泌尿系结石手术患者护理需求现状及影响因素分析

Analysis of the status of nursing needs and influencing factors of patients undergoing urinary calculi surgery

目的探讨泌尿系结石手术患者护理需求现状及其影响因素。方法选取2016年1月至2019年12月就诊于首都医科大学附属北京友谊医院的100例泌尿系结石手术患者为研究对象,采用自制护理需求量表对患者的护理需求进行评估,将得分≥192分的64例患者作为高需求组,得分<192分的36例患者作为低需求组。术后第1天,采用自制护理需求量表、视觉模拟评分法(visual analogue scale,VAS)、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)、社会支持量表评估两组患者的护理需求、疼痛情况、心理状态、社会支持度;采用调查问卷评估两组患者的手术并发症担忧程度和治疗信心。采用多因素logistic回归方法分析泌尿系结石患者护理需求的独立性影响因素。结果高需求组患者术后第1天的VAS、SAS、SDS、手术并发症担忧程度评分均显著高于低需求组(P<0.05),而社会支持度和治疗信心评分均显著低于低需求组(P<0.05)。多因素logistic回归分析显示,VAS、SAS、SDS和社会支持度评分为泌尿系结石手术患者护理需求的独立性影响因素(P<0.05)。结论术后的疼痛程度、焦虑抑郁情绪和社会支持度是泌尿系结石手术患者护理需求的独立性影响因素,在临床护理工作中需重点关注这些影响因素,从而全方位满足患者的护理需求,促进患者的康复进程。

Objective To explore the current status of nursing needs and influencing factors of patients with urinary calculi surgery.Method A total of 100 patients who underwent urinary calculi surgery in Beijing Friendship Hospital affiliated to Capital Medical University from January 2016 to December 2019 were included as the research objects.The self-made nursing demand scale was used to evaluate the patients’nursing needs.64 patients with score≥192 points regarded as the high-demand group,and 36 patients with score less than 192 points regarded as the low-demand group.The first day after surgery,self-made care needs scale,visual analogue scale(VAS),self-rating depression scale(SDS),self-rating anxiety scale(SAS)and social support scale were used to evaluate the nursing needs,pain,psychological state and social support of patients in two groups.A questionnaire was used to assess the degree of concern about surgical complications and the confidence of treatment in two groups.The logistic regression equation was used to analyze the factors affecting the nursing needs of patients with urinary calculi surgery.Result Postoperative VAS,SAS,SDS and worry degree of surgical complications in high-demand group were significantly higher than those in low-demand group(P<0.05),and the scores of social support and treatment confidence were significantly lower than those in low-demand group(P<0.05).Multiple logistic regression analysis showed that VAS,SAS,SDS and social support score were independent influencing factors for the nursing needs of patients undergoing urolithiasis surgery(P<0.05).Conclusion Postoperative pain,anxiety,depression and social support are independent factors affecting the nursing needs of patients with urolithiasis surgery.Focus on these factors in clinical nursing work,so as to fully meet the nursing needs of patients and promote the rehabilitation process of patients.