基于5G物联网的认知行为疗法对老年冠心病经皮冠状动脉介入术后患者康复效果及运动恐惧的影响

doi:10.3969/j.issn.1006-5725.2024.23.017

Abstract

Abstract:

Objective To explore the effects of cognitive behavioral therapy based on 5G internet of things （IOT） on rehabilitation and kinesiophobia in elderly patients after percutaneous coronary intervention （PCI） for coronary artery disease. Methods Sixty elderly postoperative PCI patients with coronary artery disease admitted from June to December 2023 were selected as study subjects and randomly divided into the control group and the 5G group， with 30 cases in each group.The control groupreceived conventional nursing intervention， while the 5G group receivedcognitive behavioral therapy based on 5G IOT in addition to traditional nursing. Left ventricular ejection fraction （LVEF）， 6-minute walking distance （6MWD）， the Tampa Scale for kinesiophobia Heart （TSK-SV Heart） scores， the Seattle Angina Questionnaire （SAQ） scores， and rehabilitation compliance were compared between the two groups. Results 12 weeks afterintervention， LVEF and 6MWD in the 5G groupwere significantly improved as compared with those in the control group （P < 0.05）. The TSK-SV Heart scores in the 5G group werelower than those in the control group （P < 0.05），but the SAQ scores were higher （P < 0.05）. And the rate of better rehabilitation compliance in the 5G group was significantly higher than thatin the control group （P < 0.05）. Conclusions Cognitive behavioral therapy based on 5G IOT helps to improve the rehabilitation effect in elderly patients with coronary artery disease after PCI， reduce kinesiophobia， improve quality of life， and enhance rehabilitationcompliance， thus promoting the rehabilitation process of the patients.

Key words: 5G, internet of things, percutaneous coronary intervention, cognitive behavioral therapy, kinesiophobia

CLC Number:

R473.5

Jie LI,Nian DENG,Guofeng SHI,Tao XU,Li YANG,Yu ZHANG,Yueyue SONG,Yuanzhu LIAO,Yixia. ZHOU. Impacts of cognitive behavioral therapy based on 5G internet of things on rehabilitation and kinesiophobia in elderly patients with coronary artery diseasefollowing PCI[J]. The Journal of Practical Medicine, 2024, 40(23): 3384-3388.

