问题导向护理干预对类风湿性关节炎患者预后的影响

Effect of problem-oriented nursing intervention on prognosis in patients with rheumatoid arthritis

目的探讨问题导向护理干预对类风湿性关节炎患者预后的影响。方法选取2018年1月—2022年1月平顶山市第一人民医院诊治的224例类风湿性关节炎患者作为研究对象,采用抽签法将患者随机分为研究组与对照组,每组112例。对照组患者给予常规护理干预,研究组患者在对照组基础上给予问题导向护理干预,2组患者均干预3个月。比较2组患者干预3个月后的临床疗效及护理满意度;比较2组患者干预前及干预3个月后免疫球蛋白(Ig)A、IgM水平及简明健康状况问卷(SF-36)评分。结果研究组患者的干预总有效率为97.32%(109/112),高于对照组的85.71%(96/112),差异有统计学意义(χ^(2)=9.719,P=0.002)。2组患者干预前IgA、IgM水平比较,差异无统计学意义(P>0.05);2组患者干预后血清IgA、IgM水平均低于干预前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者护理满意度为100.0%(112/112),高于对照组的91.96%(103/112),差异有统计学意义(χ^(2)=7.409,P=0.006)。2组患者干预前SF-36各维度评分比较,差异无统计学意义(P>0.05);2组患者干预后SF-36各维度评分均高于干预前,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论问题导向护理干预应用于类风湿性关节炎患者,有助于改善患者预后,提高患者生活质量及护理满意度,值得在临床推广。

Objective This paper aims to explore the effect of problem-oriented nursing intervention on the prognosis in patients with rheumatoid arthritis.Methods A total of 224 patients with rheumatoid arthritis from January 2018 to January 2022 were randomly assigned to the study group(n=112)and control group(n=112)by drawing lots.Patients in the control group received routine nursing intervention,and patients in the study group received problem-oriented nursing intervention based on the control group.Patients in both groups were intervened for 3 months.The response of intervention and the degree of satisfaction with nursing between the two groups after intervention.The immunoglobulin(Ig)A and IgM levels,and the 36-Item Short-Form Health Survey(SF-36)between the two groups before and after intervention.Results The overall response rate of intervention in the study group was 97.32%(109/112),which was significantly higher than that in the control group(85.71%,96/112;χ^(2)=9.719,P=0.002).There was no significant difference in serum IgA and IgM levels before intervention between the two groups(P>0.05).The serum IgA and IgM levels after intervention in the two groups were lower than those before intervention,and the study group was lower than the control group,with statistical significance(P<0.05).The degree of satisfaction with nursing in the study group was 100.0%(112/112),which was significantly higher than that in the control group(91.96%,103/112;χ^(2)=7.409,P=0.006).There was no significant difference in subscale scores of the Chinese version of the SF-36 before intervention between the two groups(P>0.05).The subscale scores of the Chinese version SF-36 after intervention in the two groups were higher than those before intervention,and the study group was higher than the control group,with statistical significance(P<0.05).Conclusion Problem-oriented nursing intervention in patients with rheumatoid arthritis is helpful to improve the prognosis,quality of life,and nursing satisfaction.These advantages hold promise for a wider application of this technique clinically.