护士观察量表在住院精神病患者中的应用探讨

Evaluating hospitalized psychiatric patients with NOSIE

目的应用护士观察量表(NOSIE)对住院精神病患者病情进行纵向观察评定,调查不同住院阶段、不同病种患者病情变化特点,协助护士完善护理评估、护理诊断及制定护理措施。方法运用护士用住院病人观察量表(NOSIE-30)对129例住院精神病患者进行评定。入院48小时内进行第一次评定,以后每周评定一次,出院时再评定一次。结果随着病情的缓解,患者的各项评分虽有明显改善,但是,在社会兴趣评分方面仍然处于较低水平。精神分裂症组与非精神分裂症组第一次评分比较显示：精神分裂症组个人整洁、总分、总积极分低于非精神分裂症组(P＜0．05)；而精神病表现分高于非精神分裂症组(P＜0．001),与精神分裂症患者精神病性症状较多相吻合。第二次评分比较显示：精神分裂症组精神病表现分仍然高于非精神分裂症组(P＜0．01),提示一周内精神病性症状缓解不明显；总积极分低于非精神分裂症组(P＜0．05)。第三次评分比较显示：非精神分裂症组激惹、抑郁分高于精神分裂症组(P＜0．05)。结论对新入院的精神分裂症患者护理工作重点在于生活护理和精神病症状的观察、处理；针对恢复期精神病患者存在社会兴趣的障碍,应该及早进行心理干预、行为治疗、健康教育,提高患者的康复效果。

Objective： To evaluate psychotic in- patients with NOSIE and to investigate illness characters of different phase and different psychosis of in - patients, and to help nurses to improve disease evaluation disease diagnosis, and to constitute nurse measures. Methods： To evaluate 129 psychotic in - patients with NOSIE -30 with the first evaluation done when the patients enterd the hospital within 48 hours, then the next evaluations execnted once a week, and the last evaluation finished when the patients left hospital. Results：The scores of patients had a significant improvement with the state of illness improved, but the social interesting scores of patients were low relatively. The individual tidiness, total scores and total positive scores of schizophrenia patients were lower than those of non - schizophrenia patients on the first evaluation （ P 〈 0. 05 ）. The psychosis scores of schizophrenia patients were higher than those of non - schizophrenia patients （ P 〈 0. 001 ）. Those resluts tally with schizophrenia patients having more psychosis syndromes. The scores of psychosis of schizophrenia patients were still higher than those of non - schizophrenia patients on the second evaluation （ P 〈 0. 01 ）, and that means the syndromes of psychosis had little improvement in the first week. The total positive scores of schizophrenia patients were lower than those of non - schizophrenia patients （ P 〈 0. 05 ）. The stimulation and depressive scores of non - schizophrenia patients were higher than those of schizophrenia patients （ P 〈 0. 05 ）. Conclusion： The emphases of schizophrenia patient nursing were living nursing, observation ,and the treatment of psychotic syndromes, but for convalescent patient, the emphases should be moved to mental intervention, behavior treatment, and health education to improve the rehabilitation quality of patients.