分级式急诊护理联合心理护理在急性上消化道出血患者护理中的应用

Application of Hierarchical Emergency Care Combined with Psychological Care in the Care of Patients with Acute Upper Gastrointestinal Bleeding

目的探究对急性上消化道出血(UGIB)患者应用联合护理方案(分级式急诊护理+心理干预)的临床护理价值。方法选取2020年3月至2022年3月到中山大学附属第七医院就诊的88例UGIB患者,通过随机选取的方式将88例患者平分为两组,各44例。对照组实施单一心理护理,试验组实施分级式急诊护理+心理干预联合护理方案。护理后对两组患者的护理结果进行比较,包括消化道总出血量、二次出血发生率、出血症状消失时间、总住院时间进行比较,对患者的负面情绪(抑郁、焦虑)、自护能力(ESCA量表)和护理依从性(Morisky问卷)进行比较,并比较两组患者对医院护理人员服务评分情况。结果试验组患者总出血量、二次出血发生率、出血症状消失时间、总住院时间都略少于对照组(P<0.05);试验组SAS、SDS评分比对照组低,且ESCA指数比对照组高(P<0.05);试验组患者对护理人员的服务态度、行为规范、宣教水平和卫生环境评分都比对照组高(P<0.05)。结论对UGIB患者联合实施分级式急诊护理和心理干预可以有效改善患者的临床出血症状,提高患者的预后效果。

Objective To explore the clinical nursing value of the combined nursing program(hierarchical emergency care+psychological intervention)for patients with acute upper gastrointestinal bleeding(UGIB).Methods The study time was selected as from March 2020 to March 2022.A total of 88 UGIB patients visited our hospital in the past two years.All patients were divided into two groups of 44 each.A group of patients implementing the single psychological nursing was set as the control group,and a group implementing the hierarchical emergency nursing program and psychological intervention was set as the experimental group.After nursing the nursing results of the two groups of patients,including the total amount of gastrointestinal bleeding,secondary bleeding rate,bleeding symptoms disappear time,total hospital stay,to compare the patients'negative emotions(depression,anxiety),self-care ability(ESCA scale)and nursing compliance(Morisky questionnaire),and compare the score of the two groups.Results The total bleeding volume,incidence of secondary bleeding,bleeding disappearance time and the total hospitalization were slightly less than the control group(P<0.05);the SAS and SDS scores were lower than the control group and the ESCA index was higher than the control group(P<0.05);the service attitude,code of conduct,education level and health environment scores were higher than the control group(P<0.05).Conclusions The combined implementation of graded emergency care and psychological intervention for UGIB patients can effectively improve the clinical bleeding symptoms and improve the prognosis of patients.