基于疾病评估的“一病一优”护理服务应用于抑郁症患者中的实践研究

Practical research on the application of"one disease,one quality"nursing service based on disease assessment in patients with depression

目的探讨在抑郁症患者中基于疾病评估的“一病一优”护理服务的实践效果。方法将我院2017年6月~2018年8月收治的82例抑郁症患者以随机数表分为常规组(n=41)、研究组(n=41)。常规组予常规护理,研究组予常规护理+基于疾病评估的“一病一优”护理服务。比较两组干预前、1个月后、2个月后、3个月后汉密尔顿抑郁量表(HAMD-17)评分,干预前后自我护理能力改变,干预期间不良事件发生率,干预后护理满意度评价。结果HAMD-17评分组间、时间、交互比较差异均有统计学意义(P<0.05),且1个月后、2个月后、3个月后均低于干预前(P<0.05),2个月后、3个月后均低于1个月后(P<0.05),3个月后均低于2个月后(P<0.05),1个月后、2个月后、3个月后两组间HAMD-17评分比较研究组均低于常规组(P<0.05);干预后两组自我概念、自我护理责任感、自我护理技能和健康知识水平评分均升高(P<0.05),且干预后研究组上述各维度自我护理能力评分均明显高于常规组(P<0.05);研究组干预期间睡眠障碍、进食问题、排便障碍、焦虑、社交障碍、思维障碍和自杀危机发生率均低于常规组(P<0.05);干预后研究组服务态度、护理技术、人文关怀护理满意度评分和总分均高于常规组(P<0.05),两组医疗环境护理满意度评分比较差异无统计学意义(P>0.05)。结论对抑郁症患者实施基于疾病评估的“一病一优”护理服务不仅可减轻症状,提升其自我护理能力,还可减少睡眠障碍、进食问题等不良事件,提升患者的护理满意度。

Objective To explore the practical effects of“one disease,one quality”nursing service based on disease assessment in patients with depression.Methods 82 patients with depression who were admitted in the hospital from June 2017 to August 2018 were randomized into conventional group(n=41)and study group(n=41).The conventional group was given routine care,and the study group received routine care combined with"one disease,one quality"nursing service based on disease assessment.The Hamilton Depression Scale(HAMD-17)scores,self-care ability changes before and after the intervention,the incidence of adverse events during the intervention,and the satisfaction evaluation of the nursing after the intervention between two groups before the intervention,and at 1 month,2 months and 3 months after the intervention were compared.Results The differences in HAMD-17 scores between groups and different time were statistically significant(P<0.05),and the scores at 1 month,2 months,and 3 months after intervention were lower than those before intervention(P<0.05).The scores after 2 months and 3 months were lower than those after 1 month(P<0.05),and the scores after 3 months were lower than those after 2 months(P<0.05).After 1 month,2 months and 3 months,the HAMD-17 scores in the study group were lower than those in the conventional group(P<0.05).After the intervention,the self-concept,self-care responsibility,self-care skills and health knowledge level scores of the two groups increased(P<0.05),and after the intervention,the self-care ability scores of the above dimensions of the study group were significantly higher than those of the conventional group(P<0.05).The incidence of sleep disorder,eating problems,defecation disorder,anxiety,social disorder,thinking disorder and suicide crisis during the intervention of the study group was lower than that of the conventional group(P<0.05).After the intervention,the service attitude,nursing technique,human care nursing satisfaction score and total score of the study group were higher than that of the conventional group(P<0.05).There was no significant difference in the medical environmental care satisfaction score between two groups(P>0.05).Conclusion The implementation of“one disease,one quality”nursing service based on disease assessment for patients with depression can not only alleviate symptoms,improve their self-care ability,but also reduce adverse events such as sleep disorders and eating problems,and improve patient satisfaction.