肾移植术后发生急性排斥反应患者舒适状况研究

Study on Patients' Comfort Status in Acute Reject Reaction after Kidney Transplantation

目的了解肾移植术后发生急性排斥反应患者的舒适状况,为舒适护理提供依据。方法采用肾移植受者舒适量表于2005年11月-2006年8月对22例肾移植术后发生急性排斥反应逆转后的患者进行调查。量表根据肾移植受者特点,在美国舒适护理专家Kolcaba研制的简化舒适状况量表(GCQ)基础上修订而成。结果肾移植术后发生急性排斥反应的患者整体舒适感不高[得分(56.91±6.74)分,总分100分,62.5分以下为舒适感差]。在精神心理领域主要存在对疾病康复担心引起的沮丧、焦虑、不确定感以及缺乏信心等不适;生理不适主要是疲乏、疼痛、口渴、入睡困难及胃肠不适等;社会领域的不适主要体现为缺乏康复相关知识及他人的理解和同情以及对经济的担忧。经多元逐步回归分析表明影响其舒适的主要人口学因素是性别(X^1)和住院费用来源(X^7),回归方程为:=63.44-8.07X^1+2.66X^7。结论肾移植术后发生急性排斥反应的患者在精神心理和生理领域舒适感差,社会领域和环境领域舒适感相对较好。从缓解精神心理不适、促进生理舒适及社会支持、营造舒适的病房环境等方面针对性地提出健康教育、按摩、缓解疼痛、满足睡眠习惯、促进社会支持等舒适护理措施。

Objective To understand patients＇ comfort status in acute rejection reaction after kidney transplantation and supply bases for comfort nursing. Methods From Dec, 2005 to Aug, 2006, 22 patients of acute reject reaction adverse after kidney transplantation were investigated with Comfort Scale. This scale was based on GCQ by Kolcaba （ American Comfort Nursing Expert） and characteristics of kidney transplant recipients. Results The average score of patients＇ comfort after kidney transplantation was （56.91±6.74） which was not good （the total score was 100 and the score under 62.5 indicated discomfort）. Psychological problems included depression, anxiety, uncertainty and lack of confidence caused by worries about reoccurrence. Physical problems included tiredness, pain, thirst, poor sleep and digestical dysfunction. Sociological problems included lack of related health knowledge and other＇s sympathy and financial worries. Demographic problems included genders（X3 and resources of medical fees（X7） according to multiple stepwise regression analysis. The regression equation was： y^^ =63.44-8.07X1＋2.66X7. Conclusion Patients with acute rejection reaction have psychological problems and physical problems while they have less sociological problems. The comfort nursing measures include health education, massage, reducing pain, good sleep habit and social support in order to ease psychological problems, promote physical comfort and create good ward environment.