胸外科患者分级心理护理模式效果评价

Effect evaluation of hierarchical psychological nursing mode on patients in Thoracic Surgery Department

目的评价分级心理护理模式对胸外科患者的干预效果,为今后临床心理护理提供参考。方法选取2011年2月～2012年10月至武警内蒙古总队医院外三科住院治疗行择期胸外科手术的患者116例作为研究对象,将其分为干预组(n=86)和对照组(n=30)。计算患者术前SCL-90量表及匹兹堡睡眠指数量表得分,并根据评估结果将干预组患者划分心理护理等级,采取相应的分级护理策略进行干预,在术后出院前再次评估SCL-90量表及匹兹堡睡眠指数量表得分,同时比较术后恢复活动的时间、并发症发生情况。结果出院前干预组的SCL-90平均得分为(1.79±0.48)分,匹兹堡睡眠指数得分为(2.96±0.44)分;对照组SCL-90平均得分为(2.96±0.44)分,匹兹堡睡眠指数得分为(3.21±0.48)分,干预组及对照组得分均低于术前,差异有统计学意义(P<0.05)。通过分级心理护理干预,出院前干预组SCL-90平均得分及匹兹堡睡眠指数得分低于对照组,差异有统计学意义(P<0.01),但术后恢复活动时间及手术并发症发生率比较差异无统计学意义(P>0.05)。结论分级心理护理模式能够改善患者的术后负性情绪及睡眠质量,效果优于普通心理护理。

Objective To evaluate the effect of hierarchical psychological nursing mode for patients in thoracic surgery department,thus to provide reference for future clinical psychological nursing.Methods 116 cases of research objects were selected from inpatients who accepted selective thoracic surgery in the Third Department of Surgery of Inner Mongolia Armed Police Hospital from February 2011 to October 2012.They were divided into intervention group（n = 86） and control group（n = 30）.The patients were scored with preoperative SCL-90 scale and Pittsburgh sleep quality index.And according to the evaluation results,patients in intervention group were subdivided with psychologi cal nursing grade,and they were intervened with corresponding hierarchical nursing strategies.SCL-90 scale and Pittsburgh sleep quality index scores were evaluated again after operation and before discharge.Meanwhile,motion re covery time after operation and complications were compared.Results The average SCL-90 score in intervention group before discharge was（1.79 ±0.48） points,Pittsburgh sleep quality index score was（2.96 ±0.44） points.The average SCL-90 score in control group was（2.96 ±0.44） points,Pittsburgh sleep quality index score was（3.21 ±0.48） points.Postoperative score in intervention group and control group were both lower than that before operation,the difference was statistically significant（P〈0.05）.Through hierarchical psychological nursing intervention,the average SCL-90 score and Pittsburgh sleep quality index score in intervention group before discharge were lower than those in control group,the differences were statistically significant（P 0.01）.But the differences on postoperative motion recovery time and the incidence of operation complications were not statistically significant（P〈0.05）.Conclusion Hierarchical psychological nursing mode can improve patient＇s postoperative negative mood and sleep quality,the effect is better than that of common psychological nursing.