认知行为干预结合疼痛控制管理对SICU严重创伤骨折患者术后康复的影响

The impact of cognitive behavioral intervention combined with pain control management on postoperative rehabilitation of SICU patients with severe traumatic fractures

目的 探讨认知行为干预结合疼痛控制管理对SICU严重创伤骨折患者术后康复的影响。方法 选取驻马店市中心医院重症医学科SICU于2020年11月-2022年10月收治的75例创伤骨折患者,以随机数字表法分为对照组(37例)和观察组(38例)。予以两组患者急诊救治后,实施早期微创内固定手术治疗,治疗期间,对照组患者接受科室规范化护理管理,观察组同时联合认知行为干预结合疼痛控制管理;术后随访3个月。分别于干预前和出院时对患者进行疼痛、睡眠质量评分评估;分别于出院时及干预后1个月、3个月对患者进行Berg平衡量表、中文版活动平衡信心量表评分评估;采用我院自行设计的护理满意度调查问卷评估2组护理满意度。结果 经过术后住院期间的护理干预,经比较,观察组出院时VAS和睡眠PSQI评分均较干预前降低,且比对照组降低显著(均P <0.05)。与出院时比较,干预后1个月和3个月时,两组患者平衡能力、活动平衡信心评分升高,各个观察时间点,观察组高于对照组(均P <0.05)。观察组总满意率为97.37%,显著高于对照组总满意率(81.08%)(P <0.05)。结论 认知行为干预结合疼痛控制管理对SICU严重创伤骨折应用效果确切,可有效减轻患者术后疼痛,改善睡眠质量;同时重建患者对疾病和术后康复的认知,缓解恐惧心理,有效提高了患者术后康复的积极性,进而提升活动平衡信心和平衡能力;患者对护理的满意度高,具有较高的推广价值。

Objective To explore the effect of cognitive behavioral intervention combined with pain control management on postoperative rehabilitation of SICU patients with severe traumatic fractures.Methods 75 patients with traumatic fractures admitted to Intensive Care Department,Zhumadian Central Hospital from November 2020 to October 2022 were selected and randomly divided into control group(37 cases)and observation group(38 cases).After emergency treatment,patients in the two groups were given early minimally invasive internal fixation surgery.During treatment,patients in the control group received standardized nursing management from the department,while patients in the observation group were combined with cognitive behavioral intervention and pain control management.Postoperative follow-up was 3 months.Pain and sleep quality were evaluated before intervention and at discharge.Berg balance Scale and the Chinese version of Activity Balance Confidence Scale were evaluated at discharge,1 month and 3 months after the intervention.The nursing satisfaction questionnaire designed by our hospital was used to evaluate the nursing satisfaction of two groups.Results After nursing intervention during postoperative hospitalization,VAS and sleep PSQI scores in the observation group at discharge were lower than those before intervention,and significantly lower than those in the control group(all P<0.05).Compared with discharge,at 1 and 3 months after intervention,the balance ability and activity balance confidence scores of the two groups were increased.At each observation time point,the observation group was higher than the control group(all P<0.05).The total satisfaction rate of observation group was 97.37%,which was significantly higher than that of the control group(81.08%)(P<0.05).Conclusion Cognitive behavioral intervention combined with pain control and management has a definite effective on SICU severe traumatic fractures,which can effectively alleviate postoperative pain and improve sleep quality.At the same time,it reconstructs the patient’s cognition of the disease and postoperative rehabilitation,alleviates the fear,effectively enhances the patient’s enthusiasm for postoperative rehabilitation,and further improves the confidence and balance ability of activity.The satisfaction of patients to nursing is high,which has a high popularization value.