社区老年性骨质疏松患者疼痛护理干预模式的构建与实施

Construction and implementation of pain nursing intervention mode for elderly osteoporosis patients in community

目的探索疼理干预模式对社区老年性骨质疏松患者疼痛管理的应用效果。方法将108例在百色市东合社区卫生服务中心门诊确诊的老年骨质疏松症患者随机分为干预组与对照组,每组54例。对照组给予传统治疗方法,干预组按预定的干预模式实施,即在传统治疗方法的基础上,给予疼痛评估并结合有效的疼痛护理干预措施。分别比较干预前、干预后6个月患者骨密度(BMD)、血碱性磷酸酶(AKP)及血钙(Ca)值,以及干预前、干预后3个月、干预后6个月患者疼痛程度及生活质量。结果通过疼痛干预模式实施6个月后,(1)干预组的踝关节与膝关节BMD值较干预前显著升高,且明显高于对照组(P<0.001);干预后6个月干预组AKP明显升高,血Ca值明显下降,与对照组比较差异有统计学意义(P<0.001)。(2)两组患者在干预后3个月、干预后6个月的VAS评分呈下降趋势(P<0. 01),但观察组各时间点均低于对照组,疼痛改善更为明显,差异有统计学意义(P<0.001)。(3)两组患者干预后的WHOQOL-BRLEF评分均比干预前升高(P<0.001),但干预组升高更明显,差异有统计学意义(P<0.001)。结果表明,干预组患者骨密度含量明显增加,疼痛症状明显减轻或消失,骨代谢生化指标明显下降,生活质量明显提高。结论疼痛护理干预模式的构建在社区老年性骨质疏松患者疼痛管理中应用切实可行,为各地社区护理服务中心开展病人疼痛健康教育提供有益的借鉴。

Objective To explore the application effect of pain nursing intervention mode for elderly patients with osteoporosis in community.Methods 108 elderly patients with osteoporosis diagnosed in Donghe Community Health Service Center of Baise City were randomly divided into intervention group and control group,with 54 cases in each group.The control group were treated with traditional therapy.However,the intervention group were treated with predetermined mode of intervention,that was,on the basis of traditional therapy,pain evaluation and effective pain nursing intervention were carried out.Bone mineral density(BMD),serum alkaline phosphatase(AKP)and serum calcium(Ca)before intervention and 6 months after intervention as well as pain degree and quality of life(QOL)before intervention,3 months after intervention and 6 months after intervention were compared between the two groups.Results (1)After 6 months of pain intervention,the BMD values of ankle joint and knee joint in the intervention group were significantly higher than those before the intervention,and significantly higher than those in the control group(P<0.001).And the AKP of the intervention group increased significantly,and the Ca value of the blood decreased significantly while comparing with the control group,difference was statistically significant(P<0.001).(2)The VAS scores of the two groups decreased at 3 months and 6 months after intervention(P<0.01),but those of the observation group were lower than those of the control at all time points,and the improvement of pain of the observation group was more obvious,so difference was statistically significant(P<0.001).(3)After intervention,the WHOQOL-BRLEF scores of the two groups increased while comparing with those before intervention(P<0.001),but the increase was more obvious in the intervention group,difference was statistically significant(P<0.001).The results showed that the content of BMD in the intervention group obviously increased,the symptoms of pain statistically alleviated or disappeared,the biochemical indexes of bone metabolism obviously decreased,and the quality of life obviously improved in the intervention group.Conclusion The construction of pain nursing intervention mode is feasible in the pain management of elderly patients with osteoporosis in the community.It provides a useful reference for community nursing service centers to carry out patients’pain health education.