according to the heart function. Patients with cardiac function grade ⅰ should rest properly, ensure sleep and pay attention to the combination of work and rest; Patients with cardiac function ⅱ should rest more, but they can get up and move; Patients with cardiac function grade ⅳ limit their activities and increase their bed rest time; Patients with cardiac function grade ⅵ must stay in bed and have no symptoms.
2.2.2 Reasonable adjustment of diet structure, appropriate control of food intake, low salt and low fat, avoid alcohol and tobacco.
2.2.3 Take medicine on time according to the doctor's advice, and carry with you nitroglycerin and other drugs that dilate coronary arteries. Pay attention to combining work and rest. If you have symptoms such as chest tightness, palpitation, dyspnea and rapid heartbeat, you should see a doctor in time.
2.2.4 Maintain a good mood and avoid various inducing factors, such as tension, fatigue, emotional excitement, constipation, infection, etc. Usually take an active part in physical exercise.
2.2.5 Frequent outpatient follow-up visits and continuous medication.
3 forms and methods of health education
3. 1 Regular health education lectures: explain the relevant knowledge of diseases in theory, understand the factors of coronary heart disease attack, make patients and their families cooperate with each other, master the methods to avoid the stimulation of adverse factors, and improve patients' self-protection ability.
3.2 Individual guidance: in the daily treatment and nursing or in the communication with patients in the patrol ward, give guidance at any time when problems are found.
3.3 Establish a health education manual: the content is the health knowledge of patients with coronary heart disease, such as the mechanism, induced causes, commonly used drugs and adverse reactions of coronary heart disease. The content is easy to understand and illustrated, which is convenient for patients and their families to master.
Four results
4. 1 changed the role and nursing methods of nurses: in the health education for patients, the roles of nurses are not only caregivers and managers, but also educators and researchers; Can't the nursing method pass? Mainly based on supervision? Nursing mode is based on physiological, psychological, social and cultural background.
4.2 Enhance patients' awareness of self-protection: Through planned, organized and systematic health education, patients and their families can have a correct understanding of the factors that induce coronary heart disease, master the matters that should be paid attention to in different periods and how to avoid the adverse stimulation of the inducing factors, and improve patients' self-protection ability and quality of life.
4.3 Contribute to the improvement of nurses' own quality: In the process of implementing health guidance, nurses are required to have a wide range of knowledge, keen observation, solve problems in time when they find them, have certain teaching and communication skills, and stimulate their curiosity.
5 conclusion
Through our health education for patients with coronary heart disease, we can encourage patients to actively participate in health maintenance, actively change unhealthy lifestyles, prevent acute attacks, delay disease progress and improve quality of life. To improve the heart function of critically ill patients and improve the body's ability to prevent diseases. Teaching health knowledge to patients with coronary heart disease can change their cognitive model and adjust their diet structure, thus reducing their morbidity and mortality. At the same time, nurses should have the ability of health education and carry out multi-angle and multi-level education according to patients' occupation, age and social background, so that every patient can accept, understand and benefit from it.
refer to
[1] Xiao Chunfang. Health education of coronary heart disease. Clinical study on common diseases in China. 2005,5 (2): 102- 103.
[2] Cao Cuirong. Nursing care of cardiovascular diseases in convalescence. China Journal of Misdiagnosis. 2005，2005 (3): 393。
[3] Cheng Jianchu, Qiu Guixiang. Observation and nursing of acute myocardial infarction. 2005，3( 13): 1235- 1236。
About the author: Ma Haijing, nurse in charge of hyperbaric oxygen therapy center of Heilongjiang Provincial Hospital, bachelor degree.