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References 29

1	陈纪言，陈韵岱，韩雅玲，等. 经皮冠状动脉介入治疗术后运动康复专家共识［J］. 中国介入心脏病学杂志，2016，24（7）：361-369.
2	MAZNYCZKA A， HAWORTH P. Adjunctive Intracoronary Fibrinolytic Therapy During Primary Percutaneous Coronary Intervention［J］. Heart Lung Circ， 2021， 30（8）： 1140-1150. doi:10.1016/j.hlc.2021.02.016 doi: 10.1016/j.hlc.2021.02.016
3	HANSEN D， ABREU A， AMBROSETTI M， et al. Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond： why and how： a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology［J］. Eur J Prev Cardiol， 2022， 29（1）： 230-245. doi:10.1093/eurjpc/zwab007 doi: 10.1093/eurjpc/zwab007
4	KEESSEN P， DEN UIJL I， VISSER B， et al. Fear of movement in patients attending cardiac rehabilitation： A validation study［J］. J Rehabil Med， 2020， 52（2）： jrm21. doi:10.2340/16501977-2749 doi: 10.2340/16501977-2749
5	RICHMOND H. Using a CBT approach to manage low back pain［J］. Nurs Times， 2016， 112（18）： 12-14.
6	龙珊，刘兴德，李甜甜，等. 冠心病患者经皮冠状动脉介入治疗术后合并焦虑抑郁机制及治疗的研究进展［J］. 实用医学杂志，2023，39（21）：2850-2856. doi:10.3969/j.issn.1006-5725.2023.21.026 doi: 10.3969/j.issn.1006-5725.2023.21.026
7	马宗庆，陈坤，徐伟锋. “5G+物联网”技术用于大型综合医院设备管理系统中的策略分析［J］. 医疗装备，2024，37（5）：63-65.
8	叶玲燕，陈圆圆，金丽红，等. 云平台联合早期康复训练在经皮冠状动脉介入治疗术后运动康复高危患者中的应用［J］. 中华护理杂志，2022，57（23）：2851-2856.
9	韩雅玲. 2016中国经皮冠状动脉介入治疗指南解读［J］. 临床军医杂志，2016，44（5）：441-443.
10	中华医学会，中华医学会杂志社，中华医学会全科医学分会，等. 冠心病心脏康复基层指南（2020年）［J］. 中华全科医师杂志，2021，20（2）：150-165.
11	罗淳. 关于人口年龄组的重新划分及其蕴意［J］. 人口研究，2017，41（5）：16-25.
12	BACK M， JANSSON B， CIDER A， et al. Validation of a questionnaire to detect kinesiophobia （fear of movement） in patients with coronary artery disease［J］. J Rehabil Med， 2012， 44（4）： 363-369. doi:10.2340/16501977-0942 doi: 10.2340/16501977-0942
13	BACK M， CALDENIUS V， SVENSSON L， et al. Perceptions of Kinesiophobia in Relation to Physical Activity and Exercise After Myocardial Infarction： A Qualitative Study［J］. Phys Ther， 2020， 100（12）： 2110-2119. doi:10.1093/ptj/pzaa159 doi: 10.1093/ptj/pzaa159
14	LAPPALAINEN L， STENVALL H， LAVIKAINEN P， et al. Patient-reported outcomes in coronary artery disease： the relationship between the standard， disease-specific set by the International Consortium for Health Outcomes Measurement （ICHOM） and the generic health-related quality of life instrument 15D［J］. Health Qual Life Outcomes， 2021， 19（1）： 206. doi:10.1186/s12955-021-01841-6 doi: 10.1186/s12955-021-01841-6
15	赵燕乐，李转珍，李旭春，等. 冠心病特异性生活质量评估工具西雅图心绞痛量表的应用研究进展［J］. 全科护理，2023，21（9）：1191-1195.
16	WINZER E B， WOITEK F， LINKE A. Physical Activity in the Prevention and Treatment of Coronary Artery Disease［J］. J Am Heart Assoc， 2018， 7（4）：e007725. doi:10.1161/jaha.117.007725 doi: 10.1161/jaha.117.007725
17	PHILIPS H C. Avoidance behaviour and its role in sustaining chronic pain［J］. Behav Res Ther， 1987， 25（4）： 273-279. doi:10.1016/0005-7967(87)90005-2 doi: 10.1016/0005-7967(87)90005-2
18	周苔花，祁末红，朱萍，等. 老年心肌梗死患者A型行为与社会支持、心理健康、生活质量的关系［J］. 中国老年学杂志，2021，41（17）：3813-3815.
19	李琪，朴京京，万博雅，等. 冠心病病人运动恐惧的评价与干预研究进展［J］. 护理研究，2023，37（2）：269-272.
20	ROSENBAUM A N， KREMERS W K， SCHIRGER J A， et al. Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients［J］. Mayo Clin Proc， 2016， 91（2）： 149-156. doi:10.1016/j.mayocp.2015.12.002 doi: 10.1016/j.mayocp.2015.12.002
21	任月，田婷，韦光胜，等. Ⅰ期综合心脏康复对ST段抬高型心肌梗死急诊经皮冠状动脉介入术后患者的疗效［J］. 实用医学杂志，2024，40（5）：682-687. doi:10.3969/j.issn.1006-5725.2024.05.016 doi: 10.3969/j.issn.1006-5725.2024.05.016
22	郭佳茹，商临萍，杨丽洁，等. 冠心病患者参与心脏康复感知障碍的质性研究［J］. 护理学杂志，2019，34（24）：11-14.
23	王艳玲，张楠楠，阚亦非，等. 认知行为干预对冠心病PCI术后患者负性情绪、自我效能及生活质量的影响［J］. 齐鲁护理杂志，2022，28（18）：5-7.
24	BAYKAL S H， KALAYCIOGLU E， SAHIN M. The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease［J］. Turk J Phys Med Rehabil， 2021， 67（2）： 203-210. doi:10.5606/tftrd.2021.5164 doi: 10.5606/tftrd.2021.5164
25	周叶珍，蒋慧，曾肖娜，等. 冠心病心脏运动康复的心血管保护机制及临床获益研究进展［J］. 实用医学杂志，2020，36（8）：1000-1004.
26	周友根，宋平，邓晓剑，等. 认知行为疗法对冠心病患者心理及运动处方依从性的影响［J］. 心血管康复医学杂志，2018，27（4）：369-372.
27	曹红京，曲畅，张翠莲，等. 认知行为干预对冠心病患者负性情绪与治疗依从性的影响［J］. 中华现代护理杂志，2019，25（36）：4803-4806.
28	SODHRO A H， AWAD A I， BEEK J V D， et al. Intelligent authentication of 5G healthcare devices： A survey［J］. Int Things， 2022， 20： 100610. doi:10.1016/j.iot.2022.100610 doi: 10.1016/j.iot.2022.100610
29	田常俊. 基于患者体验的医疗服务质量评价研究［D］. 武汉：华中科技大学，2014.

