协同家属护理管理联合保护动机理论干预对RA患者疼痛程度及炎症指标的影响

E ffect of collaborative family care management combined with protective motivation theory intervention on pain level and inflammatory indexes in patients with rheumatoid arthritis

目的探究协同家属护理管理联合保护动机理论干预对类风湿关节炎(RA)患者疼痛程度及炎症指标水平的影响。方法选取2020年5月—2021年5月平顶山某医院收治的108例RA患者作为研究对象,采用随机数字表法分为对照组和观察组,每组54例。对照组患者给予常规护理,观察组患者在常规护理基础上给予协同家属护理管理联合保护动机理论干预,2组患者均持续干预3个月。比较2组患者干预前后自我管理行为、自我效能感、生活质量评分和疼痛程度、病情活动度评价表(DAS28)评分,比较2组患者干预前后炎症指标[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和超敏C反应蛋白(hs-CRP)]水平。结果干预后,观察组患者自我管理行为、自我效能感及生活质量评分均高于对照组,差异均有统计学意义(P<0.05)。干预后,观察组患者疼痛程度和DAS28评分均低于对照组,差异均有统计学意义(P<0.05)。干预后,观察组患者IL-6、TNF-α、hs-CRP水平均低于对照组,差异均有统计学意义(P<0.05)。结论协同家属护理管理联合保护动机理论干预在RA患者临床护理中应用效果良好,可有效提升患者自我管理行为、自我效能感,改善其生活质量,有效缓解患者疼痛程度并减轻炎症反应,值得在临床上推广使用。

Objective To investigate the effect of collaborative family care management combined with protective motivation theory intervention on the level of pain and inflammatory indexes in patients with rheumatoid arthritis(RA).Methods A total of 108 RA patients admitted to a hospital in Pingdingshan from May 2020 to May 2021 were selected as subjects and assigned to a control group and an observation group using the random number table method,with 54 cases in each group.Patients in the control group received conventional care,and patients in the observation group received collaborative family care management combined with protective motivation theory intervention in addition to conventional care,and patients in both groups received continuous intervention for 3 months.The self-management behavior,self-efficacy,quality of life score and pain level and The Disease Activity Score-28(DAS28)scores were compared before and after the intervention,and the levels of inflammation indexes[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)]were compared before and after the intervention in the two groups.Results After the intervention,patients in the observation group had higher self-management behavior,self-efficacy and quality of life scores than the control group,and the differences were statistically significant(P<0.05).The pain level and DAS28 scores of patients in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of IL-6,TNF-αand hs-CRP were lower in the observation group than those in the control group,and the differences were all statistically significant(P<0.05).Conclusion Collaborative family care management combined with protective motivation theory intervention is effective in the clinical care of RA patients,which can effectively enhance patients’self-management behaviors and self-efficacy,improve their quality of life,and effectively relieve patients’pain level and inflammatory response.These benefits justify a wider application of this procedure clinically.