循证护理联合睑板腺按摩对行强脉冲光治疗的睑板腺障碍性干眼症患者康复效果的影响

Effect of evidence-based nursing combined with meibomian gland massage on the rehabilitation of patients with dry eye syndrome caused by meibomian gland disorders treated with intense pulse light therapy

目的探讨循证护理联合睑板腺按摩干预对行强脉冲光治疗的睑板腺障碍性干眼症患者康复效果的影响。方法选取2021年9月至2022年11月在郑州大学第一附属医院眼科门诊就诊的164例睑板腺障碍性干眼症患者为研究对象,按随机数表法分为循证护理组和常规护理组各82例。两组患者均接受强脉冲光治疗,常规护理组采用睑板腺按摩和常规护理干预,循证护理组采用睑板腺按摩和循证护理干预。干预9周后,比较两组患者的眼部症状严重程度[眼表疾病指数(OSDI)问卷评]、睑板腺功能、应对方式、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、治疗依从性、护理满意度和复发率。结果干预9周后,循证护理组患者的OSDI、SAS、SDS、消极应对评分分别为(12.63±1.02)分、(37.25±1.68)分、(33.98±2.63)分、(5.17±0.86)分,明显低于常规护理组的(17.96±1.22)分、(45.63±2.05)分、(39.87±3.52)分、(9.36±1.23)分,积极应对评分为(33.04±1.05)分,明显高于常规护理组的(28.30±1.17)分,差异均有统计学意义(P<0.05);干预9周后,循证护理组患者的睑板腺开口体征、睑板腺脂质分泌物性状、睑板腺缺失评分及睑板腺功能总分分别为(0.73±0.14)分、(0.54±0.10)分、(0.82±0.11)分、(2.09±0.23)分,明显低于常规护理组的(1.42±0.23)分、(1.28±0.19)分、(1.58±0.21)分、(4.28±0.46)分,差异均有统计学意义(P<0.05);循证护理组患者的治疗总依从率为93.90%,明显高于常规护理组的73.17%,总满意度为97.56%,明显高于常规护理组的82.93%,差异均有统计学意义(P<0.05);干预后6个月,循证护理组患者的复发率为2.50%,明显低于常规护理组的11.54%,差异有统计学意义(P<0.05)。结论循证护理联合睑板腺按摩可改善行强脉冲光治疗的睑板腺障碍性干眼症患者的负性情绪,调节其应对方式,提升其治疗依从性,还可改善眼部症状及睑板腺功能,降低疾病复发风险,提升护理满意度。

Objective To explore the effect of evidence-based nursing combined with meibomian gland massage intervention on the rehabilitation of patients with dry eye syndrome caused by meibomian gland disorders treated with intense pulse light therapy.Methods A total of 164 patients with dry eye syndrome caused by meibomian gland disorders who visited Outpatient Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University from September 2021 to November 2022 were collected and randomly divided into evidence-based nursing group and routine nursing group by number table method,with 82 patients in each group.Both groups received intense pulse light therapy.The routine nursing group received meibomian gland massage and routine nursing intervention,while the evidence-based nursing group received meibomian gland massage and evidence-based nursing intervention.After 9 weeks of intervention,the severity of eye symptoms(OSDI questionnaire evaluation),meibomian gland function,coping style,negative emotions[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],treatment compliance,nursing satisfaction,and recurrence rate were compared between the two groups.Results After 9 weeks of intervention,the scores of OSDI,SAS,SDS,and negative coping in the evidence-based nursing group were(12.63±1.02)points,(37.25±1.68)points,(33.98±2.63)points,and(5.17±0.86)points,respectively,which were significantly lower than(17.96±1.22)points,(45.63±2.05)points,(39.87±3.52)points,and(9.36±1.23)points in the routine nursing group,while the positive coping score was(33.04±1.05)points,which was significantly higher than(28.30±1.17)points in the routine nursing group,with statistically significant differences(P<0.05).After 9 weeks of intervention,the scores of meibomian gland opening signs,meibomian gland lipid secretion characteristics,meibomian gland deficiency scores,and total meibomian gland function in the evidence-based nursing group were(0.73±0.14)points,(0.54±0.10)points,(0.82±0.11)points,and(2.09±0.23)points,respectively,which were significantly lower than(1.42±0.23)points,(1.28±0.19)points,(1.58±0.21)points,and(4.28±0.46)points in the routine nursing group(P<0.05).The total compliance rate of the evidence-based nursing group was 93.90%,which was significantly higher than 73.17% of the routine nursing group,and the total satisfaction rate was 97.56%,which was significantly higher than 82.93% of the routine nursing group,with statistically significant differences(P<0.05).After 6 months of intervention,the recurrence rate in the evidence-based nursing group was 2.50%,which was significantly lower than 11.54%in the routine nursing group(P<0.05).Conclusion Evidence-based nursing combined with meibomian gland massage can improve the negative emotions of patients with dry eye syndrome caused by meibomian gland disorders treated with intense pulse light,regulate their coping styles,enhance their treatment compliance,improve eye symptoms and meibomian gland function,reduce the risk of disease recurrence,and increase nursing satisfaction.