延续性护理对严重创伤患者ICU后综合征的效果

Effect of continuous nursing on post-ICU syndrome in patients with severe trauma

目的探讨延续性护理对严重创伤患者ICU后综合征(PICS)的效果。方法选取2016年1月~2018年9月我院收治的86例严重创伤的ICU患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组各43例。对照组患者给予常规护理干预,观察组患者在对照组基础上给予延续性护理干预。比较两组患者的PICS发生率、干预前后的心理韧性[中文版心理韧性量表(CD-RISC)]和负性情绪情况[焦虑自评量表(SAS)和抑郁自评量表(SDS)]以及干预6个月后的生活质量[健康测量量表(SF-36)中文版]和护理满意度(本院自制的护理满意度调查表)。结果观察组患者的PICS发生率(4.65%)低于对照组(18.61%),差异有统计学意义(P<0.05)。干预前,两组患者的CD-RISC、SAS、SDS评分比较,差异均无统计学意义(P>0.05);干预后,两组患者的CD-RISC评分均高于本组干预前,SAS、SDS评分均低于本组干预前,差异有统计学意义(P<0.05);观察组患者干预后的CD-RISC评分高于对照组,SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05)。干预6个月后,两组患者的SF-36各项评分中除躯体疼痛项评分比较,差异无统计学意义(P>0.05)外,其余各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者的护理总满意度(100%)高于对照组(79.07%),差异有统计学意义(P<0.05)。结论延续性护理干预应用于严重创伤患者PICS中,能够提高患者的心理韧性,减少其负性情绪、提高生活质量以及护理满意度,值得临床应用推广。

Objective To explore the effect of continuing nursing on post-ICU syndrome(PICS)in patients with severe trauma.Methods A total of 86 cases of ICU patients with severe trauma admitted to our hospital from January 2016 to September 2018 were selected as the research objects,they were divided into observation group and control group by random number method,43 cases in each group.The patients in control group were given routine nursing intervention,while the patients in observation group were given continuing nursing intervention on the basis of control group.The PICS incidence rate,psychological resilience(Chinese version of psychological resilience scale[CD-ISC])and negative emotions(self-rating anxiety scale[SAS]and self-rating depression scale[SDS])before and after the intervention,as well as the quality of life(Chinese version of health measurement scale[SF-36])and nursing satisfaction(self-made nursing satisfaction questionnaire)after 6 months of intervention were compared between the two groups.Results The incidence of PICS in the observation group(4.65%)was lower than that in the control group(18.61%),and the difference was statistically significant(P<0.05).Before the intervention,there were no significant difference in CD-RISC,SAS and SDS scores between the two groups(P>0.05).After the intervention,the CD-RISC scores of the two groups of patients were higher than before the intervention,and the SAS and SDS scores were lower than before the intervention,with statistically significant difference(P<0.05).The CD-RISC scores of patients in the observation group after intervention were higher than those in the control group,and the SAS and SDS scores were lower than those in the control group,the differences were statistically significant(P<0.05).After 6 months of intervention,the SF-36 scores of the two groups were significantly higher than those of the control group,the differences were statistically significant(P<0.05),except for the physical pain scores(P>0.05).The total nursing satisfaction of patients in the observation group(100%)was higher than that in the control group(79.07%),and the difference was statistically significant(P<0.05).Conclusion Continuous nursing intervention applied in PICS of patients with severe trauma can improve the patients′psychological resilience,reduce their negative emotions,improve the quality of life and nursing satisfaction,and is worthy of clinical application and promotion.