以护理为主导的慢病管理对癫痫患儿情绪、睡眠障碍等的影响

Impact of Nursing Led Chronic Disease Management on Emotional and Sleep Disorders in Children with Epilepsy

目的:探讨以护理为主导的慢病管理对癫痫患儿情绪、睡眠障碍的影响。方法:选取2021年2月至2023年2月江苏省南通市第一人民医院/南通大学第二附属医院儿科收治的癫痫患儿66例进行回顾性研究,依据护理方法分为观察组和对照组,每组33例。观察组给予以护理为主导的慢病管理,对照组给予常规管理。统计分析2组情绪障碍、日常生活能力、智能状况、睡眠状况、缺陷感、自尊程度、生命质量、遵医情况、健康行为领域问题发生情况、不良事件发生情况、家长满意度。结果:观察组患儿的汉密尔顿抑郁量表17项版(HRSD-17)、汉密尔顿焦虑量表(HAMA)、儿童焦虑型情绪障碍筛查量表(SCARED)、儿童抑郁障碍自评量表(DSRSC)、日常生活能力量表(ADL)评分均低于对照组(P<0.05),即刻记忆、短时记忆、语言理解、语言表达、语言复述、时间地点定向、物体命名、注意与计算、图形描画、阅读理解评分及简易智能量表(MMSE)总分均高于对照组(P<0.05),Berlin睡眠问卷评分、匹兹堡睡眠质量指数量表(PSQI)评分均低于对照组(P<0.05),缺陷感量表(FIS)、自尊量表(SES)、认知功能、发作担忧、生命质量、总健康评分均高于对照组(P<0.05)。观察组患儿的遵医率96.97%(32/33)高于对照组75.76%(25/33)(χ2=4.632,P<0.05)。观察组患儿的用药、营养、睡眠问题发生率均低于对照组(P<0.05)。观察组患儿的不良事件发生率3.03%(1/33)低于对照组24.24%(8/33)(χ2=4.632,P<0.05)。观察组患儿的家长满意度96.97%(32/33)高于对照组72.73%(24/33)(χ2=7.543,P<0.05)。结论:癫痫护理中以护理为主导的慢病管理较常规管理更能改善癫痫患儿情绪和睡眠障碍。

Objective:To explore the impact of nursing led chronic disease management on emotional disorders in children with epilepsy.Methods:A retrospective study was conducted on 66 children with epilepsy admitted to the Pediatric Department of the First People′s Hospital/Second Affiliated Hospital of Nantong University in Jiangsu Province from February 2021 to February 2023.They were divided into an observation group,a control group(observation group),and a control group based on nursing methods,with 33 cases in each group.The observation group was given nursing led chronic disease management,while the control group was given routine management.Statistical analysis was conducted on two groups of emotional disorders,daily living ability,intelligence status,sleep status,sense of defect,self-esteem level,quality of life,medical compliance,occurrence of health behavior issues,occurrence of adverse events,and parental satisfaction.Results:The Hamilton Depression Scale 17(HRSD-17)scores,Hamilton Anxiety Scale(HAMA),Children′s Anxiety Disorder Screening Scale(SCARED),Children′s Depression Self Rating Scale(DSRSC),and Daily Living Ability Scale(ADL)scores of the observation group were lower than those of the control group(P<0.05).Immediate memory,short-term memory,language understanding,language expression,language repetition,time and place orientation,object naming the scores of attention and calculation,graphic drawing,reading comprehension,and the total score of the Simple Intelligence Scale(MMSE)were higher than those of the control group(P<0.05),while the scores of the Berlin Sleep Questionnaire and Pittsburgh Sleep Quality Index(PSQI)were lower than those of the control group(P<0.05).The scores of the Defect Perception Scale(FIS),Self Esteem Scale(SES),Cognitive Function,Attack Worry,Quality of Life,and Total Health were all higher than those of the control group(P<0.05).The compliance rate of 96.97%(32/33)in the observation group was higher than 75.76%(25/33)in the control group(χ2=4.632,P<0.05).The incidence of medication,nutrition,and sleep problems in the observation group was lower than that in the control group(P<0.05).The incidence of adverse events in the observation group was 3.03%(1/33)lower than that in the control group,which was 24.24%(8/33)(χ2=4.632,P<0.05).The parents′satisfaction rate of 96.97%(32/33)in the observation group was higher than that of 72.73%(24/33)in the control group(χ2=7.543,P<0.05).Conclusion:Nursing led chronic disease management in epilepsy care is more effective in improving emotional disorders in children with epilepsy compared to routine management.