循证护理对首发脑卒中患者情绪状态的影响

Effect of Evidence-based Nursing on Emotional State of Patients with First Stroke

目的：探究对首发脑卒中患者采用循证护理后对其情绪状态的影响,为首发脑卒中的护理提供理论依据。方法：本探究采用回顾性分析的方法,研究对象选择2015年8月-2016年8月于我院治疗的110例首发脑卒中患者,两组患者均进行积极的常规治疗,将采用常规护理的55例患者设为对照组,采用循证护理的55例患者设为观察组。比较两组患者护理前后医学应对方式评分,并比较护理前后两组患者生存质量、焦虑及抑郁水平,评价两组患者护理前后负性面情绪的改善。结果：观察组护理后医学应对方式量表（NCMQ）中面对评分、回避评分以及屈服评分均与对照组具有显著性差异,有统计学意义（t=9.692,5.279,-4.569;P〈0.001）;两组患者护理前后SAS、HAMD、WHOQOL-100评分差异显著,且护理后观察组与对照组具有显著性差异,有统计学意义（t=-4.335,-8.249,5.191;P〈0.001）;观察组护理后PANAS负性评分中害怕、害羞、易怒、紧张、心神不宁、敌意、坐立不安、内疚、恐惧、心烦意乱等显著低于对照组,有统计学意义（P〈0.001）。结论：对于首发脑卒中患者,循证护理能通过护理人员个人技能、经验结合患者具体情况、愿望等开展护理工作,显著改善患者的应对方式以及负面情绪状态。

Objective：To study the effect of evidence-based nursing on emotional state of patients with first stroke,so as to provide theory gist for nursing of first stroke.Methods：Retrospective analysis was conducted on the study,and 110 cases of patients with first stroke treated in our hospital since August 2015 to August 2016 were selected as the object of study.Patients in two groups were provided with active conventional treatment,and 55 cases of patients with conventional nursing were set as control group,while the other 55 cases of patients with evidencebased nursing were set as observation group.Patients in two groups were compared for scores of medical coping style before and after nursing as well as quality of living,anxiety and depression level before and after nursing.They were also evaluated for improvement of negative emotions before and after nursing.Results：After nursing,confrontment,avoidance and yieldance scores in medical coping modes questionnaire（NCMQ）of observation group were distinctly differed from those in control group（t=9.692,5.279,-4.569,P〈0.001）.There were significant differences in SAS,HAMD and WHOQOL-100 scores between patients in two groups before and after nursing,and there were significant differences between observation group and control group（t=-4.335,-8.249,5.191,P〈0.001）.After nursing,the scores of fear,shyness,irritability,being nervous,feeling ill at ease,hostility,feeling restless,guilt,feeling scary and distracted of observation group in PANAS negative scoring were significantly lower than those in the control group（P〈0.001）.Conclusion：As for patients with first stroke,evidence-based nursing can improve copying style and state of negative emotion of patients dramatically by personal skills and experience of nursing personnel as well as specific conditions and wisher of patients.