Psychological nursing and rehabilitation nursing of patients with coronary heart disease

 Psychological nursing and rehabilitation nursing of patients with coronary heart disease

In the 1990s, a comprehensive cardiac rehabilitation program focusing on exercise therapy was formed. The rehabilitation treatment of coronary heart disease is generally divided into three stages: acute (inpatient) stage, recovery (outpatient) stage and community (family) rehabilitation stage. Acute (inpatient) stage rehabilitation treatment scheme after the 1970s, early rehabilitation treatment was often carried out in the intensive care unit.

1. Psychological nursing of patients with coronary heart disease

(1) Psychological nursing of anxiety: it is often seen in patients with the first onset of coronary heart disease, and may lead to complications and poor prognosis by activating the sympathetic nervous system and the hypothalamus pituitary adrenal axis. 

Because the arrhythmia of patients with coronary heart disease changes day and night, patients often have anxiety about whether their diseases can be cured. In particular, when arrhythmias occur frequently, patients are worried, restless, anxious, sleep reduced and depressed, which aggravates the original condition. For such patients, we should fully understand their personality, tell the knowledge about the disease, give patient psychological counseling, stabilize their emotions, make them correctly understand the nursing requirements, free themselves from anxiety, eliminate doubts, and consciously cooperate with treatment and nursing. 

(2) Psychological nursing of tension and fear: it is more common in patients with recurrent myocardial infarction, recurrent heart failure and unstable angina pectoris. Such patients often lose confidence in the recovery of the disease due to repeated attacks of the disease, poor drug efficacy, and always feel unwell, manifested as depression, pessimism, frowning and indifference to people. 

Fear is often manifested as tension in clinic. Patients with coronary heart disease often attack at night or aggravate their symptoms at night. Some patients begin to be nervous every night before going to bed. Some patients are nervous and afraid when they see rescuing other patients. Some patients are nervous when they see some rescue instruments and oxygen inhalation devices, which makes their condition worse. In view of this mentality, the patient contacted him with a warm and cordial attitude after admission, took the initiative to introduce the environment of the ICU, and won the trust of the patient with steady and skilled operation. At the same time, use the methods of hint, persuasion, demonstration and induction to let patients learn to relax, divert their attention, eliminate nervous psychological factors, make patients have a sense of trust and security to medical staff, and enhance their confidence in overcoming diseases. 

(3) Psychological nursing of anxiety: Anxiety Psychology is clinically manifested as worry about future events and their results. Medical education network collection and sorting are mostly seen in patients in remission and recovery. These patients are worried about the recurrence of coronary heart disease and the onset of disease after discharge, which can not be treated and cared by medical staff in time. Some patients are willing to let the doctor who has been in charge of his treatment, worried that after changing the doctor, they will not understand the condition and delay the 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 occurrence mechanism of coronary heart disease, precautions in treatment and rest, self-care and self rescue. Explain to the patient before discharge, indicating that the patient's condition is improved. In the remission period, as long as the patient persists in treatment, regular follow-up review, cheerful spirit, identify and avoid inducing factors, the attack can be reduced or no longer occur. 

(4) Denial of psychological care: some patients do not admit that they are ill or their condition is getting worse, lack ideological preparation for possible serious consequences, believe that their body will resist all diseases, or simply do not believe that their healthy body will get sick in the past.

In view of this situation, we should actively and appropriately tell the patients the condition and the doctor's diagnosis, so that the patients can understand the degree of the disease, through a period of psychological counseling, make the patients admit the disease, explain the condition, introduce the current research progress of coronary heart disease, and clearly point out that coronary heart disease is not incurable, and avoidance can only be detrimental to themselves. At the same time, combined with some examples of coronary heart disease cure in this ward, please introduce your personal experience in the treatment process to enhance the patient's confidence, make the patient recognize the disease and cooperate with the treatment. 

(5) Psychological nursing and health education of role disorder: our most common method is to introduce the rehabilitation cases of the same kind of patients, create opportunities for patients to meet with the rehabilitation patients, let them talk directly and exchange two-way information. Due to the same role between the introducer and the listener, the patient's psychology is easy to accept, intuitively and vividly see that the disease can be recovered, and enhance the confidence to overcome the disease.

(6) Meet the psychological needs of patients for disease-related knowledge: explain the risk factors of coronary heart disease and a series of changes in the occurrence, development and prognosis of coronary heart disease. Inducement of angina pectoris, use method, effect and side effect of therapeutic drugs. Tell the patient the purpose and precautions of each examination, and feed back the examination results to the patient in time after the examination. 

2. Rehabilitation nursing of coronary heart disease

(1) The objectives of rehabilitation nursing of coronary heart disease: to improve cardiac function, reduce the incidence of re infarction and sudden death, and improve the quality of life of patients, including: ① taking measures for rehabilitation when coronary heart disease has clinical manifestations; ② The scope of rehabilitation services includes physical, psychological, social and vocational rehabilitation, and maintains good adaptability; ③ Take targeted measures to delay the development of potential disease process. The specific contents include controlling risk factors, increasing patients' relevant knowledge, reducing psychological anxiety and depression, carrying out three-stage rehabilitation treatment in hospital, family and community, and improving their ability of reemployment. 

(2) specific measures for rehabilitation nursing: the risk factors for coronary heart disease include smoking, dyslipidemia, hypertension, obesity, diabetes, kidney disease, sedentary lifestyle and excessive life pressure. According to the who survey report, the mortality of coronary heart disease caused by smoking is about 20%. If you stop smoking for one year, the incidence of coronary heart disease will be reduced by 50%. If you stop smoking for more than 15 years, the possibility of coronary heart disease will be very small. 

The contents of health education should include the risk factors of coronary heart disease, the treatment of angina pectoris, the precautions and toxic and side effects of taking drugs (such as coronary artery dilators, anticoagulants and antiarrhythmic drugs, etc.), the methods of selecting exercise type, intensity, frequency, time, quality skills, etc.