医院-社区-家庭过渡期护理方案在PICU重症肺炎患儿中的应用

Application of Hospital-Community-Family Transitional Nursing Program in Children with Severe Pneumonia in PICU

目的:探讨医院-社区-家庭过渡期护理方案在儿科重症监护病房(PICU)重症肺炎患儿中的应用效果。方法:将2018年12月1日~2020年12月31日在PICU接受治疗的120例重症肺炎患儿采用随机数字表法分为观察组和对照组各60例,对照组实施常规护理干预,观察组在常规护理干预基础上实施医院-社区-家庭过渡期护理方案;比较两组患儿干预前、干预1个月后血气状态[包括血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))]、肺功能[包括第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最大呼气流量(PEF)、每分钟最大通气量(MVV)]、家长应对方式[采用简易应对方式问卷(SCSQ)]、家长照护能力[采用家庭管理测量量表(FaMM)],比较干预后1个月内两组患儿肺炎复发情况。结果:干预1个月后,两组患儿SaO_(2)、PaO_(2)、FEV_(1)、FVC、PEF、MVV高于干预前(P<0.05)、PaCO_(2)低于干预前(P<0.05),且观察组优于对照组(P<0.05);干预1个月后,两组家长SCSQ中积极应对得分、FaMM中患儿认可、照护能力及家长关系得分均较干预前升高(P<0.05)、家长SCSQ消极应对得分较干预前降低(P<0.01),且观察组优于对照组(P<0.05);干预后1个月内,观察组患儿肺炎复发率低于对照组(P<0.05)。结论:医院-社区-家庭过渡期护理方案在PICU重症肺炎患儿中的应用效果显著,有助于改善患儿血气状态和肺功能,同时可促进患儿家长应对方式趋于积极、照护能力趋于改善,具有较高的临床应用价值。

Objective:To explore the application effect of hospital-community-family transitional nursing program on children with severe pneumonia in pediatric intensive care unit(PICU).Methods:A total of 120 cases of children with severe pneumonia admitted during December 1,2018 to December 31,2020 were divided into the observation group and the control group by the random number table method,with 60 cases in each group.The control group received routine nursing intervention,and the observation group was given hospital-community-family transitional nursing program on the basis of the control group.The blood gas status including blood oxygen saturation(SaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),partial pressure of blood oxygen(PaO_(2)),lung function including forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),peak expiratory flow(PEF),maximum ventilation volume per minute(MVV),parental coping styles by Simplified Coping Style Questionnaire(SCSQ)score and parental care ability by Family Management Measure(FaMM)were compared between the two groups before intervention and after 1 months of intervention,and the recurrence of pneumonia was compared between the two groups within 1 months after intervention.Results:After 1 months of intervention,the SaO_(2),PaO_(2),FEV_(1),FVC,PEF and MVV in the two groups were higher than those before intervention(P<0.05),PaCO_(2)was lower than that before intervention(P<0.05),and better in the observation group than those in the control group(P<0.05).The parental SCSQ negative coping scores,FaMM recognition,care ability and the relationship between parents in the two groups were higher than those before intervention(P<0.05),the parental SCSQ negative coping scores in the two groups were lower than those before intervention(P<0.01),and better in the observation group than those in the control group(P<0.05).Within 1 months after intervention,the recurrence rate of pneumonia in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of hospital-community-family transitional nursing program has a significant effect in children with severe pneumonia in PICU,can help to improve the blood gas status and lung function,and meanwhile promote the coping styles of children′s patrents to become positive and the care ability to be improved,with a high clinical application value.