以患者为主导的护理干预对消化道大出血患者焦虑情绪的影响

Effect of patient-oriented nursing intervention on the anxiety of patients with gastrointestinal hemorrhage

目的通过对消化道大出血患者焦虑情绪的护理干预，消除患者不良心理影响，使其积极配合治疗和护理。方法将2010年1月至2011年10月收治的100例消化道大出血患者按照入院顺序分为对照组和干预组各50例。对照组接受常规药物治疗和护理，干预组在此基础上，给予以患者为主导的护理干预，观察5周。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）分别在干预前后进行调查。结果实施护理干预前，两组患者的SAS及SDS得分比较，差异无统计学意义（P〉0．05）；实施护理干预后，两组患者的SAS及SDS得分均较干预前明显降低，其中干预组下降趋势更明显[SAS得分：（26．78±6．45）分比（52．98±6．78）分；SDS得分：（16．56±7．98）分比（38．16±4．38）分]，干预前后比较，差异均有统计学意义（t分别为10．03，10．30；P〈0．01）。干预组SAS得分为（26．78-4-6．45）分，对照组为（38．35±6．53）分，两组比较，差异有统计学意义（t=10．85，P〈0．01）；干预组SDS得分为（16．56±7．98）分，对照组为（23．01±5．98）分，两组比较，差异有统计学意义（t=11．09，P〈0．01）。结论通过认知、心理、行为等以患者为主导的护理干预能有效地减轻急性消化道大出血患者的焦虑情绪，从而促进患者康复。

Objective To eliminate undesirable psychological influence and help patients actively cooperate with treatment and nursing by means of nursing intervention with the anxiety of patients with gastrointestinal hemorrhage. Methods According to their admission order, 100 patients with gastrointestinal hemorrhage from Gastroenterology Department of Nanjing General Hospital of Nanjing Military Command from January 2010 to October 2011 were divided into control group （50 cases） and observation group （50 cases）. The control group received conventional drugs and nursing, while the observation group, in addition, received patient-oriented nursing intervention for 5 weeks. SAS and SDS were respectively used to investigate before and after the intervention. Results The differences between SAS and SDS scores of two groups before the intervention were not statistically significant （P 〉 0.05）. After the intervention, SAS and SDS scores of two groups were lower than that before the intervention, and the differences were statistically significant （t = 10.03, 10.30, respectively; P 〈0.01 ）. The SAS score of the observation group was （26.78 ±6.45） ,while that of the control group was （ 38.35 ± 6.53 ）, and the differences were statistically significant （ t = 10.85, P 〈 O. 01 ）. The SDS score of the observation group was （ 16.56 ±7.98） while that of the control group was （ 23. 01± 5.98）, and the differences were statistically significant （ t = 11.09, P 〈 O. O1 ）. Conclusions Patient-led nursing intervention by cognition, psychology and behavior can effectively reduce the anxiety of the patients with gastrointestinal hemorrhage, thus to promote their recovery from disease.