预见性护理结合循证护理在手术患者中的应用

The Effects of Predictability Nursing Combined with Evidence-based Nursing on Surgical Patients

目的探讨预见性护理、循证护理以及预见性护理结合循证护理在手术患者中的应用效果。方法以该院2011年1月—2012年12月收治的1 488例手术患者为研究对象,将手术病人随机分为4组：A组371例,入院后按常规方式护理;B组377例,入院后按照预见性护理的方式护理;C组369例,入院后按循证护理的方式护理;D组372例,入院后按预见性护理和循证护理结合的方式进行护理。利用二元logistic回归和有序logistic回归的方法研究不同护理方式对病人的影响。结果研究人群共1 488例,其中男875例,女613例,平均年龄为（44.9±16.9）岁。相比于常规护理,预见性护理、循证护理以及预见性护理结合循证护理都能降低患者术前恐惧、术后并发症,提高疗效和病人满意度,并且预见性护理结合循证护理的效果比前两者更为显著。预见性护理结合循证护理的患者术前恐惧为常规护理的0.71（0.58~0.80）倍,术后并发症发病率为接受常规护理患者的0.79（0.67~0.91）倍,疗效为接受常规护理患者的1.34（1.25-1.41）倍,病人满意度为接受常规护理患者的2.11（1.97-2.34）倍。结论对手术患者开展预见性护理结合循证护理能有效的提高手术成功率,降低术后并发症。

Objective To study the effects of predictability nursing, evidence-based nursing and predictability nursing combined with evidence-based nursing on surgical patients. Methods 1488 surgical patients admitted in our hospital from January, 2011 to December, 2012 were randomly divided into four groups： group A（n=371）, group B（n=377）, group C（n=369） and group D（n= 372）. Group A was given conventional nursing, group B was given predictability nursing, group C was given evidence-based nursing, and group D was given predictability nursing combined with evidence-based nursing. The effects of the four nursing modes on surgical patients were analyzed by binary logistic regression method and ordinal logistic regression method. Results 1488 patients（875 males, 613 females, mean age 44.9卤16.9 years） were included in the present analysis. As compared to conventional nursing, we found that predictability nursing, evidence-based nursing and predictability nursing combined with evidence-based nursing could reduce preoperative fear and postoperative complications of the patients. And they also could improve the efficacy of surgery and patients＇ satisfaction. Moreover, the effects of the latter were much better than those of the former two. Patients using predictability nursing combined with evidence-based nursing had a lower risk of preoperative fear than patients using conventional nursing（OR： 0.71, 95% CI： 0.58~0.80）. Patients with predictability nursing combined with evidence-based nursing had a lower risk of complications than patients using conventional nursing（OR： 0.79, 95% CI： 0.67-0.91）. Patients with predictability nursing combined with evidence-based nursing had a higher ratio of the efficacy of surgery than patients using conventional nursing（OR： 1.34, 95% CI： 1.25~1.41）.Meanwhile, patients with predictability nursing combined with evidence-based nursing had a higher ratio of patients＇ satisfaction than patients using conventional nursing（OR： 2.11, 95% CI： 1.97-2.34）. Conclusion Predictability nursing combined with evidence-based nursing could effectively improve the success rate of operation and reduce the incidence of postoperative complications.