康复前移模式在慢性化脓性中耳炎患者护理中的效果观察

Rehabilitation forward mode nursing for patients with chronic suppurative otitis media

目的探讨康复前移模式在慢性化脓性中耳炎(CSOM)患者护理中的应用效果。方法本研究采用类实验研究方法,便利选取2018年5月至2021年6月在湖南省人民医院耳鼻喉科住院的146例CSOM行手术治疗患者,按照入院的先后顺序进行分组。2018年5月至2019年12月收治的74例患者设为对照组,其中男28例、女46例,年龄(42.26±10.34)岁;2020年1月至2021年6月收治的72例患者设为观察组,其中男31例、女41例,年龄(37.01±12.17)岁。对照组给予常规护理模式,观察组采用康复前移模式进行护理,其主要内容包括心理康复护理前移、运动康复训练前移、术后疼痛护理指导前移、术后并发症护理指导前移。比较两组患者术后焦虑情况、疼痛症状、自我效能感、总住院时间及术后并发症发生率。统计学方法采用χ^(2)检验、t检验。结果干预后,观察组患者术后焦虑得分低于对照组[(43.93±3.95)分比(48.03±2.54)分],差异有统计学意义(t=7.436,P<0.05);观察组患者术后6 h、24 h、48 h的疼痛得分均低于对照组[(4.49±1.04)分比(5.15±1.09)分、(3.60±0.97)分比(4.69±0.98)分、(1.88±0.86)分比(2.82±0.98)分],差异均有统计学意义(t=3.758、6.759、6.215,均P<0.05);干预后,观察组患者自我效能感得分高于对照组[(27.39±2.27)分比(25.86±2.38)分],差异有统计学意义(t=-3.956,P<0.05);观察组患者总住院时间低于对照组[(5.83±2.91)d比(7.86±2.72)d],差异有统计学意义(t=4.360,P<0.05);两组并发症情况比较,差异有统计学意义(χ^(2)=4.622,P<0.05)。结论应用康复前移模式对CSOM手术治疗患者进行护理,可有效缓解术后疼痛和焦虑不适,提高自我效能感,缩短住院时间并降低术后并发症的发生,值得临床推广。

Objective To explore the effect of rehabilitation forward mode nursing for patients with chronic suppurative otitis media.Methods This study adopted a quasi-experimental research method.One hundred and forty-six patients with chronic suppurative otitis media who received surgical treatment in Department of Otolaryngology,Hunan Provincial People's Hospital from May 2018 to June 2021 were conveniently selected.According to the sequence of admission,the patients were grouped.The 74 patients admitted from May 2018 to December 2019 were set as a control group,including 28 males and 46 females who were(42.26±10.34)year old.The rest 72 patients admitted from January 2020 to June 2021 were set as an observation group,including 31 males and 41 females who were(37.01±12.17)years old.The control group took the conventional nursing;the observation group took rehabilitation forward mode nursing,including psychological rehabilitation forward nursing,exercise rehabilitation training forward,postoperative pain nursing guidance forward,and postoperative complication nursing guidance forward.The postoperative anxiety,pain symptoms,self-efficacies,total hospital stays,and incidences of postoperative complications were compared between the two groups.χ^(2) and t tests were applied.Results After the intervention,the postoperative anxiety score and the pain scores 6,24,and 48 h after the operation in the observation group were lower than those in the control group[(43.93±3.95)vs.(48.03±2.54),(4.49±1.04)vs.(5.15±1.09),(3.60±0.97)vs.(4.69±0.98),and(1.88±0.86)vs.(2.82±0.98)],with statistical differences(t=7.436,3.758,6.759,and 6.215;all P<0.05).After the intervention,the score of self-efficacy in the observation group was higher than that in the control group[(27.39±2.27)vs.(25.86±2.38)],with a statistical difference(t=-3.956,P<0.05).The total hospital stay in the observation group was shorter than that in the control group[(5.83±2.91)d vs.(7.86±2.72)d],with a statistical difference(t=4.360,P<0.05).There was a statistical difference in the incidence of complications between the two groups(χ^(2)=4.622,P<0.05).Conclusion Rehabilitation forward mode nursing for patients with chronic suppurative otitis media can effectively relieve their postoperative pain and anxiety,improve their self-efficacy,shorten their hospital stay,and reduce the occurrence of postoperative complications,so it is worthy of clinical promotion.