心理疏导联合健康宣教对高位复杂肛瘘术后患者换药时切口疼痛的效果评价

Effects of psychological counseling coupled with health education on the alleviation of pain during dressing change after surgery in the patients with high and complex anal fistula incision

目的探讨心理疏导联合健康宣教对高位复杂肛瘘术后患者换药时切口疼痛的效果。方法将77例行肛肠外科手术治疗的高位复杂性肛瘘患者根据其术后护理方法分为对照组(n=38)与观察组(n=39)。对照组采用常规护理,观察组在此基础上采用心理疏导联合健康宣教。比较2组患者换药时及换药后10 min视觉模拟评分(VAS评分)、健康教育达标率及护理工作满意度、换药后生活自理能力。结果 (1)2组患者换药后10 min VAS评分与换药时比较差异有统计学意义(P<0.05),且从术后第2天开始,观察组患者换药后10 min VAS评分均显著小于对照组患者换药后10 min VAS评分,差异有统计学意义(P<0.05);(2)观察组患者健康教育达标率及护理工作满意度(94.84%,100%)均显著高于对照组(86.84%,89.47%),差异有统计学意义(P<0.05);(3)观察组患者换药后生活自理能力优良率(89.74%)高于对照组(81.58%),差异有统计学意义(P<0.05)。结论心理疏导联合健康宣教可有效缓解高位复杂肛瘘术后患者换药时切口疼痛,改善患者生活质量,提高护理满意度及生活自理能力。

Objective To explore the effects of psychological counseling coupled with health education on the alleviation of pain during dressing change after surgery in the patients with high and complex anal fistula incision. Methods Seventy-seven patients with high and complex anorectal surgery were divided into two groups in accordance with different nursing methods after surgery： the control group （n = 38） and the observation group （n =39）. The control group received routine nursing care, while the observation group was given psychological counseling coupled with health education in addition to routine nursing care. Then, comparisons were made in visual analogue scores （VAS） at the time of dressing change and 10 min after dressing change, the rate of reaching the set health education standards/the rate of satisfaction with nursing care, the SF-36 scores at the time of dressing change and 10 min after dressing change, as well as the ability of self-care after dressing change. Results （1） Ten minutes after dressing change, the VAS scores of the 2 groups were all significantly lower than those at the time of dressing change（P 〈0. 01 ）. Furthermore, from the second day after surgery, the VAS scores of the observation group 10 min after dressing change were significantly lower than those of the control group at the same time point of dressing change（P 〈0. 01） . Statistical significance could be noted, when comparisons were made be-tween them（P 〈 0. 05） . （2） The rate of reaching the set health education standards/the rate of satisfaction with nursing care for the ob-servation group were as high as 94. 84% and 100% , which were obviously higher than those of the control group（86. 84% , 89. 47% ）, with statistical significance （ P 〈 0. 05 ） . （ 3 ） The excellent rate of self-care after dressing change for the observation group was as high as 89. 74% , which was significantly higher than that of the control group （81. 58%） , also with statistical significance （P 〈 0. 05 ） . Conclusion Psychological counseling coupled with health education could effectively alleviate pain during dressing change after surgery in the patients with high and complex anal fistula incision, improve their life quality and increase the rate of satisfaction with nursing care and the ability of self-care.