摘要
目的 探讨阶段性康复干预对重症监护病房(ICU)机械通气清醒患者康复效果、创伤后成长及应对方式的影响。方法 将96例ICU机械通气清醒患者按随机数字表法分为对照组和研究组,各48例。对照组患者给予常规护理干预,研究组患者在对照组基础上给予阶段性康复干预,观察住院全程。干预前后采用创伤后成长量表(PTGI)评估患者创伤后成长水平,采用简易应对方式问卷(SCSQ)评估患者的应对方式,比较干预前后两组患者呼吸指标(浅快呼吸指数、氧合指数)、康复情况、PTGI评分、SCSQ评分及不良事件发生率。结果 干预后两组患者浅快呼吸指数低于干预前(P<0.01),氧合指数均高于干预前(P<0.01),研究组优于对照组(P<0.01)。干预后两组患者SCSQ的消极应对维度评分低于干预前(P<0.01),SCSQ的积极应对维度评分及PTGI的人生感悟、新的可能性、个人力量维度评分均高于干预前(P<0.01),研究组优于对照组(P<0.01)。研究组患者ICU入住时长、机械通气时长短于对照组(P<0.01),脱机成功率高于对照组(P<0.05),不良事件总发生率低于对照组(P<0.05)。结论 阶段性康复干预可改善ICU机械通气清醒患者的呼吸状态,提高创伤后成长水平,缩短康复进程,转变其应对疾病的方式,降低不良事件发生率。
Objective To explore the influence of phased rehabilitation intervention(PRI) on the rehabilitation results,post-traumatic growth(PTG),and coping styles of conscious patients with mechanical ventilation in the ICU.Methods Ninety-six patients with mechanical ventilation in ICU were divided into control and research group with 48 cases in each according to random number table.Controls received routine nursing,research group did the PRI on the basis of control group,and the whole course of hospitalization was observed.Post-traumatic growth levels and coping styles were respectively assessed using Post-traumatic Growth Inventory(PTGI) and Simplified Coping Style Questionnaire(SCSQ) before and after intervention,pre-and post-intervention respiratory indexes(rapid shallow breathing index [RSBI] and oxygenation index),rehabilitation condition,PTGI and SCSQ score,and incidence of adverse events were compared between two groups.Results After intervention RSBIs in both groups were lower(P<0.01),oxygenation indexes higher(P<0.01) compared with pre-intervention,and those better in research than control group(P<0.01).After intervention scores on negative coping of the SCSQ in both groups were lower compared with pre-intervention(P<0.01),those on positive coping of the SCSQ as well as reflections on life,new possibilities,and personal power of the PTGI higher(P<0.01) compared with pre-intervention,and those better in research than control group(P<0.01).The length of ICU stay and duration of mechanical ventilation were shorter and off-line success rate was higher in research than control group(P<0.05 or 0.01);the total incidence of adverse events was lower in research than control group(P<0.05).Conclusion The PRI could improve respiratory status of conscious patients with mechanical ventilation in ICU and post-traumatic growth level,shorten rehabilitation process,change the styles of coping with disease,and lower the incidence of adverse events.
作者
杨阳
王淑敏
许琰
邵春梅
Yang Yang;Wang Shumin;Xu Yan;Shao Chunmei(The First People's Hospital of Shangqiu,Shangqiu 476100,Henan,China)
出处
《临床心身疾病杂志》
CAS
2024年第2期83-87,共5页
Journal of Clinical Psychosomatic Diseases
