护理延伸服务对白内障患者自我效能及负性情绪的影响

Effects of extended nursing service on serf-efficacy and negative emotions of cataract patients

目的探讨护理延伸服务对白内障患者自我效能以及负性情绪的影响。方法选择2014年6-12月白内障手术患者120例，随机分为对照组和观察组，每组60例。对照组给予常规出院指导和随访，观察组出院后实施护理延伸服务，对患者进行上门或电话随访，继续进行白内障术后恢复相关健康教育。于患者出院前1d和出院后3个月评估患者自我效能和自我管理能力、采用汉密尔顿焦虑量表（HAMA）和抑郁量表（HAMD）评估患者负性情绪。结果出院3个月后，观察组患者自我效能和自我管理能力评分分别为（35．8±3．7）分和（52．7±6．6）分，均高于对照组，差异有统计学意义（t值分别为2．645，2．884；P〈0．05）；观察组患者HAMD和HAMA评分分别为（11．8±3．7）分和（12．5±2．1）分，均低于对照组，差异有统计学意义（t值分别为2．664，2．887；P〈0．05）。结论护理延伸服务符合白内障术后患者生活中护理需求，可有效纠正出院后患者恢复期间的误区，协助患者进行自我护理监督，改善患者院外情绪，从而提高白内障患者院外生活质量。

Objective To explore the effects of extended nursing service on self-efficacy and negative emotions of cataract patients. Methods A total of 120 patients undergoing cataract surgery in department of ophthalmology from June to December 2014 were selected and divided randomly into control group and observation group, each with 60 cases. Patients in the control group were given routine discharge guidance and follow-up visit, while patients in the observation group were given extended nursing service after leaving hospital by visiting or calling and provided continue health education about postoperative recovery of cataract surgery. Self-efficacy and self-management abilities of patients were compared between 1 d before discharge and 3 months after discharge. Negative emotions of patients were evaluated by Hamilton anxiety scale （HAMA） and Hamilton depression scale （HAMD）. Results Three months after discharge, scores of self-efficacy and self-management abilities of patients in the observation group were （35.8 ± 3.7 ） and （52.7 ± 6.6） points, higher than those in the control group （ t = 2.645, 2. 884 ; P 〈 0.05 ）. HAMD and HAMA scores of patients in the observation group were （ 11.8 ± 3.7） and （ 12.5 ± 2.1 ） points, lower than those in the control group （t = 2.664, 2. 887 ; P 〈 0.05）. Conclusions Extended nursing service can meet nursing demands in cataract patients＇ life after the surgery, effectively correct misunderstandings of patients during the recovery period after discharge, assist patients to supervise self-care and improve patients＇ emotions, so as to improve the quality of life of cataract patients outside hospital.