基于问题解决模式的多维度干预对糖尿病足溃疡患者心理状态和创面愈合的影响

Effects of Multi-dimensional Intervention Based on Problem-Solution Mode onPsychological State and Wound Healing in Patients with Diabetic Foot Ulcer

目的观察基于问题解决(ADOPT)模式的多维度干预对糖尿病足溃疡(DFU)患者心理状态和创面愈合的影响。方法选取2018年3月至2021年3月河南省人民医院收治的86例DFU患者,以随机数表法分成研究组与对照组,各43例,给予对照组患者常规护理,研究组患者则在对照组基础上接受基于ADOPT的多维度干预。比较两组患者干预前后的焦虑自评量表(SDS)评分、抑郁自评量表(SAS)评分、创面严重程度、生活质量(SF-36)评分以及不良事件的发生情况。结果干预后研究组患者的SAS及SDS评分低于对照组,溃疡面积小于对照组(P<0.05)。研究组Wagner分级Ⅰ级与Ⅱ级占比及SF-36评分高于对照组(P<0.05)。干预期间研究组不良事件总发生率(4.65%)低于对照组(18.60%)(P<0.05)。结论基于ADOPT多维度干预能有效改善DFU患者的心理状态,促进创面愈合,同时有助于生活质量的提高,并减少不良事件的发生率。

Objective To observe the effects of multi-dimensional intervention based on problem-solution(ADOPT)mode on psychological state and wound healing in patients with diabetic foot ulcer(DFU).Methods A total of 86 patients with DFU admitted to Henan Provincial People’s Hospital from March 2018 and March 2021 were enrolled.According to random number table method,they were divided into study group and control group,with 43 cases in each group.The control group was given routine nursing,while study group was additionally given multi-dimensional intervention based on ADOPT mode.The scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS),wound severity,score of the 36-item shot-form health status survey(SF-36)and the occurrence of adverse events were compared between the two groups before and after intervention.Results After intervention,SAS and SDS scores in study group were lower than those in control group,and ulcer area in study group was less than that in control group(P<0.05).The proportion of Wagner grading at gradeⅠ-Ⅱand SF-36 scores in study group were higher than those in control group(P<0.05).During intervention,total incidence of adverse events in study group(4.65%)was lower than that in control group(18.60%)(P<0.05).Conclusion The multi-dimensional intervention based on ADOPT mode can effectively improve psychological status and promote wound healing in DFU patients,which is beneficial to improve quality of life and reduce incidence of adverse events.