互动达标理论在急性闭角型青光眼患者术后心理护理中的作用

The effect of interactive compliance theory on psychological nursing of patients with acute angular closure glaucoma after operation

目的观察互动达标理论对处于急性发作期的原发性急性闭角型青光眼(PAACG)患者术后心理护理的作用。方法选取符合纳入标准的PAACG患者81例(81只眼),随机分为对照组40例(40只眼)和观察组41例(41只眼)。对照组手术前后均予常规护理,观察组在对照组的基础上联合基于互动达标理论的心理护理,2组均护理14 d。分别于护理前和护理后测得2组患者的焦虑自评量表(SAS)、抑郁自评量表(SDS)、疼痛数字评定量表(NRS)、最佳矫正视力(BCVA)、眼压和中央前房深度(CACD)数据并进行统计分析。结果(1)心理状态:与护理前比较,2组SAS评分均降低,差异均有统计学意义(t_(观察组)=25.175,t_(对照组)=12.662,均P=0.000)。护理后,观察组SAS评分低于对照组,差异有统计学意义(t=12.602,P=0.000)。与护理前比较,2组SDS评分均降低,差异均有统计学意义(t_(观察组)=21.041,t_(对照组)=8.565,均P=0.000)。护理后,观察组SDS评分低于对照组,差异有统计学意义(t=12.911,P=0.000);(2)疼痛程度:与护理前比较,2组护理后1 d、7 d和14 d的NRS评分均降低,差异均有统计学意义(P<0.05)。2组护理后1 d、7 d和14 d,观察组NRS评分均低于对照组,差异均有统计学意义(t1 d=5.361,t7 d=7.541,t14 d=8.520,均P=0.000);(3)BCVA:与护理前比较,2组护理后均改善,差异均有统计学意义(t_(观察组)=15.884,t_(对照组)=6.704,均P=0.000)。护理后,观察组优于对照组,差异有统计学意义(t=7.962,P=0.000);(4)眼压:与护理前比较,2组护理后均降低,差异均有统计学意义(t_(观察组)=42.753,t_(对照组)=32.566,均P=0.000)。护理后,观察组低于对照组,差异有统计学意义(t=8.593,P=0.000);(5)CACD:与护理前比较,2组护理后均变深,差异均有统计学意义(t_(观察组)=6.718,t_(对照组)=3.972,均P=0.000)。护理后,观察组深于对照组,差异有统计学意义(t=2.753,P=0.007)。结论基于互动达标理论的护理方案在PAACG患者的心理护理中作用突出,可改善患者不良情绪,降低疼痛程度,有助于术后恢复。

OBJECTIVE To observe the effect of interactive compliance theory on psychological nursing of patients with primary acute angle-closure glaucoma(PAACG)in acute phase after operation.METHODS A total of 81 patients(81 eyes)with PAACG were randomly divided into the control group(TG)with 40 cases(40 eyes)and the observation group(OG)with 41 cases(41 eyes).The control group was intervened with routine nursing before and after operation.The observation group was treated with psychological nursing based on interactive compliance theory on basis of nursing scheme of the control group.Both groups were intervened for 14 days.The observation indexes included self-rating anxiety scale(SAS),self-rating depression scale(SDS),pain digital rating scale(NRS),best corrected visual acuity(BCVA),intraocular pressure and central anterior chamber depth(CACD).The data were measured and statistically analyzed before and after nursing.RESULTS(1)psychological status:After intervention,SAS scores of the two groups decreased,and the difference was statistically significant(t_(OG)=25.175,t_(TG)=12.662,all P=0.000).While the SAS score of the observation group was lower than that of the control group,and the difference was statistically significant(t=12.602,P=0.000).After intervention,the SDS scores of the two groups decreased,and the difference was statistically significant(t_(OG)=21.041,t_(TG)=8.565,all P=0.000).While the SDS score of the observation group was lower than that of the control group,and the difference was statistically significant(t=12.911,P=0.000).(2)Degree of pain:After intervention,the NRS scores of the two groups decreased at the 1^(st),7^(th) and 14^(th) day after nursing,and the difference was statistically significant(P<0.05).At the 1st,7th and 14th after nursing,the NRS scores of the observation group were lower than those of the control group,and the differences were statistically significant(t_(1d)=5.361,t_(7d)=7.541,t_(14d)=8.520,all P=0.000).(3)BCVA:After intervention,BCVA of the two groups improved after nursing,and the difference was statistically significant(t_(OG)=15.884,t_(TG)=6.704,all P=0.000).After nursing,BCVA in the observation group was higher than that in the control group,and the difference was statistically significant(t=7.962,P=0.000).(4)Intraocular pressure:Before nursing,the intraocular pressure of the two groups both decreased,and the difference was statistically significant(t_(OG)=42.753,t_(TG)=32.566,all P=0.000).After nursing,the intraocular pressure in the observation group was lower than that in the control group,the difference was statistically significant(t=8.593,P=0.000).(5)CACD:After nursing,the CACD of the two groups became deeper,and the difference was statistically significant(t_(OG)=6.718,t_(TG)=3.972,all P=0.000).After nursing,the CACD in the observation group was significantly higher than that in the control group(t=2.753,P=0.007).CONCLUSIONS The nursing scheme based on the interactive standard theory plays an important role in the psychological nursing of patients with PAACG.It can regulate the emotion of patients,reduce the degree of pain and boost postoperative recovery.