个案管理模式在类风湿关节炎患者护理中的应用效果研究

Study on the application effect of case management mode in the nursing of patients with rheumatoid arthritis

目的探讨个案管理模式在类风湿关节炎(RA)患者护理中的应用效果。方法 96例类风湿关节炎患者,随机分为观察组和对照组,各48例。对照组患者给予常规治疗及护理,观察组患者在对照组基础上进行个案管理干预比较两组患者干预前后晨僵时间、关节疼痛指数、关节肿胀个数、类风湿因子、C-反应蛋白、红细胞沉降率、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分及生活质量评分。结果干预后,两组晨僵时间、关节疼痛指数、关节肿胀个数均优于干预前,且观察组优于对照组,差异有统计学意义(P<0.05),干预后,两组类风湿因子、C-反应蛋白、红细胞沉降率水平均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组SAS、SDS评分均低于干预前,且观察组SAS(29.45±5.34)分、SDS评分(30.06±5.67)分均低于对照组的(37.41±6.95)、(38.71±6.89)分,差异有统计学意义(P<0.05)。干预后,两组患者生理功能、生理职能、躯体疼痛、总体健康、活力、情感职能、精神健康、社会功能评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论通过实施个案管理,可以提高类风湿关节炎患者的临床治疗效果,改善生活质量及心理情绪情况。

Objective To discuss the application effect of case management mode in the nursing of patients with rheumatoid arthritis (RA). Methods A total of 96 patients with rheumatoid arthritis were randomly divided into observation group and control group, with 48 cases in each group. The control group received routine therapy and nursing, and the observation group received case management on the basis of the control group. Comparison were made on morning stiffness time, joint pain index, number of joint swelling, rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score and quality of life score before and after intervention between the two groups. Results After intervention, both groups had better morning stiffness time, joint pain index, number of joint swelling than those before intervention, and the observation group was better than the control group. Their difference was statistically significant (P<0.05). After intervention, both groups had lower rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate than those before intervention, and the observation group was lower than the control group. Their difference was statistically significant (P<0.05). After intervention, both groups had lower SAS and SDS score than those before intervention, and the observation group had lower SAS score as SAS (29.45 ± 5.34) points and SDS score as (30.06 ± 5.67) points than (37.41 ± 6.95) and (38.71 ± 6.89) points in the control group. Their difference was statistically significant (P<0.05). After intervention, both groups had higher physiological, physiological, physical pain, general health, vitality, emotional function, mental health, social function score than those before intervention, and the observation group was higher than the control group. Their difference was statistically significant (P<0.05). Conclusion Application of case management can improve the clinical treatment effect of patients with rheumatoid arthritis and improve the quality of life and psychological mood.