疼痛管理配合心理疏导对缓解甲沟炎患者疼痛的效果观察

Effect of pain management combined with psychological counseling on patients with paronychia

目的:观察疼痛管理配合心理疏导对甲沟炎患者的影响。方法:选取我院2017年1月-2018年1月收治的趾(指)甲沟炎术后或甲沟炎早期需每日换药治疗的患者233例。根据干预方法不同分为对照组(n=110)和观察组(n=123),前者采用常规干预,后者实施疼痛管理联合心理疏导。观察两组患者换药效果、换药时间及患趾(指)愈合时间,了解换药后一个月患趾疼痛、感染、复发情况发生率,比较干预前后视觉模拟疼痛评分法(VAS)、焦虑自评量表(SAS)评分。结果:观察组的换药时间较对照组缩短,换药次数较对照组减少,均有统计学意义(t=-13.17,-20.85;P<0.05);观察组换药效果有效率为80.49%显著高于对照组的60.00%,有统计学差异(χ^2=11.79,P<0.05);观察组患趾(指)出现疼痛、感染、复发的发生率(14.63%、4.07%、2.44%)均低于对照组(30.00%、14.55%、9.09%),有统计学意义(χ^2=8.02,7.78,4.88;P<0.05);观察组治疗后VAS、SAS评分均低于对照组,有统计学差异(t=-29.02,-19.00;P<0.05)。结论:在甲沟炎患者换药前进行心理疏导,换药期间应用疼痛管理进行干预,可降低患者对疼痛的感应,缓解患者紧张、焦虑等负面情绪。

Objective:To observe the effects of pain management and psychological counseling on paronychia patients.Methods:A total of 233 cases of patients after toe(finger)paronychia or undergoing daily dressing treatment of early paronychia in our hospital from January 2017 to January 2018 were selected.According to different nursing methods,they were divided into control group(n=110)and observation group(n=123),and the former one was treated with routine nursing,and the latter one was given pain management combined with psychological counseling.The dressing change effects,dressing change time and the healing time of affected toe(finger)were observed in the two groups.The incidence rates of pain,infection and recurrence of affected toe were studied at 1 month after dressing change.The scores of visual analogue pain score(VAS)and self-rating anxiety scale(SAS)were compared before and after nursing.Results:The dressing change time in observation group was shorter than that in control group,and the frequency of dressing change was significantly lower than that in control group(t=-13.17,-20.85;P<0.05).The effective rate of dressing change in observation group was significantly higher than that in control group(χ^2=11.79,P<0.05).The incidence rates of pain,infection and recurrence of affected toe(finger)in observation group were lower than those in control group(χ^2=8.02,7.78,4.881;P<0.05).The scores of VAS and SAS were lower in observation group than those in control group after treatment(t=-29.02,-19.00;P<0.05).Conclusion:Psychological counseling is given to patients with paronychia before dressing change,and pain management is given during dressing change for intervention,and it can reduce the patient’s induction of pain and relieve the negative emotions of tension and anxiety.