护理干预对喉切除患者生活质量的影响及效果评价

Impact and effectiveness evaluation of nursing intervention on quality of life in patients with laryngectomy

目的通过观察喉切除患者在手术前后心理状态的变化,探讨规范的护理干预措施对全喉切除患者生活质量的影响效果。方法将64例全喉切除患者随机分为干预组(36例)和对照组(28例),对照组进行常规的临床护理,干预组除进行常规的护理外,由专业的护士进行心理干预,包括心理支持、放松训练、沟通模式重建及康复指导等。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)等测评量表评价两组患者的心理状况。结果干预组手术后焦虑障碍程度及抑郁程度均得到明显改善,与手术前比较差异均有统计学意义(χ2=12.1755,P=0.0068;χ2=9.0352,P=0.0288);对照组手术前后焦虑障碍程度及抑郁程度比较差异无统计学意义(χ2=0.4563,P=0.6442;χ2=0.3894,P=0.9424)。两组患者术前SDS、SAS总评分比较差异无统计学意义(P>0.05),而术后SAS、SDS总评分比较差异有高度统计学意义(t=2.847,P﹤0.01;t=2.904,P﹤0.01),干预组患者状态明显优于对照组。结论针对性护理干预可明显降低患者的焦虑及抑郁程度,缓解患者的不良心理状态,提高喉切除患者的生活质量。

Objective To evaluate the effect of nursing intervention on the patients with total laryngectomy through analyzing data obtained from scales assessing patients’ pre and post operation psychological condition. Methods The patients were randomly divided into intervention group with 64 cases and control group with 28 cases, providing the former with normal nursing, and the latter with both normal nursing and mental intervention such as psychological support, relaxation exercise, reconstruction of communication model and rehabilitation guidance. Patients’ psychological condition in both groups was assessed with self-rating anxiety scale （SAS） and self-rating depression scale （SDS）. Results First, compared with pre-operation assessment, the patients’ post-operation anxiety disorders in the intervention group were improved with statistically significanct difference （χ2=12.1755, P=0.0068）, whereas the control group showed some statistical differences （χ2=8.0586, P=0.0448）. Second, compared with pre-operation assessment, the patients’ post-operation depression in the intervention group was improved with statistically significant differences （χ2=9.0352, P=0.0288）, while the control group showed no statistically significant differences （χ2=0.3894, P=0.9424）. Third, the comparison between the two groups’ pre-operation scores obtained from SDS and SAS displayed little differences, while the comparison between the two groups’ post-operation SDS and SAS scores displayed statistically significant differences （SAS t=2.847, P0.01）（SDS t=2.904, P0.01）. Patients situation in intervention group was better than control group. Conclusion The nursing intervention obviously reduces the patients’ anxiety and depression, improves the patients’ psychological condition and life quality with total laryngectomy.