以Neuman理论为框架的护理模式对艾滋病患者自我管理及病毒抑制的影响分析

Analysis of the Effects of a Care Model Framed by Neuman’s Theory on Self-management and Viral Suppression in Patients with AIDS

目的:探讨以Neuman理论为框架的护理模式对艾滋病患者自我管理及病毒抑制的影响。方法:选取2020年6月—2021年5月深圳市第三人民医院就诊的240例艾滋病患者作为研究对象,遵循随机原则分为试验组与对照组,每组各120例。对照组实施常规护理模式,试验组在常规护理模式基础上实施以Neuman理论为框架的护理模式,均干预3个月。比较两组患者干预前、干预后后的疾病不确定性、自我管理行为及病毒抑制情况。结果:干预前,两组患者Mishel疾病不确定性量表各维度评分比较,差异无统计学意义(t=-0.222、0.278、0.067、0.161,P>0.05);干预3个月后,两组患者Mishel疾病不确定性量表中的4个维度得分均较干预前降低,试验组患者的降低趋势较对照组更明显,差异有统计学意义(t=-9.504、-5.859、-8.506、-5.596,P<0.05)。干预前,两组患者自我管理能力量表各维度评分比较,差异无统计学意义(t=0.225、0.637、1.338、0.234、-0.196、0.555、-0.261、0.025,P>0.05);干预3个月后,两组患者自我管理能力量表中的7个维度得分及总分均较干预前升高,试验组患者的升高趋势较对照组更明显,差异有统计学意义(t=7.804、20.200、25.434、6.006、10.830、15.867、9.290、17.176,P<0.05)。干预3个月后,试验组患者的病毒完全抑制率显著高于对照组,差异有统计学意义(χ^(2)=23.721,P<0.05)。结论:以Neuman理论为框架的护理模式干预可有效减轻艾滋病患者的疾病不确定性,提高患者的自我管理能力,改善病毒的抑制效果。

Objective:To explore the impact of a care model framed by Neuman’s theory on self-management and viral suppression in patients with AIDS.Methods:A total of 240 AIDS patients attending the hospital from June 2020 to May 2021 were selected as the study population and were divided into a test group and a control group following the randomization principle,with 120 cases in each group.The control group implemented the conventional care model,and the experimental group implemented the care model based on the conventional care model with the framework of Neuman’s theory,both interventions for 3 months.The disease uncertainty,self-management behaviors and viral suppression in the two groups were compared before and after the intervention.Results:Before the intervention,there was no statistically significant difference between the scores of the dimensions of the Mishel Disease Uncertainty Scale in the two groups(t=-0.222,0.278,0.067,0.161,P>0.05).After 3 months of intervention,the scores on all 4 dimensions of the Mishel Disease Uncertainty Scale were lower in both groups than before the intervention,and the trend of reduction was more pronounced in patients in the test group than in the control group,with statistically significant differences(t=-9.504,-5.859,-8.506,-5.596,P<0.05).Before the intervention,there was no statistically significant difference between the two groups when comparing the scores of the dimensions of the self-management ability scale(t=0.225,0.637,1.338,0.234,-0.196,0.555,-0.261,0.025,P>0.05).After 3 months of intervention,the scores on the 7 dimensions of the self-management ability scale and the total scores of both groups were higher than before the intervention,and the trend of increase was more pronounced in the test group than in the control group,with statistically significant differences(t=7.804,20.200,25.434,6.006,10.830,15.867,9.290,17.176,P<0.05).After 3 months of intervention,the rate of complete viral suppression was significantly higher in the test group than in the control group,with a statistically significant difference(χ^(2)=23.721,P<0.05).Conclusion:A care model intervention framed by Neuman’s theory can effectively reduce disease uncertainty,improve patient self-management,and improve viral suppression in patients with AIDS.