根本原因分析理论下的心理干预对四肢病理性骨折患者围术期情绪 应对方式及自我护理能力的影响

Effects of psychological intervention under the theory of root cause analysis on perioperative emotion, coping style and self-care ability of patients with pathological fracture of limbs

目的 探讨根本原因分析理论下的心理干预对四肢病理性骨折患者围术期情绪、应对方式及自我护理能力的影响。方法 将126例四肢病理性骨折患者按照随机数字表法分为研究组与对照组,各63例。两组均给予常规干预,研究组在此基础上给予根本原因分析理论下的心理干预。比较两组康复情况,干预前后采用症状自评量表评定两组情绪状态,简易应对方式问卷评定两组应对方式,自我护理能力量表评定两组自我护理能力,比较两组并发症发生率及服务质量模型评分。结果 研究组肿胀消失时间、疼痛消失时间、住院时间均显著短于对照组(P<0.01)。干预后两组症状自评量表人际关系敏感、抑郁、躯体化、焦虑、恐怖维度评分均较干预前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。干预后两组简易应对方式问卷积极应对维度评分较干预前显著升高(P<0.01),消极应对维度评分较干预前显著降低(P<0.01),研究组较对照组变化更显著(P<0.01)。干预后两组自我护理能力量表各维度评分均较干预前显著升高(P<0.01),研究组显著高于对照组(P<0.01)。研究组并发症发生率显著低于对照组(P<0.05),服务质量模型各维度评分均显著高于对照组(P<0.01)。结论 根本原因分析理论下的心理干预可有效改善四肢病理性骨折患者围术期情绪状态,促使患者采取积极应对方式,提高自我护理能力,降低并发症发生率,促进患者康复,提高护理质量。

Objective To investigate the effect of psychological intervention under the theory of root cause analysis on perioperative emotion,coping style and self-care ability of patients with pathological fracture of limbs.Methods A total of 126 patients with pathological fractures of limbs were divided into study group and control group according to random number table method,with 63 cases in each group.Both groups were given routine intervention,and the study group was given psychological intervention under the theory of root cause analysis on this basis.The rehabilitation of the two groups was compared.Before and after the intervention,the emotional state of the two groups was assessed by symptom check list 90(SCL-90),the coping style of the two groups was assessed by simplified coping style questionnaire(SCSQ),and the self-care ability of the two groups was assessed by exercise of self-care agency scale(ESCA).The incidence of complications and the score of service quality(SERVQUAL)were compared between the two groups.Results The swelling disappearance time,pain disappearance time and hospitalization time in the study group were significantly shorter than those in the control group(P<0.01).After the intervention,the dimension scores of interpersonal sensitivity,depression,somatization,anxiety and horror of SCL-90 in the two groups were significantly lower than those before the intervention ( P <0.01), and the study group was significantly lower than the control group ( P <0.01). After the intervention, the positive coping scores of SCSQ in the two groups were significantly higher than those before the intervention ( P <0.01), and the negative coping scores were significantly lower than those before the intervention ( P <0 .01), and the changes in the study group were more significant than those in the control group ( P <0 .01). After the intervention, the scores of each dimension of ESCA in the two groups were significantly higher than those before the intervention ( P <0.01), and the study group was significantly higher 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 <0.05), and the scores of each dimension of SERVQUAL were significantly higher than those of the control group ( P <0.01). Conclusions Psychological intervention under the theory of root cause analysis can effectively improve the perioperative emotional state of patients with pathological fractures of limbs, prompt patients to take active coping styles, improve self-care ability, reduce the incidence of complications, promote patient recovery, and improve the quality of nursing.