摘要
目的探讨追踪方法学为指导的责任制护理在急性加重期慢性阻塞性肺疾病(AECOPD)合并呼吸衰竭(RF)气管插管患者中的应用效果。方法选取2018年6月至2023年6月河南大学淮河医院收治的60例AECOPD合并RF气管插管患者作为研究对象,依据随机数表法分为观察组和对照组各30例。对照组患者实施常规护理干预,观察组患者在常规护理基础上实施追踪方法学为指导的责任制护理干预,两组患者均干预至转出ICU。比较两组患者干预前后的心理状态[汉米尔顿焦虑量表(HAMA)、汉米尔顿抑郁量表(HAMD)]、自我效能[一般自我效能感量表(GSES)]、疼痛程度[自制视觉模拟游标卡尺(VAS)]和生活质量[生活质量综合评定问卷(GQOLI-74)];同时比较两组患者的并发症发生率和康复效果。结果干预后,观察组患者的HAMA、HAMD分别为(5.24±2.78)分、(6.61±2.33)分,明显低于对照组的(8.57±3.65)分、(9.54±2.17)分,GSES评分为(31.69±3.54)分,明显高于对照组的(28.13±2.91)分,而VAS评分为(1.36±0.74)分,明显低于对照组的(2.93±0.85)分,差异均有统计学意义(P<0.05);干预后,观察组患者的躯体功能、心理功能、社会功能、物质生活评分分别为(80.38±6.81)分、(81.32±5.82)分、(85.49±4.63)分、(87.45±4.32)分,明显高于对照组的(71.64±5.57)分、(73.44±6.85)分、(79.38±5.48)分、(75.75±5.89)分,差异均有统计学意义(P<0.05);干预后,观察组患者的并发症发生率为0,明显低于对照组的13.33%,差异有统计学意义(P<0.05);干预后,观察组患者的ICU治疗时间、机械通气时间、住院时间分别为(6.72±1.35)d、(5.42±0.35)d、(13.39±2.61)d,明显短于对照组的(9.79±1.68)d、(6.79±0.68)d、(15.96±2.57)d,差异均具有统计学意义(P<0.05)。结论采用追踪方法学为指导的责任制护理能改善AECOPD合并RF患者的心理状态,增强自我效能,降低疼痛感,减少并发症发生,促进身体康复,提高生活质量。
Objective To investigate the effect of responsible nursing guided by tracking methodology in intu-bation of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respira-tory failure(RF).Methods Sixty patients with AECOPD and RF undergoing intubation who were admitted to Huaihe Hospital of Henan University from June 2018 to June 2023 were selected as the research subjects.They were randomly divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Patients in the control group received routine nursing intervention,while patients in the observation group re-ceived responsible nursing guided by tracking methodology on the basis of routine nursing intervention.The intervention was continued until the patients were transferred out of ICU.The psychological status[Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD)],self-efficacy[General Self-efficacy Scale(GSES)],pain level[self-made Visual Analogue Scale(VAS)],and quality of life[GQOLI-74]before and after intervention were compared between the two groups.Meanwhile,the incidence of complications and rehabilitation effect of pa-tients were compared between the two groups.Results After intervention,the HAMA and HAMD scores in the ob-servation group were(5.24±2.78)points and(6.61±2.33)points,respectively,which were significantly lower than(8.57±3.65)points and(9.54±2.17)points in the control group;the GSES score was(31.69±3.54)points,which was sig-nificantly higher than(28.13±2.91)points in the control group;the VAS score was(1.36±0.74)points,which was signifi-cantly lower than(2.93±0.85)points in the control group;the differences were statistically significant(P<0.05).After in-tervention,the physical function,mental function,social function,material life scores in the observation group were(80.38±6.81)points,(81.32±5.82)points,(85.49±4.63)points,(87.45±4.32)points,respectively,which were significant-ly higher than(71.64±5.57)points,(73.44±6.85)points,(79.38±5.48)points,(75.75±5.89)points in the control group(P<0.05).After intervention,the incidence of complications in the observation group was 0,which was significantly lower than 13.33%in the control group(P<0.05).After intervention,the length of ICU stay,mechanical ventilation time,length of hospital stay in the observation group were(6.72±1.35)d,(5.42±0.35)d,(13.39±2.61)d,respectively,which were signifi-cantly shorter than(9.79±1.68)d,(6.79±0.68)d,(15.96±2.57)d in the control group(P<0.05).Conclusion Responsible nursing guided by tracking methodology can improve the mental state,enhance self-efficacy,reduce pain,reduce compli-cations,promote physical rehabilitation,and improve quality of life in patients with AECOPD and RF.
作者
杨芳
王曼
赵敏华
徐锋
YANG Fang;WANG Man;ZHAO Min-hua;XU Feng(Department of Respiratory and Critical Care Medicine,Huaihe Hospital of Henan University,Kaifeng 475000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第8期1180-1184,共5页
Hainan Medical Journal
基金
河南省高等学校重点科研项目计划(编号:20B320001)。
关键词
急性加重期慢性阻塞性肺疾病
追踪方法学
责任制护理
心理状态
生活质量
并发症
Acute exacerbation of chronic obstructive pulmonary disease
Tracking methodology
Responsible nursing
Psychological state
Quality of life
Complications
