心理护理干预在产后神经性尿失禁患者中的应用

Application of psychological nursing intervention in patients with neurogenic urinary incontinence after delivery

目的探讨心理护理干预在产后神经性尿失禁患者中的应用情况。方法分析2014年1月-2015年7月在陕西省榆林市第二医院急诊医学科治疗的144例产后神经性尿失禁患者的临床资料，依据护理干预措施的不同将患者分为常规护理干预组（日常生活基础护理措施）和心理护理干预组（和谐环境、健康教育、功能训练、生活和饮食、社会支持），各72例，两组患者均干预3个月。观察两组心理护理需求情况和护理干预前后症状总积分、社会支持评分、抑郁评分、焦虑评分，比较两组满意度和复发率情况。结果心理护理干预组心理护理总时间[（368．3±30．1）min]、每天心理护理时间[（22．9±4．2）min／d]、心理护理总频次[（46．8±7．2）次]、每天心理护理频次[（2．5±0．4）次／d]均高于常规护理干预组[（320．5±26．7）min、（15．4±3．0）min／d、（35．6±6．1）次、（1．8±0．3）次／d]，差异均有统计学意义（P〈0．05）。常规护理干预组和心理护理干预组护理干预前症状总积分[（6．0±2．2）、（6．1±2．4）分]、社会支持评分[（41．5±6．4）、（42．1±6,8）分]、抑郁评分[（51．7±5．2）、（51．3±5．0）分]、焦虑评分[（52．1±5．0）、（52．3±5.3）分]比较差异均无统计学意义（P〉0．05），干预后常规护理干预组和心理护理干预组症状总积分[（1．9±0．7）、（1．0±0．5）分]、抑郁评分[（44．4±4．3）、（39．6±3．5）分1、焦虑评分[（45．8±4．3）、（40．8±4．0）分]均低于干预前，社会支持评分[（62．8±7．9）、（73．4±8．0）分1高于干预前，差异均有统计学意义（P〈0．05），且心理护理干预组干预后症状总积分、抑郁评分、焦虑评分均低于常规护理干预组，社会支持评分高于常规护理干预组，差异均有统计学意义（P〈0．05）。心理护理干预组满意度（97．2％）高于常规护理干预组（80．6％），复发率（2．8％）低于常规护理干预组（13．9％），差异均有统计学意义（P〈0．05）。结论心理护理干预应用于产后神经性尿失禁患者可以有效减轻患者的心理负担，提升满意度。具有较大的临床价值。

Objective To investigate the application conditions of psychological nursing intervention in patients with neurogenie urinary incontinence after delivery. Methods The clinical data of 144 cases with neurogenic urinary incontinence after delivery treated in Department of Emergency Medicine, the Second Hospital of Yulin City from January 2014 to July 2015 was analyzed. The patients were divided into routine nursing intervention group （basic nursing measures of daily life） and psychological nursing intervention group （harmonious environment, health education, functional exercise, life and diet, social support）, with 72 cases in each group, both groups were intervened for 3 months. The conditions of psychological nursing needs and the total symptom score, social support score, depression score, anxiety score before and after nursing intervention in the two groups were observed, the degree of satisfaction and recurrence rate of the two groups were compared. Results The total time of psychological nursing [（368.3±30.1） min], the time of psychological nursing every day [（22.9±4.2） min/d], the total frequency of psychological nursing [（46.8±7.2） times], the frequency of psychological nursing every day [（2.5±0.4） times/d] in the psychological nursing intervention group were all higher than those of routine nursing intervention group [（320.5±26.7） min, （15.4±3.0） min/d, （35.6±6.1） times, （1.8± 0.3） times/d], the differences were all statistically significant （P 〈 0.05）. There were no statistically significant differences of total symptom score [（6.0±2.2）, （6.1_±2.4） points], social support score [（41.5±6.4）, （42.1±6.8） points], depression score [（51.7±5.2）, （51.3±5.0） points], anxiety score [（52.1±5.0）, （52.3±5.3） points] before intervention between routine nursing intervention group and psychological nursing intervention group （P 〉 0.05）, after intervention, the total symptom score [（1.9±0.7）, （1.0±0.5） points], depression score [（44.4±4.3）, （39.6±3.5） points], anxiety score [（45.8±4.3）, （40.84.0） points] in routine nursing intervention group and psychological nursing intervention group were all lower than those before intervention, the social support score [（62.8±7.9）, （73.4±8,0） points] was higher than that before intervention, the differences were all statistically significant （P 〈 0.05）, and the total symptom score, depression score, anxiety score after intervention in the psychological nursing intervention group were all lower than those of routine nursing intervention group, the social support score was higher than that of routine nursing intervention group, the differences were all statistically significant （P 〈 0.05）. The degree of satisfaction in psychological nursing intervention group （97.2%） was higher than that of routine nursing intervention group （80.6%）, the recurrence rate （2.8%） was lower than that of routine nursing intervention group （13.9%）, the differences were all statistically significant （P 〈 0.05）. Conclusion Application of psychological nursing intervention in patients with neurogenic urinary incontinence after delivery can effectively reduce the psychological burden of patients, improve degree of satisfaction, which has great clinical value.