职业病护理评估方法及模式的构建与研究

Study of nursing assessment method and pattern design in occupational disease

目的探讨职业病护理评估方法与模式的研究设计和应用价值。方法构建职业病护理评估方法与标准，分病种进行设计，编制护理量化评估表。将2010年1月至2012年3月深圳市5种常见职业病（职业性三氯乙烯药疹样皮炎、职业性慢性正己烷中毒、职业性慢性苯中毒、职业性慢性铅中毒、肺尘埃沉着病）234名患者采用随机区组法分为对照组107例和观察组127例。对照组采用常规的评估方法（统一的职业病科首次护理评估单）及护理，观察组采用新设计的护理评估方法（入院时采用各病种的首次护理评估单，再采用各病种护理量化评估表）进行评估，并相应实施护理干预。比较护理人员采用两种职业病护理评估方法对不同病种、不同等级的职业病患者的身心症状护理评估效果及评估能力，并对患者、护士及医生作满意度调查，对护士职业病相关知识技能进行考核。结果观察组护理记录合格率、护理操作指导合格率分别为98．5％，98．4％，对照组为90．5％，91．3％，两组比较，差异有统计学意义（x。分别为6．16，5．16；P〈0．05）；观察组初级责任护士评估完整率及初级、高级责任护士评估差异率分别为96．9％，1．6％，均优于对照组的89．8％，8．7％，两组比较，差异有统计学意义（x2分别为4．06，5．16；P〈0．05）；评估设计研究前后患者及医生对护士的满意度[（40．35±4．86）分比（47．28±1．99）分、（41．06±3．52）分比（48．21±1．47）分]、护士职业病相关知识技能考核成绩[（82．52±5．24）分比（93．89±0．62）分]均明显提高，差异有统计学意义（u分别为17．76，13．00；t=10．16；P〈0．01）。结论职业病护理评估方法与模式的构建使专科护理人员专业技能稳步提高，全面提高了临床护理质量。

Objective TO explore the nursing assessment method and pattern design of occupational disease and its application value. Methods The nursing assessment methods and standards of occupational diseases was constructed and designed according to different diseases, and nursing quantitative evaluation scale was established. Totals of 234 patients were recruited and randomly divided into observational group （ n = 127 ） and control group （n = 107） between January 2010 and March 2012. Conventional nursing assessment methods and nursing care were adopted in the control group, while new designed assessment methods and corresponding nursing intervention were adopted in the observational group. Then, nurses＇ abilities of nursing assessment on different entity and rank occupational diseases, assessment effect, satisfaction degree of nurses, doctor and patients, the master status of occupation diseases knowledge and skills among nurses were observed. Results In observational group, qualified rate of nursing records and nursing operation guides qualified rate were 98.5% and 98.4% ,respectively, significantly higher than that （ 90.5% and 91.3% ） of control group （ X2 = 6. 16, 5.16 ;P 〈 0.05 ）. Between observational group and control group, the primary nurses＇ estimates integrity rate was 96% vs 89.8% and the difference ratio between primary nurses and senior primary nurses was 1.6% vs 8.7%, and the difference was statistically significant （ X2 = 4.06,5.16 ; P 〈 0.05 ）. Before and after the new nursing assessment designed, satisfaction degree of patients was （40.35 ±4.86） vs （47.28 ± 1.99）, and that of doctors was （41.06 ± 3.52） vs （48.21±1.47）,occupation diseases knowledge and skills score of nurses was （ 82.52 ±5.24 ） vs （ 93.89 ±0.62 ）, and the difference was statistically significant（ u = 17.76,13.00 ; t = 10.16 ;P 〈 0.01 ）. Conclusions The construction of nursing assessment method and pattern of occupational disease can improve professional skills of special nurses and improve the quality of clinical nursing.