多元化临床路径护理对黄斑变性患者康复效果及疾病感知、焦虑情绪的影响

Effect of diverse clinical pathway nursing on rehabilitation effect,disease perception and anxiety of patients with macular degeneration

目的探讨多元化临床路径护理对黄斑变性患者康复效果及疾病感知、焦虑情绪的影响。方法选取2021年2月—2022年2月郑州市第二人民医院诊治的86例黄斑变性患者,采用随机数字表法分为对照组与观察组,每组43例。对照组患者给予常规护理干预,观察组患者在对照组基础上给予多元化临床路径护理干预,出院3个月后比较2组患者视力变化情况,同时比较2组患者护理干预前后的希望水平、自我管理能力、疾病感知水平、心理状况、生活质量,并发症发生情况及护理满意度。结果观察组患者干预后视力恢复效果优于对照组,差异有统计学意义(Z=1.568,P=0.029)。2组患者干预前慢性病自我管理研究测量表(CDSMS)、Herth希望量表(HHI)、疾病感知问卷简化版(BIPQ)评分比较,差异均无统计学意义(P>0.05);观察组患者干预后CDSMS、HHI评分高于对照组,BIPQ评分低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前抑郁-焦虑-压力量表中文简版(DASS-21)、贝克焦虑量表(BAI)、生活质量综合评定问卷(GQOLI-74)评分比较,差异均无统计学意义(P>0.05);观察组患者干预后DASS-21、BAI评分低于对照组,GQOLI-74评分高于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为2.33%(1/43),低于对照组的18.60%(8/43),差异有统计学意义(χ^(2)=4.468,P=0.035)。观察组患者护理满意度为100.00%(43/43),高于对照组的86.05%(37/43),差异有统计学意义(χ^(2)=4.479,P=0.034)。结论在黄斑变性患者中应用多元化临床路径护理干预,可促进患者视力恢复,提升患者希望水平及自我管理能力,改善患者疾病感知水平,缓解患者负性情绪,降低并发症发生风险,提升护理满意度及生活质量,值得在临床应用。

Objective This paper aims to investigate the effect of diverse clinical pathway nursing on the rehabilitation effect,disease perception,and anxiety of patients with macular degeneration.Methods Eighty-six patients with macular degeneration the Second People's Hospital of Zhengzhou from Feb.2021 to Feb.2022 were randomly assigned to the control group(n=43)and observation group(n=43).The patients in the control group received routine nursing intervention,while the patients in the observation group received diverse clinical pathway nursing intervention on the basis of the control group.At three months after discharge,the vision changes of the patients in the two groups were compared.The hope level,self-management ability,disease perception level,psychological status,quality of life,complications,and nursing satisfaction before and after nursing intervention were also compared between the groups.Results The vision recovery effect of the observation group was significantly better than that of the control group after intervention(Z=1.568,P=0.029).There were no significant differences in the scores of the Chronic Disease Self-Management Support(CDSMS),Herth Hope Index(HHI),and Brief Illness Perception Questionnaire(BIPQ)before intervention between the 2 groups(P>0.05).The CDSMS and HHI scores after intervention in the observation group were higher than those in the control group,and the BIPQ score was lower than that in the control group,all with statistical significance(P<0.05).There were no significant differences in the scores of Depression Anxiety and Stress Scale 21(DASS-21),Beck Anxiety Inventory(BAI),and Generic Quality of Life Inventory-74(GQOLI-74)before intervention between the two groups(P>0.05).The scores of DASS-21 and BAI after intervention in the observation group were lower than those in the control group,and the score of GQOLI-74 were higher than that in the control group,all with statistical significance(P<0.05).The incidence rate of complications in the observation group was 2.33%(1/43),which was significantly lower than that in the control group(18.60%,8/43;χ^(2)=4.468,P=0.035).The degree of satisfaction with nursing in the observation group was 100.00%(43/43),which was significantly higher than that in the control group(86.05%,37/43;χ^(2)=4.479,P=0.034).Conclusion The application of diverse clinical pathway nursing intervention in patients with macular degeneration can promote vision recovery,improve their hope levels and self-management abilities,enhance their disease perception levels,alleviate negative emotions,reduce the risk of complications,and increase their degree of satisfaction with nursing and quality of life.These benefits hold promise for a wider application of this technique clinically.