Study on the Application Effect of Nursing Intervention Based on the Transtheoretical Model in the Rehabilitation Treatment of Patients with Chronic Heart Failure.

OBJECTIVE: To analyze the application effect of nursing intervention based on the Transtheoretical Model in rehabilitating patients with chronic heart failure (CHF).

METHODS: A retrospective analysis of clinical data was conducted for 156 CHF patients admitted to our hospital from May 2019 to September 2022. All patients met the complete inclusion criteria. They were divided into two groups based on the different nursing interventions provided during their treatment. The control group (n=78) received the routine nursing intervention, while the observation group (n=78) received nursing intervention based on the Transtheoretical Model and the care provided to the control group. The treatment compliance (MMAS-8 scale), quality of life (MLHFQ questionnaire), self-care ability (ESCA scale), cardiopulmonary function [anaerobic threshold oxygen consumption (VO2AT), carbon dioxide ventilation equivalent slope (VE/VCO2), peak VO2], and rehospitalization rates were compared between the two groups.

RESULTS: Before the intervention, the two groups had no significant difference in MMAS-8 and MLHFQ scores (P > .05). After the intervention, the MMAS-8 scores in the observation group were significantly higher than those in the control group (7.25±0.64 vs. 6.32±0.98), indicating improved treatment compliance. Additionally, the MLHFQ scores were significantly lower in the observation group compared to the control group (48.61±10.42 vs. 57.43±12.15, P < .05), indicating an enhanced quality of life. Before the intervention, the two groups had no significant differences in self-care skills, self-concept, health knowledge level, and self-care responsibility level (P > .05). However, after the intervention, the observation group showed significantly higher self-care skills (33.89±6.16 vs. 28.56±5.84), self-concept (24.79±3.96 vs. 21.34±4.15), health knowledge level (57.43±6.84 vs. 49.23±7.26), and self-care responsibility level (19.67±3.83 vs. 16.47±3.72) than the control group (P < .05). Before the intervention, the two groups had no significant differences in VO2AT, VE/VCO2, and peak VO2 levels (P > .05). However, after the intervention, the observation group exhibited significantly higher VO2AT (12.79±2.42 vs. 11.68±2.43) and peak VO2 levels (19.58±2.72 vs. 18.15±2.36) compared to the control group. VE/VCO2 levels were significantly lower in the observation group compared to the control group (28.32±3.16 vs. 30.47±3.42, P < .05). The rehospitalization rate in the control group was 35.90%, while it was 10.26% in the observation group. The rehospitalization rate in the observation group was significantly lower than that in the control group (P < .05).

CONCLUSION: The integration of nursing intervention based on the Transtheoretical Model into the rehabilitation treatment of CHF patients exhibited significantly improved treatment compliance, enhanced self-care abilities, and favorable changes in cardiopulmonary function and quality of life. These outcomes carry important implications for CHF patients' overall health and well-being, including improved medication adherence, increased exercise tolerance, and reduced rehospitalization rates. The positive outcomes suggest that integrating nursing interventions based on the Transtheoretical Model into standard care for chronic heart failure patients holds promise, with potential applications in other chronic conditions, paving the way for personalized and effective healthcare strategies.