临床护理路径在白内障患者围手术期的应用

Clinical observation of clinical pathway of nursing in the perioperative nursing of cataract patients

目的观察临床护理路径在白内障患者围手术期护理中的应用效果，探讨提高白内障患者围手术期护理质量的措施。方法选择白内障手术患者80例，随机分为对照组40例和临床路径组40例，对照组患者围手术期实行常规专科护理，临床路径组患者围手术期在临床路径下实行专科护理，于住院时、手术前1d和手术后第2天比较两组患者的汉密尔顿抑郁量表（HAMD）及汉密尔顿焦虑量表（HAMA）评分，于出院前ld比较两组患者健康知识掌握情况及对住院期间的护理满意度，出院后第2周门诊随访比较两组患者视力恢复情况。结果临床路径组患者手术前1d和手术后第2天的HAMD评分分别为（23．4±2．7），（19．5±2．2）分，对照组分别为（30．5±3．1），（25．3±2．8）分，两组比较差异均有统计学意义（t值分别为2．013，2．237；P〈0．05）。临床路径组患者手术前1d和手术后第2天的HAMA评分分别为（24．1±3．3），（20．3±2．5）分，对照组分别为（31．7±3．6），（26．8±3．0）分，两组比较差异均有统计学意义（t值分别为2．263，2．371；P〈0．05）。两组健康知识掌握例数与临床护理满意度比较，差异均具有统计学意义（P〈0．05）；出院后第2周视力〈0．3和视力〉0．6的例数比较，差异均具有统计学意义（P〈0．05），临床路径组均显著优于对照组。结论应用临床护理路径对白内障患者进行围手术期护理，可有效缓解患者的负性情绪，提高患者对健康知识的掌握率与临床护理的满意度，促进患者的术后恢复。

Objective To observe the clinical effect of clinical pathway of nursing （CPN） on the cataract patients in the perioperative nursing and to research the measures to improve the nursing quality of it. Methods Totals of 80 cataract patients were collected and randomly divided into control group （ n = 40） and clinical pathway group （ n = 40）. The Hamilton Depression Scale （HAMD） score and Hamilton Anxiety Scale （HAMA） score at admission, 1 d before surgery and 2 d after surgery, the grasp rate of health knowledge and the nursing satisfaction before discharge, the recovery of vision acuity at the second week after discharge were observed and compared between two groups. Results The HAMD score at 1 d before surgery and 2 d after surgery was （23.4 ±2.7 ）, （ 19.5 ± 2.2） in chnical pathway group and （ 30.5 ± 3.1 ）, （25.3 ±2.8 ） in control group, and there was a statistical significant difference between two groups （t = 2. 013,2. 237; P 〈 0. 05）. The HAMA score at 1 d before surgery and 2 d after surgery was （ 24. 1 ± 3.3 ）, （ 20.3 ± 2.5 ） in clinical pathway group and （ 31.7 ± 3.6）, （26.8 ± 3.0） in control group, and there was a statistical significant difference between two groups （ t = 2. 263,2. 371 ; P 〈 0. 05 ）. There was a statistical significant difference between two groups as well as the grasp rate of health knowledge and the nursing satisfaction before discharge （ P 〈 0. 05）. And significant difference was found in the cases number of eyesight 〈 0.3 and eyesight 〉 0.6 at second week after discharge between control group and Clinical pathway group （ P 〈 0. 05 ）. Conclusions CPN should be actively promoted in the cataract patients in the perioperative nursing, and it could effectively alleviate the negative emotions, improve the grasp rate of health knowledge and the nursing satisfaction and promote the patient＇ s postoperative recovery.