PDCA循环联合积极心理干预对腹腔镜手术患者术后疼痛并发症及心身健康的影响

Effect of PDCA cycle combined with positive psychological intervention on postoperative pain,complications and psychosomatic health of patients undergoing laparoscopic surgery

目的探讨PDCA循环联合积极心理干预对腹腔镜手术患者术后疼痛、并发症及心身健康的影响。方法将182例择期行腹腔镜手术治疗者按入院时间分为研究组与对照组,各91例。两组均给予常规护理,研究组在此基础上给予PDCA循环联合积极心理干预,观察住院全程。干预前后采用简明心境状态量表、焦虑自评量表、抑郁自评量表评定两组情绪状况,术后8 h及干预后采用视觉模拟评分法评定两组疼痛状况,干预前后采用健康调查简表评定两组心身健康状况,比较两组并发症发生率及护理满意度。结果干预后两组简明心境状态量表、焦虑自评量表、抑郁自评量表评分均显著低于干预前(P<0.01),健康调查简表各维度评分均显著高于干预前(P<0.05或0.01),研究组较对照组变化更显著(P<0.05或0.01)。干预后两组视觉模拟评分法评分显著低于术后8 h(P<0.01),研究组显著低于对照组(P<0.01)。研究组并发症发生率显著低于对照组(P<0.01),护理总满意率显著高于对照组(P<0.01)。结论PDCA循环联合积极心理干预有助于改善腹腔镜手术患者的不良情绪,促进康复,缓解疼痛,降低并发症发生率,提高护理服务满意度,值得临床推广应用。

Objective To investigate the effect of(plan-do-check-act)PDCA cycle combined with positive psychological intervention on postoperative pain,complications and psychosomatic health of patients undergoing laparoscopic surgery.Methods A total of 182 patients with elective laparoscopic surgery were divided into study group and control group according to the date of admission,with 91 cases in each group.Both groups were given routine nursing.On this basis,the study group was given PDCA cycle combined with positive psychological intervention.The whole process of hospitalization was observed.Before and after the intervention,the emotional status of the two groups were assessed by profile of mood states(POMS),self-rating anxiety scale(SAS)and self-rating depression sale(SDS).The pain status of the two groups was evaluated by visual analogue scale(VAS)8 hours after operation and after intervention.Before and after the intervention,the MOS item short from health survey(SF-36)was used to evaluate the psychosomatic health status of the two groups,and the incidence of complications and nursing satisfaction were compared between the two groups.Results After the intervention,the POMS,SAS,and SDS scores of the two groups were significantly lower than those before the intervention(P<0.01),and the scores of each dimension of SF-36 were significantly higher than those before the intervention(P<0.05 or 0.01).The changes in the study group were more significant than those in the control group(P<0.05 or 0.01).After the intervention,the VAS scores of the two groups were significantly lower than those of 8 hours after operation(P<0.01),and the study group was significantly lower than the control group(P<0.01).The incidence of complications in the study group was significantly lower than that in the control group(P<0.01),and the total satisfaction rate of nursing was significantly higher than that in the control group(P<0.01).Conclusions PDCA cycle combined with positive psychological intervention can help improve the negative emotions of patients with laparoscopic surgery,promote recovery,relieve pain,reduce the incidence of complications,and improve nursing service satisfaction,which is worthy of clinical application.