目前,全球每年有超过200万冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,简称冠心病)患者需行经皮冠状动脉介入治疗(per-cutaneous coronary intervention,PCI),PCI 已成为治疗冠心病的主要手段[1]。但PCI只能机械性地改变冠状动脉血管腔的几何形态,并不能减缓冠状动脉粥样硬化的生物学进程,没有消除导致疾病的危险因素,患者术后仍有再发心脏不良事件(adverse cardiac events )的风险。既往研究[2]表明,随着年龄、血脂、血压、血糖等冠心病危险因素的升高,心脏不良事件发生率也随之升高。尽管有研究[3]报道, PCI患者冠心病危险因素有所控制,但心脏不良事件的发生率仍很高。因此,积极控制 PCI 术后患者冠心病危险因素,降低心脏不良事件的发生率依然是我们面临的难题。

Objective:To explore the effect of transitional self-management intervention based on self-management model and transitional nursing model on quality of life among patients with Percutaneous Coronary Intervention (PCI). Methods:Totally 90 PCI patients were divided into the control group (44 cases) and the intervention group (46 cases). The intervention group received transitional self-management intervention, whereas the control group received routine cardiology health education. Both groups were investigated by the SF-36 before intervention , 1 and 6 month after the intervention .Results:The subscale scores of SF-36 in the intervention group were higher than those in the control group except physical function and bodily pain in 1 month and bodily pain in 6 month after the intervention (P<0.05). Conclusion:The transitional self-management intervention is an effective method to improve quality of life among patients with PCI.

Objective To evaluate the effects of transitional self-management intervention on patients after percutaneous coronary intervention ( PCI ) .Methods One hundred PCI patients were assigned into the control group (50 cases) and the intervention group (50 cases) according to draw method.The control group was treated with the cardiology conventional health education .The intervention group was treated with the self-management model and the transitional nursing model .The coronary artery self-management scale ( CSMS) was used to compare between the groups at one month and six month after PCI .Results There was no significant difference in the score of CSMS before the investigation (P>0.05).After one month of intervention, the score of daily management , disease management and emotional cognition of the intervention group were ( 48 .17 ± 7.20), (46.43 ±5.66) and (47.96 ±9.69), respectively, which were significantly higher than (30.68 ± 8.51), (33.40 ±4.86) and (22.44 ±8.56) in the control group, the difference was statistically significant (t=10.539, 10.767, 13.221, respectively;P <0.01).After six month of intervention, the score of daily management, disease management and emotional cognition of the intervention group were (58.83 ±6.16), (65.30 ±5.28) and (61.55 ±8.23), respectively, which were significantly higher than (30.68 ±8.51), (28.45 ±5.07) and (24.00 ±7.25) in the control group, the difference was statistically significant (t =18.373, 33.822, 22.929, respectively;P <0.01).After one month of intervention, the self-management knowledge and behavior of the intervention group were significantly better than the control group , the difference was statistically significant (P <0.05).At one month, the daily management, disease management and behavior of the control group was significantly improved , the difference was statistically significant (P<0.05).However , the score of disease management at six month after the intervention was significantly decreased compared with that at month, the difference was statistically significant (P<0.05).Conclusions Comparing with the conventional health education , the transitional self-management intervention is effective , and it is worthy of getting widely extension in hospital .

Objective To investigate the long-term quality of life ( QOL ) in the patients after percutaneous coronary intervention (PCI) and to explore its influencing factors in order to provide the basis for clinical nursing and health education .Methods A total of 1 028 patients with PCI from June 2012 to May 2013 were surveyed by the CROQ-PTCA-Post, and the results were analyzed .Results The average score of long-term QOL in patients with PCI was (69.58 ±7.97), and the scoring rate 69.6%.The scoring rates of different dimensions from high to low were respectively 97.3% ( adverse reactions ), 77.1% ( cognitive function ), 68.5%(treatment satisfaction), 60.3%(physical function), 58.9% (symptoms), 55.5% (psychological and social function ) .The one-way ANOVA showed that the differences were found between the total score of QOL in patients at the different stages after the operation and the scores of four dimensions including symptoms , physical function, psychological and social function , treatment satisfaction (P <0.01).Conclusions The long-term QOL in the patients after PCI is generally lower , and the various types of health education should be pertinently carried out , and the social support system should be fully mobilized , and the postoperative follow-up system should be improved in order to increase the long-term QOL in the patients .

阐述自我管理模式的内容，冠状动脉介入治疗病人自我管理现状，国内外对冠状动脉介入治疗自我管理干预的研究以及测评工具的研究进展，提出建立冠状动脉介入治疗病人自我管理行为干预方案的重要性。

Objective To develop an assessment tool for the simulated quality of standardized patients. Methods Based on the evaluation index system for the simulated quality of standardized patients, combining with relevant literatures,semi-structured interviews, expert advices and pre-test, a preliminary version of the scale had been formed. By investigating 598 students of the seven-year clinical medicine, the five-year clinical medicine, anesthesia and nursing in the objective structured clinical examination (OSCE),the final scale was formed and the reliability and validity of the scale were tested. Results The final formation of the SQSPS composed of 20 items, 3 factors and the cumulative variance contribution rate was 60. 826% . Cronbach’s alpha coefficient and the mean inter-item correlations were 0. 928 and 0. 394. Confirmatory factor analysis showed that the fit indexes X2、df、X2 / df、 RMSEA、GFI、AGFI、CFI、NFI、IFI and TLI were 448. 653、151. 000、2. 971、0. 055、0. 935、0. 909、0. 960、0. 942、0. 961、0. 950. Conclusions This scale has good reliability and validity and can be used as the evaluation tool for the simulated quality of standardized patients.

目的:了解标准化病人(SP)模拟质量的现状,为有针对性地提高SP的模拟水平提供实证依据.方法:应用标准化病人模拟质量评价量表(SQSPS)对某医科大学三所教学医院的临床、护理、麻醉专业参加客观结构化临床考试(OSCE)的598名医学生进行调查,被评价者为43名SP.结果:SP模拟质量的总体得分较高(90.15±10.01)分.其中“模拟态度”维度得分率最高,“模拟能力”维度得分率最低.不同类型SP之间的得分无统计学差异.不同专业的学生对SP的评分之间存在差异.结论:SP的整体模拟质量较高,不同类型的SP都能有效地胜任模拟病人的工作.学生对SP的评价受多方面因素的影响,今后对SP模拟质量的评价应多元化.

>随着世界经济的飞速发展,疾病致死原因也在随之改变,慢性病死亡人数在全世界范围占总死亡人数的60,76%,已成为世界人口死亡的主要原因 [1] 。慢性病已成为最普遍的全球卫生问题,全球卫生保健系统面临着巨大挑战。与此同时,慢性病的病程十分漫长,治疗过程往往伴随终生。因此,如何对慢性病进行防治与管理已经成为我国乃至世界医疗卫生研究的热点问题。慢性病患者与疾病长期作斗争,熟悉疾病全过程,决定了他们自己才是慢性病控制与管理的最佳人选 [2] ,即让患者进行有效的自我管理。自我管理干预作为一种行为学的策略和干预方法,强调患者本身对其健康的