Smart Nursing-Based Tripartite Dual-Track Interactive Nursing in Elderly Patients with Coronary Heart Disease Complicated by the "Three Highs"

Summary

This study found that smart nursing-based tripartite dual-track interactive nursing helps to improve the quality of rehabilitation in elderly coronary heart disease patients with diabetes, hypertension, or hyperlipidemia.

Abstract

The objective of this study was to evaluate the effectiveness of the Tripartite Dual-Track Interactive Nursing (TDTIN) model, incorporating smart nursing technologies, in elderly patients with coronary heart disease (CHD) complicated by hypertension, hyperglycemia, and hyperlipidemia (collectively termed the "three highs"), and to verify its improvement effects on patients' self-care capacity, quality of life, and psychological well-being. A randomized controlled trial was conducted with 162 elderly CHD patients with the "three highs," allocated equally into an observation group (n = 81, receiving smart nursing-based TDTIN) and a conventional group (n = 81, receiving conventional care). Both groups were monitored for 3 months post-discharge. Standardized assessments included the Exercise of Self-Care Agency (ESCA) scale for self-care ability, the Barthel Index (BI) for activities of daily living, the Hamilton Anxiety (HAMA) and Depression (HAMD) scales for psychological status, a self-made scale for compliance, and a satisfaction survey. Compared to the conventional group, the observation group demonstrated significantly greater improvements in self-care ability (ESCA) and quality of life (BI), along with lower HAMA and HAMD scores (P < 0.05). The observation group also exhibited higher treatment compliance and satisfaction ratings (P < 0.05). Additionally, caregivers in the observation group showed enhanced caregiving skills and support scores (P < 0.05). The TDTIN model, leveraging smart nursing, significantly enhances self-care capacity, quality of life, treatment compliance, and psychological outcomes in elderly CHD patients with the "three highs," while strengthening family-community support systems.

Introduction

The accelerating pace of global aging has led to a growing prevalence of comorbidities, particularly the concurrent presence of coronary heart disease (CHD) and metabolic disorders-hypertension, hyperglycemia, and hyperlipidemia (collectively termed the "three highs")-among elderly populations^1,2. Epidemiological data reveal that in China, approximately 35% of individuals aged 60 and above suffer from CHD in combination with at least one of these metabolic abnormalities. Notably, the risk of cardiovascular events in such patients is 2-3 times higher compared to those with a single condition, while the five-yea....

Protocol

This study has completed clinical trial registration (No: ChiCTR2500104288) and has been approved by the ethics committee of the hospital, and all participants remained unaware of their group allocation throughout the study period.

Study subjects
Patients with CHD complicated by the "three highs" who were admitted to the hospital between August 2023 and January 2025 were selected as the study participants. Sample size calculation was performed using GPower 3.1.9.7. Assuming a medium effect size (Cohen's d=0.5), α=0.05, and power (1-β)=0.80, a total sample size of 164 participants (n = 70/group) was required. In addition....

Results

General information
First, we compared the clinical baseline data of the two groups, and the results showed that there were no differences in clinical baseline data between the two groups (P > 0.05) (Table 1).

Comparison of self-care skills
Comparison results of ESCA scale findings showed that there was no difference between the baseline scores of the two groups (P > 0.05), the scores of self-care responsibility and self-care ski.......

Discussion

This study evaluated the effectiveness of smart nursing-based TDTIN versus conventional nursing in elderly patients with CHD complicated by the "three highs". The results demonstrated that the observation group exhibited significantly greater improvements in self-care capacity, quality of life, emotional regulation, family caregiver competence, treatment adherence, and nursing satisfaction compared to the conventional group receiving conventional care. These robust findings underscore the clinical value and potential sup.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Blood glucose meter 701	Jump of fish	20162400064	Used to detect the glucose concentration in capillary whole blood in hospital and home.
Blood pressure meter U701	Omron	20152070051	Blood pressure was monitored by smart compression technology
GPower	Heinrich-Heine-Universität Düsseldorf	v.3.1.9.7	G*Power was used for sample size calculation, statistical power analysis, and effect size estimation.
Mi Band	Xioami	https://www.mi.com/ae-en/product/xiaomi-smart-band-7/
SPSS 25.0	IBM	https://www.ibm.com/products/spss-statistics	Statistical analysis software
Wechat	Tencent	https://weixin.qq.com/	A free application that provides instant messaging services for smart terminals.