针对性护理在镜面右位心患者冠状动脉介入治疗住院期间的应用效果

Application effect of targeted nursing in patients with dextrocardia undergone percutaneous coronary intervention during hospitalization

目的探讨针对性护理对行经皮冠状动脉(冠脉)造影术的镜面右位心(以下简称右位心)患者住院期间干预的临床应用效果。方法连续入选2006年7月~2019年10月于首都医科大学附属北京安贞医院心内科收治的行冠脉介入术的右位心患者28例,分2个阶段进行研究。第一阶段为2006年7月~2016年10月收集的20例为观察组,分析患者特点,总结护理中的问题后形成针对性护理方案。第二阶段为2016年11月~2019年10月收集的8例为实验组,1:1匹配相应的左位心普通患者为对照组。对照组采用常规护理,实验组在此基础上再加入针对性护理。借助抑郁自评量表(SDS)对该组患者实施相应护理前后的心理状态进行评估,设计问卷比较两组患者护理满意度,对针对性护理方案进行评价。结果第一阶段发现在护理右位心的冠脉介入患者时护士意识不足、应变不够,团队协作欠佳等问题。据此生成了从护理调整、心理疏导到团队协作3个层面的6项措施。第二阶段将此方案应用在8例右位心患者的护理上,与匹配的普通左位心患者相比,接受针对性护理实验组患者的SDS评分从入院时的高于对照组(47.98±9.22 vs.41.24±7.43,P<0.05)到出院时2组基本持平(32.15±5.21 vs.34.75±4.84,P>0.05),实验组改善更为明显。出院时右位心患者护理满意度显著高于普通左位心患者(97.23±2.38 vs.92.52±5.72,P<0.01)。结论常规护理不能完全满足右位心患者住院接受冠脉介入诊疗时的需求,针对性护理可改善患者抑郁情绪,提高护理满意度。

Objective To discuss the application effect of targeted nursing intervention in patients with dextrocardia undergone percutaneous coronary intervention(PCI)during hospitalization.Methods The patients(n=28)were chosen from Department of Cardiology in Beijing Anzhen Hospital affiliated to Capital University of Medical Sciences from July 2006 to Oct.2019.The study process was divided into 2 stages.In the first stage,20 patients were chosen into observation group from July 2006 to Oct.2016,and their features were analyzed,problems were summed up during nursing intervention and a targeted nursing plan was made up.In the second stage,8 patients were chosen into test group from the observation group from Nov.2016 to Oct.2019,and patients with levocardia matched with test group by 1:1 were chosen into control group.The control group was given routine nursing and test group was additionally given target nursing.The self-rating depressive scale(SDS)was used for reviewing psychological state in test group before and after nursing.The degree of satisfaction to nursing service and targeted nursing plan were compared and reviewed in 2 groups after designed a questionnaire.Results In the first stage,some problems,such as lack of consciousness,strain and team cooperation in nurses,were found during nursing process for patients with dextrocardia.According to this status,there were 6 measures carried out including nursing adjustment,psychological counseling and team cooperation.In the second stage,the target nursing plan was applied in test group,and SDS scores were higher in test group than those in control group(47.98±9.22 vs.41.24±7.43,P<0.05)at admission time,and were basically the same(32.15±5.21 vs.34.75±4.84,P>0.05)at discharge time.The improvement was more significant in test group.At discharge time,the degree of satisfaction to nursing service was significantly higher in test group than that in control group(97.23±2.38 vs.92.52±5.72,P<0.01).Conclusion The routine nursing cannot fully meet the needs of patients with dextrocardia undergone PCI,and target nursing intervention can relieve patients’depression emotion and improve degree of satisfaction to nursing service.