结构式心理护理联合循证护理对冠状动脉介入治疗患者不确定感、术中应激反应及并发症的影响

Effects of structural psychological nursing combined with evidence-based nursing on uncertainty,intraoperative stress response and complications in patients with coronary intervention

【目的】探讨结构式心理护理联合循证护理对冠状动脉介入治疗患者不确定感、术中应激反应及并发症的影响。【方法】将本院在2017年1月至2020年1月收治的经皮冠状动脉介入治疗的冠心病患者110例作为研究对象,随机分为对照组55例,观察组55例。对照组实施常规护理,观察组实施结构式心理护理联合循证护理方式。采用汉密尔顿焦虑量表(HAMA)评价患者焦虑评分,采用汉密尔顿抑郁量表(HAMD)评价患者抑郁评分,采用Mishel疾病不确定感量表评价患者不明确性、复杂性、信息缺乏性、不可预测性评分,比较两组患者术中血压(收缩压、舒张压)、肾上腺素及并发症发生情况等指标,采用西雅图心绞痛量表(SAQ)评价患者生活质量评分。【结果】护理后观察组HAMA、HAMD评分均低于对照组(P<0.05);两组不明确性、复杂性、信息缺乏性及不可预测性方面得分相比,观察组低于对照组(P<0.05);观察组血压、肾上腺素均优于对照组(P<0.05);观察组各项生活质量评分高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。【结论】结构式心理护理联合循证护理应用于冠状动脉介入治疗冠心病患者中可减少患者不确定感,减少术中应激反应,减少并发症产生,效果显著。

【Objective】To explore the effects of structural psychological nursing combined with evidence-based nursing on uncertainty,intraoperative stress response and complications in patients with coronary intervention.【Methods】A total of 110 patients with coronary heart disease treated by percutaneous coronary intervention in our hospital from January 2017 to January 2020 were used as subjects and randomly divided into control group(55 cases)and observation group(55 cases).The control group received routine nursing,and the observation group was given structural psychological nursing combined with evidence-based nursing.Hamilton Anxiety Scale(HAMA)was used to evaluate the anxiety score,Hamilton Depression Scale(HAMD)was used to evaluate the depression score,Mishel Disease Uncertainty Scale was used to evaluate the scores of uncertainty,complexity,lack of information and unpredictability,the intraoperative blood pressure(SBP,DBP),epinephrine and complications were compared between the two groups,Seattle Angina Questionnaire(SAQ)was used to evaluate the quality of life.【Results】After nursing,HAMA and HAMD scores of the observation group were lower than those of the control group(P<0.05);the scores of uncertainty,complexity,lack of information and unpredictability in the observation group were lower than those in the control group(P<0.05);the blood pressure and epinephrine in the observation group were better than those in the control group(P<0.05);the scores of quality of life in the observation group were higher than those in the control group(P<0.05);the incidence of complications in the observation group was lower than that in the control group(P<0.05).【Conclusion】The application of structural psychological nursing combined with evidence-based nursing in patients with coronary heart disease undergoing percutaneous coronary intervention can reduce the uncertainty of patients,reduce the stress reaction during operation,and reduce the occurrence of complications,with remarkable effect.