集束化护理方案对无抽搐电休克治疗后谵妄的影响

Effects of cluster nursing program on post-MECT delirium

目的观察集束化护理在无抽搐电休克治疗(MECT)后谵妄中的干预效果,探索MECT后谵妄护理的新方法。方法将符合《国际疾病分类(第10版)》(ICD-10)精神疾病诊断标准并首次接受MECT治疗的住院患者154例作为研究对象,按随机数字表法分为对照组和研究组各77例。所有患者均进行6~12次MECT治疗,共1个疗程。两组均接受MECT常规护理,研究组在此基础上接受集束化护理。在每次治疗后采用Richmond躁动镇静评分量表(RASS)和护理不良事件记录表收集资料,比较两组患者MECT后谵妄发生率、持续时间及MECT后谵妄致护理不良事件发生率。结果患者接受一个MECT疗程治疗后,研究组MECT后谵妄发生率为11.80%、对照组为16.67%,差异有统计学意义(χ^(2)=6.314,P<0.05);谵妄的持续时间,研究组为(5.78±2.73)min、对照组为(11.20±4.44)min,差异有统计学意义(t=3.403,P<0.05);MECT后谵妄导致护理不良事件发生率研究组为7.13%、对照组为12.70%,差异有统计学意义(χ^(2)=10.940,P<0.01)。结论实施集束化护理可能有助于降低MECT治疗后谵妄发生率,缩短谵妄的持续时间、减少MECT后谵妄致护理不良事件。

Objective To observe the intervention effect of cluster nursing in post-MECT delirium,and explore a new method of post-MECT delirium nursing.Methods A total of 154 inpatients who met the diagnostic criteria of International Classification of Diseases,tenth edition(ICD-10)and received MECT treatment for the first time were selected and they were randomly divided into control group(n=77)and study group(n=77).The intervention lasted for one course of MECT,6-12 times MECT as one course.Both groups recieved MECT routine nursing,while the study group was given cluster nursing on the basis of routine nursing.After each treatment,Richmond Agitation Sedation Scale(RASS)and nursing adverse events record form were used to collect data.The incidence and duration of post-MECT delirium and the incidence of nursing adverse events caused by post-MECT delirium were compared between the two groups.Results After one course of MECT,the incidence of post-MECT delirium was 11.80%in the study group and 16.67%in the control group,the difference was statistically significant(χ^(2)=6.314,P<0.05).The duration of post-MECT delirium in the study group was(5.78±2.73)min and(11.20±4.44)min in the control group,the difference was statistically significant(t=3.403,P<0.05).The incidence of nursing adverse events caused by post-MECT delirium was 7.13%in the study group and 12.70%in the control group,and the difference was statistically significant(χ^(2)=10.940,P<0.01).Conclusion The implementation of cluster nursing can reduce the incidence of post-MECT delirium,shorten the duration and reduce the nursing adverse events caused by post-MECT delirium.