术前治疗性沟通对人工耳蜗术患儿配合度、家属焦虑抑郁情绪及应对能力的影响

Effect of preoperative therapeutic communication on cooperation degree,anxiety,depression and coping ability of family members in children undergoing cochlear implantation

目的:探讨术前治疗性沟通对人工耳蜗术患儿配合度和家属焦虑抑郁情绪及应对能力的影响。方法:选取80例行人工耳蜗植入术的患儿为研究对象,根据术前护理干预方式不同分为对照组和观察组,每组各40例。对照组术前采取常规护理干预;观察组在常规护理基础上实施治疗性沟通干预。比较两组患儿术后不适及患儿治疗期间配合度和干预前、后家属负性情绪[焦虑自评量表(SAS)及抑郁自评量表(SDS)评分]及应对能力[心理一致感量表(SOC-13)评分]。结果:观察组患儿术后疼痛、睡眠障碍及哭闹、烦躁发生率低于对照组(P<0.05);治疗期间配合度优良率高于对照组(P<0.05)。干预后,两组患儿家属SAS、SDS评分均下降(P<0.05),且观察组低于对照组(P<0.05);SOC-13各维度评分及总分均升高(P<0.05),且观察组高于对照组(P<0.05)。结论:对人工耳蜗植入术患儿及家属实施术前治疗性沟通能提高其配合度,能减轻患儿术后不适,减轻患儿家属焦虑抑郁等负性情绪,提升应对能力。

Objective:To investigate the effect of preoperative therapeutic communication on cooperation degree,anxiety,depression and coping ability of family members in children with cochlear implantation.Methods:A total of 80 children receiving cochlear implantation were selected as the research objects.According to the different preoperative nursing methods,they were divided into control group and observation group,with 40 cases in each group.The control group received routine nursing before operation,and the observation group received therapeutic communication on the basis of routine nursing.Postoperative discomfort,cooperation during nursing,psychological status[score of self rating anxiety scale(SAS)and self rating depression scale(SDS)]and coping ability[sense of coherence(SOC)score]of family members before and after intervention were compared between the two groups.Results:The incidence of postoperative pain,sleep disorder,crying and restlessness in the observation group were lower than those in the control group(P<0.05).The excellent and good rate of coordination in the observation group was higher than that in the control group(P<0.05).After intervention,SAS and SDS scores of family members in both groups decreased(P<0.05),and those in the observation group were lower(P<0.05).The scores and total scores of the subscales of understanding,controllability and sense of meaning in the SOC-13 scale of family members in the two groups were increased(P<0.05),and those in the observation group were higher(P<0.05).Conclusion:Preoperative therapeutic communication for children with cochlear implantation and their families can improve their cooperation,relieve postoperative discomfort,reduce negative emotions such as anxiety and depression,and improve their coping ability.