以正强化理论为指导的护理干预对类风湿关节炎患者疼痛及功能锻炼依从性影响

Effects of nursing intervention guided by positive strengthening theory on pain and functional exercise compliance in patients with rheumatoid arthritis

目的观察类风湿关节炎(RA)患者锻炼期间应用以正强化理论为指导的护理干预所产生的疼痛感、功能锻炼依从性及关节活动度的影响。方法便利抽样法选取2018年2月至2020年2月就诊于南京医科大学附属淮安第一医院的96例RA患者为研究对象,按照随机数字表法将其分为对照组(49例)及观察组(49例)。对照组采用常规护理,观察组在对照组的基础上行以正强化理论为指导的护理干预,干预时间为8周。比较两组干预前,干预2、8周主观疼痛感、关节活动度、功能锻炼依从性。结果观察组中存在2例患者中途脱组,最后入组47例。整体分析发现:两组视觉模拟评分法(VAS)评分、28个关节的疾病活动评分(DAS28)、家庭锻炼依从性量表组间、时间及交互作用比较,差异有统计学意义(P<0.05)。组内比较:对照组不同时间点VAS评分、DAS28评分、家庭锻炼依从性量表评分比较,差异无统计学意义(P>0.05);干预2、8周时,观察组VAS评分、DAS28评分低于本组干预前,家庭锻炼依从性量表评分高于本组干预前,差异有统计学意义(P<0.05)。组间比较:干预2、8周时,观察组VAS评分、DAS28评分低于对照组,家庭锻炼依从性量表评分高于对照组,差异有统计学意义(P<0.05)。结论以正强化理论为指导的护理干预对RA患者护理过程中,能够降低患者功能锻炼期间主观疼痛感及疾病活动度,提升功能锻炼依从性。

Objective To observe the effects of nursing intervention guided by positive strengthening theory on pain and functional exercise compliance in patients with rheumatoid arthritis(RA).Methods A total of 96 RA patients admitted to the Affiliated Huaian NO.1 Hospital of Nanjing Medical University from February 2018 to February 2020 were selected as subjects by convenience sampling method.According to random number table method,they were divided into control group(49 cases)and observation group(49 cases).The control group received routine nursing,and the observation group received nursing intervention guided by positive strengthening theory on the basis of the control group,the intervention time was eight weeks.Subjective pain,range of motion,and functional exercise compliance were compared between two groups before intervention,and at two and eight weeks of intervention.Results In the observation group,two patients left the group midway,and 47 patients were enrolled at last.The overall analysis showed that there were statistically significant differences in visual analog scale(VAS)scores,disease activity score 28(DAS28),and family exercise compliance scale between two groups in intergroup,time,and interaction(P<0.05).Intra-group comparison:VAS scores,DAS28 scores,and family exercise compliance scale scores of control group at different time points showed no significant difference(P>0.05).At two and eight weeks of intervention,VAS scores and DAS28 scores of observation group were lower than those before intervention,and functional exercise family exercise compliance scale scores were higher than those before intervention,and the differences were statistically significant(P<0.05).Comparison between groups:at two and eight weeks of intervention,VAS scores and DAS28 scores of observation group were lower than those of control group,and family exercise compliance scale scores were higher than those of control group,and the differences were statistically significant(P<0.05).Conclusion Nursing intervention guided by positive strengthening theory can reduce patients’subjective pain perception and disease activity during functional exercise,and improve the compliance of functional exercise in the nursing process of patients with RA.