ICU手术患者认知闭合需要与ICU综合征的关系

The relationship between cognitive closure needs and ICU syndrome in patients undergoing ICU surgery

目的探讨ICU手术患者认知闭合需要与ICU综合征的关系。方法2019年6月至2020年6月应用一般调查知识问卷、认知闭合需要量表、应对方式量表、ICU意识模糊评估法(CAM-ICU)量表对182例ICU手术患者进行评价,采用Pearson相关因素分析认知闭合需要与应对方式的关系,采用多元回归分析影响ICU综合征发生的相关因素。结果入组患者中56例发生ICU综合征,发生率为30.77%。ICU综合征患者认知闭合需要总分及各维度评分、应对方式(回避、屈服)评分高于非ICU综合征患者(P<0.05),而ICU综合征患者面对评分低于非ICU综合征(P<0.05)。多元回归分析可知,患者年龄、学历、气管插管、机械通气时间、睡眠障碍、急性生理与慢性健康评分(APACHEⅡ)、认知闭合需要总分、屈服及回避维度是影响ICU综合征发生的危险因素(P<0.05),而面对维度是影响ICU综合征发生的保护因素(P<0.05)。结论ICU手术患者ICU综合征发生率较高,并与认知闭合需要及应对方式有密切的关系,护士除了对患者做好基础护理外,还应关注患者对疾病认知的需求,通过提高患者对疾病的认识,促使患者以积极的方式面对疾病,从而有效预防ICU综合征发生,改善患者预后。

Objective To explore the relationship between the need for cognitive closure and ICU syndrome in patients undergoing ICU surgery.Methods From June 2019 to June 2020,182 patients undergoing ICU surgery were evaluated by general survey knowledge questionnaire,cognitive closure needs scale,coping style scale ICU ambiguity assessment(CAM-ICU)scale.Pearson correlation factors were used to analyze the relationship between cognitive closure need and coping style,and multiple regression was used to analyze the related factors affecting the occurrence of ICU syndrome.Results A total of 56 cases of enrolled patients developed ICU syndrome,with an incidence rate of 30.77%.The cognitive closure requires total scores,scores of various dimensions,and coping styles(avoidance,yielding)scores of ICU syndrome patients were higher than those of non-ICU syndrome patients(P<0.05),while ICU syndrome patients'face scores were lower than non-ICU syndrome(P<0.05).The patient's age,education,tracheal intubation,mechanical ventilation time,sleep disturbance,acute physiology and chronic health evaluation(APACHE)Ⅱ score,total score for cognitive closure,yield and avoidance dimensions were risk factors affecting the occurrence of ICU syndrome by multiple regression analysis(P<0.05).The face dimension was protective with factor affects occurrence of ICU syndrome(P<0.05).Conclusions The incidence of ICU syndrome in patients undergoing ICU surgery is relatively high,and it is closely related to the need for cognitive closure and coping styles.In addition to providing basic care for patients,nurses should also pay attention to patients'needs for disease awareness.By improving patients'awareness of the disease,the patients are encouraged to face the disease in a positive way,thereby effectively preventing the occurrence of ICU syndrome and improving the prognosis of patients.