项目	对照组（n = 30）	5G组（n = 30）	χ ² /t值	P值
性别			0.601	0.438
男	17（56.7）	14（46.7）
女	13（43.3）	16（53.3）
年龄（x ± s）/岁	69.47 ± 4.95	70.20 ± 5.55	-0.540	0.591
高血压	19（63.3）	17（56.7）	0.278	0.598
高血脂	21（70.0）	19（63.3）	0.300	0.584
糖尿病	10（33.3）	13（43.3）	0.635	0.426
心功能分级			0.617	0.432
Ⅰ	19（63.3）	16（53.3）
Ⅱ	11（36.7）	14（46.7）
病变血管数			0.888	0.642
1支	15（50.0）	13（43.3）
2支	10（33.3）	9（30.0）
3支	5（16.7）	8（26.7）

项目	对照组（n = 30）	5G组（n = 30）	t值	P值
LVEF
干预前	48.53 ± 6.70	47.30 ± 7.81	0.656	0.514
干预后	51.03 ± 6.59	55.60 ± 5.32	-2.952	0.005
t值	-2.115	-5.698
P值	0.043	0.000
6MWD/m
干预前	360.67 ± 47.02	356.77 ± 37.50	0.355	0.724
干预后	391.13 ± 37.38	419.70 ± 31.23	-3.212	0.002
t值	-3.630	-8.547
P值	0.001	0.000

运动恐惧	对照组（n = 30）	5G组（n = 30）	t值	P值
干预前	57.27 ± 9.05	58.30 ± 8.02	-0.468	0.641
干预后	53.80 ± 6.76	49.60 ± 6.75	2.408	0.019
t值	3.081	-5.868
P值	0.004	0.000

SAQ	对照组（n = 30）	5G组（n = 30）	t值	P值
干预前	58.17 ± 9.02	56.43 ± 8.27	0.776	0.441
干预后	69.03 ± 11.02	74.53 ± 9.13	-2.104	0.040
t值	-4.337	-9.163
P值	0.000	0.000

组别	康复依从性
组别	优	良	差	优良率/%
对照组（n = 30）	14（46.7）	8（26.7）	8（26.7）	73.3
5G组（n = 30）	18（60.0）	11（36.7）	1（3.3）	96.7
χ²值				4.706
P值				0.030

Impacts of cognitive behavioral therapy based on 5G internet of things on rehabilitation and kinesiophobia in elderly patients with coronary artery diseasefollowing PCI

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