危重症管理小组模式对脑外科重症患者日常生活活动能力及神经功能的影响

Effect of critical illness management team mode on activities of daily living and neurological function in critically ill patients undergoing brain surgery

目的探讨危重症管理小组模式对脑外科重症患者日常生活活动能力及神经功能的影响,以期为临床治疗提供参考。方法选取2018年1月—2021年12月于郑州人民医院接受治疗的70例脑外科重症患者作为研究对象,采用随机数字表法将患者分为联合组(n=35)和常规组(n=35)。常规组患者接受常规护理干预,联合组患者在常规组护理基础上接受危重症管理小组模式干预。比较2组患者出院时护理管理质量和日常生活活动能力情况;比较2组患者干预前、干预后1个月、干预后3个月神经功能缺损程度量表(NDS)及应用功能综合评定量表(FCA)评分;比较2组患者不良事件发生情况及患者家属满意度。结果联合组患者护理管理质量评定量表中基础护理、病房环境管理、医疗物品管理、安全管理、消毒隔离管理以及日常生活活动能力量表(ADL)评分均高于常规组,差异均有统计学意义(P<0.05)。干预前,2组患者NDS及FCA评分比较,差异无统计学意义(P>0.05)。干预后1、3个月时,2组患者NDS评分均低于干预前,且联合组低于同时期对照组,差异均有统计学意义(P<0.05)。干预后1、3个月时,2组患者FCA评分均高于干预前,且联合组高于同时期对照组,差异均有统计学意义(P<0.05)。联合组患者不良事件发生率低于常规组,差异有统计学意义(P<0.05)。联合组患者家属满意度为97.14%,高于常规组的80.00%,差异有统计学意义(P<0.05)。结论危重症管理小组模式可提高脑外科重症患者护理管理质量,改善患者日常生活能力,降低不良事件发生率,提高患者家属满意度,值得临床推广应用。

Objective This paper aims to investigate the effect of critical illness management team mode on activities of daily living(ADL)and neurological function in critically ill patients undergoing brain surgery to provide evidence for clinical treatment.Methods Seventy critically ill patients with brain surgery who received treatment in Zhengzhou People's Hospital from January 2018 to December 2021 were selected as the study participants and assigned to the combined group(n=35)and the conventional group(n=35)by the random number table.Patients in the conventional group received routine care intervention,and patients in the combined group received critical illness management group mode intervention in addition to the care in the routine group.The quality of nursing management and activities of daily living at discharge were compared between the two groups.The Neurologic Deficit Scale(NDS)and Functional Comprehensive Assessment(FCA)Scale scores were compared between the two groups before intervention,1 month after intervention,and 3 months after intervention.The occurrence of adverse events and the degree of satisfaction of patients'families were compared between the groups.Results The scores of basic nursing,ward environment management,medical materials management,safety management,disinfection and isolation management,and activities of daily living scale(ADL)in the combined group were significantly higher than those in the conventional group(P<0.05).Before the intervention,no significant difference was observed in NDS and FCA scores between the two groups(P>0.05).At 1 and 3 months after intervention,the NDS scores of patients in both groups were decreased,and the combined group was lower than the concurrent control group,with statistical significance(P<0.05).At 1 and 3 months after intervention,the FCA scores of patients in both groups were significantly increased,and the combined group was significantly higher than the concurrent control group(P<0.05).The incidence of adverse events in the combined group was significantly lower than that in the conventional group(P<0.05).The degree of satisfaction of family members in the combined group was significantly higher than that in the conventional group(97.14%vs.80.00%,P<0.05).Conclusion Critical illness management group mode can raise the quality of nursing management,improve the activities of daily living,reduce the incidence of adverse events,and increase the degree of satisfaction of patients'families in critically ill patients undergoing brain surgery.These benefits hold promise for a wider application of this mode clinically.