心身护理在妇产科住院患者康复中的价值

Value of psychosomatic nursing in recovery of inpatient in obstetrics and gynecology department

目的探讨心身护理对妇产科住院患者日常生活能力及心身状态康复的影响。方法选择2011年7月-2014年6月陕西省咸阳市第一人民医院妇产科手术患者2549例,对其采取心身整体护理措施,干预前后分别采用日常生活活动能力（ADL）量表的Barthel指数、90项症状自评分量表（SCL-90）、社会支持评定量表（SSRS）观察患者日常生活能力、心身状况及社会支持度改善情况。结果护理干预前,客观评分Ⅰ级者所占比例（26.21%）低于主观评分Ⅰ级者（49.74%）,差异有统计学意义（P〈0.05）;客观评分Ⅱ级者所占比例（72.30%）高于主观评分Ⅱ级者（49.20%）,差异有统计学意义（P〈0.05）;主观评分与客观评分分布在干预前后差异无统计学意义（P〉0.05）。与干预前比较,干预后患者的SCL-90总分、阳性项目数、阳性均分、躯体因子、强迫因子、抑郁因子、焦虑因子、人际因子以及敌对因子得分均明显降低,差异均有统计学意义（P〈0.05）;SSRS总分、客观支持、主观支持及支持利用度得分明显升高,差异均有统计学意义（P〈0.05）。结论对妇产科住院患者采用心身护理,可有效提高患者ADL评分,降低SCL-90评分,提高其社会支持度,有利于患者康复,改善其预后。

Objective To discuss the effect of psychosomatic nursing on activity of daily living and psychosomatic rehabilitation of inpatient in obstetrics and gynecology department. Methods 2549 patients underwent surgery from July2011 to June 2014 in Obstetrics and Gynecology Department of the First People＇s Hospital of Xianyang City were selected. All patients were given psychosomatic nursing, the improvement conditions of activity of daily living, psychosomatic condition assessment, and social support were observed before and after nursing intervention by Barthel index of ADL scale, SCL-90, SSRS respectively. Results Before nursing intervention, proportion of objective scoring of grade Ⅰ（26.21%） was lower than subjective scoring（49.74%）, with statistically significant difference（P〈0.05）; proportion of objective scoring of grade Ⅱ（72.30%） was higher than subjective scoring（49.20%）, with statistically significant difference（P〈0.05）. After intervention, the distribution of subjective and objective scoring had no statistically significant difference（P〉0.05）. Compared with before nursing intervention, the total scores of SCL-90, positive item numbers,positive scores, scores of body factor, forcing factor, depression factor, anxiety factor, interpersonal factor and hostile factor were all lower after intervention, with statistically significant differences（P〈0.05）. After intervention total scores of SSRS, scores of objective support, subjective support and support availability were higher than before nursing intervention, with statistically significant differences（P〈0.05）. Conclusion Adopting psychosomatic nursing for inpatient in obstetrics and gynecology department can improve patients＇ ADL scores, reduce SCL-90 score, improve the degree of social support. It is beneficial to patients recovery, improves the prognosis.