叙事护理在维持性血液透析患者长期主要家庭照顾者中的应用

Application of narrative nursing in long-term primary family caregivers of patients undergoing maintenance hemodialysis

目的:探讨叙事护理在维持性血液透析患者长期主要家庭照顾者中的应用效果。方法:采用便利抽样法,选取2020年5—8月在某三级综合医院血液透析室行血液透析治疗的维持性血液透析患者的主要家庭照顾者120名作为研究对象,采用随机数字表法将其随机分为观察组(60名)与对照组(60名)。观察组实施叙事护理干预方案,对照组实施常规心理护理方法。干预前后采用照顾者负担量表(ZBI)、SAS、抑郁量表(BDI-Ⅱ)调查两组照顾者情况。结果:干预前,两组患者ZBI、SAS、BDI-Ⅱ总分比较差异均无统计学意义(P>0.05);干预后,观察组ZBI、SAS、BDI-Ⅱ总分分别为23.50(15.00,33.00)、33.00(27.00,41.00)、11.00(8.00,14.75)分,均低于对照组,差异均有统计学意义(P<0.05)。结论:叙事护理可有效降低维持性血液透析患者长期主要家庭照顾者的照顾负担,减轻焦虑、抑郁水平,值得临床推广应用。

Objective To explore the application effect of narrative nursing in long-term primary family caregivers of maintenance hemodialysis patients.Methods Using the convenient sampling method,a total of 120 main family caregivers of maintenance hemodialysis patients who received hemodialysis treatment in Hemodialysis Room of a tertiary general hospital were selected as the research objects from May to August 2020.The patients were randomly divided into the observation group(n=60)and the control group(n=60)by random number table method.The observation group was given narrative nursing intervention,while the control group was given routine psychological nursing.Zarit Caregiver Burden Interview(ZBI),Self-rating Anxiety Scale(SAS)and Beck Depression Scale(BDI-Ⅱ)were used to investigate the situation of caregivers in the two groups.Results Before the intervention,there was no statistically significant difference in the total scores of ZBI,SAS and BDI-Ⅱbetween the two groups(P>0.05).After the intervention,the total scores of ZBI,SAS and BDI-Ⅱin the observation group were respectively 23.50(15.00,33.00),33.00(27.00,41.00)and 11.00(8.00,14.75),which were lower than the control group,and the differences were statistically significant(P<0.05).Conclusions Narrative nursing can effectively reduce the long-term care burden of the main family caregivers of maintenance hemodialysis patients and reduce levels of anxiety and depression,which is worthy of clinical application.