“一病一优”护理模式对抑郁症住院患者自我效能感及疗效的影响

Effects of ＂one kind of high-quality nursing plan for one kind of disease＂ nursing model on self- efficacy and curative effect of depressive patients

目的探讨“一病一优”护理模式对不同程度抑郁症患者自我效能感的影响。方法选取2014年1月-2015年12月在山西医科大学第一医院精神卫生科进行住院治疗的120例抑郁症患者为研究对象，随机分为对照组和观察组各60例，对照组按照传统的护理流程进行管理，观察组采取“一病一优”护理模式进行管理；在患者入院时及入院15，30d分别进行汉密顿抑郁量表（HAMD）、一般自我效能量表（GSES）评估，比较对照组与观察组的差异；将观察组依据抑郁症严重程度分组，比较轻度、中度、重度抑郁症患者在入院时与15，30d后的HAMD、GSES评分差异。结果观察组在15d后（t=-2．79，P=0．01）、30d后（t=2．60，P=0．01）GSES评分高于对照组，同时观察组在15d后（t=2．19，P=0．03）、30d后（t=2．60，P=0．01）的HAMD评分低于对照组；观察组入院15d后，轻度（P〈0．01）、中度抑郁症患者（P=0．01）的HAMD减分率明显高于重度抑郁症患者。结论“一病一优”护理模式对促进抑郁症康复、提高抑郁症患者自我效能感的效果显著，尤其是轻、中度的抑郁症患者，同时使患者更加积极心态面对疾病，获得良好的临床治疗效果。

Objective To explore the effects of ＂one kind of high-quality nursing plan for one kind of disease＂ nursing model on self-efficacy and curative effect of depressive patients with different severity. Methods Totally 120 depressive patients hospitalized in the department of mental health of our hospital from January 2014 to December 2015 were selected as the research object, and they were assigned to the observation group（n= 60） and the control group（ n= 60）. Patients in the control group were given routine nursing procedure, while patients in the observation group were given ＂one kind of high-quality nursing plan for one kind of disease＂ nursing model. Patients were evaluated by Hamilton depression scale （HAMD） and general self-efficacy scale （GSES） at the beginning of hospitalization, 15 d and 30 d after hospitalization. The evaluation results were compared between two groups. Patients in the observation group were divided into 3 groups based on the severity of depression, and the scores of HAMD and GSES at the beginning of hospitalization, 15 d and 30 d after hospitalization were compared among 3 groups （mild group, moderate group and severe group）.Results The GSES score in the observation group at 15 d （t = - 2.79,P = 0.01 ） and 30 d （t = 2. 60,P = 0.01） after hospitalization was higher than that in the control group; the HAMD score in the observation group at 15 d （t = 2.19,P = 0.03） and 30 d （t = 2.60, p = 0.01） after hospitalization was lower than that in the control group ; the HAMD score-reducing rate of patients with mild depression （P 〈 0.01） and patients moderate depression （P = 0.01） in the observation group was significantly higher than that of severe patients.Conclusions ＂One kind of high-quality nursing plan for one kind of disease＂ nursing model has significant effect in promoting the rehabilitation of depression and enhancing self-efficacy of depressive patients, especially the patients with mild depression and moderate depression. It also can make the patients more positively faced with the disease, so to obtain good curative effect.