基于哈贝马斯交往行为理论的沟通模式在急诊脑外伤患者中的应用

Application of Habermas's theory of communicative action-based communication in emergency patients with traumatic brain injury

目的探讨基于哈贝马斯交往行为理论的沟通模式在急诊脑外伤患者中的应用效果。方法回顾性分析2021年1月—2022年12月在西安交通大学第一附属医院进行救治的106例脑外伤患者的临床资料,根据护理干预方法不同分为观察组和对照组,每组53例。对照组患者采用常规脑外伤急救护理干预,观察组患者采用基于哈贝马斯交往行为理论的沟通模式进行干预。比较2组患者的确诊时间、手术准备时间、住院时间等急诊救治效果指标及家属护理满意度,同时比较2组患者的神经功能缺损状况、日常生活能力等指标以及并发症发生情况。结果干预前,2组患者美国国立卫生研究院卒中量表(NIHSS)评分比较,差异无统计学意义(P>0.05);干预后,观察组患者的NIHSS评分低于对照组,日常生活能力量表(ADL)评分高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者神经行为认知状态检查(NCSE)量表及格拉斯哥昏迷评分量表(GCS)评分比较,差异均无统计学意义(P>0.05);干预后,观察组患者的NCSE和GCS评分均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的确诊时间、手术准备时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。观察组患者家属对护理人员沟通能力、健康宣教水平、操作技能、服务态度4项护理满意度评分均高于对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者术后并发症发生率分别为5.67%和15.09%,差异无统计学意义(χ^(2)=2.536,P=0.111)。结论基于哈贝马斯交往行为理论的沟通模式应用于急诊脑外伤患者护理中,有助于减轻患者神经功能受损程度,改善患者神经认知功能,提升急诊救治效率和家属护理满意度。

Objective To investigate the effect of communication mode based on Habermas's theory of communicative action in emergency patients with traumatic brain injury(TBI).Methods The clinical data of 106 patients with TBI treated in the First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to December 2022 were analyzed retrospectively.They were allocated to the observation group and the control group according to different nursing intervention methods,with 53 cases in each group.Patients in the control group received routine emergency nursing intervention for TBI,and patients in the observation group,communication mode based on Habermas's theory of communicative action.The time of diagno-sis,preparation time of operation,length of hospital stay,and other indicators of emergency treatment effect and degree of family member's satisfaction with nursing were compared between the two groups,and the neurological deficit,activities of daily living and other indicators and complications were also compared between the groups.Results No significant differ-ence was observed in the National Institutes of Health Stroke Scale(NIHSS)score before intervention between the two groups(P>0.05);after intervention,the NIHSS score of the observation group was significantly lower than that of the control group,and the Activities of Daily Living Scale(ADL)score was significantly higher than that of the control group(P<0.05).Before intervention,no significant difference was found in neurobehavioral cognitive status examination(NCSE)and Glasgow Coma Scale(GCS)scores between the two groups(P>0.05);after intervention,NCSE and GCS scores in the observation group were significantly higher than those in the control group(P<0.05).The confirmed time,operation preparation time,and length of hospital stay of patients in the observation group were significantly shorter than those in the control group(P<0.05).The scores of the degree of family members'satisfaction with nursing in communica-tion ability,health education level,operation skills,and service attitude in the observation group were significantly higher than those in the control group(P<0.05).The difference in the incidence rate of postoperative complications between the observation group and the control group was not statistically significant(5.67%vs.15.09%;χ^(2)=2.536,P=0.111).Conclusion The communication mode based on Habermas's theory of communicative action can reduce the degree of neuro-logical impairment,potentiate the neurocognitive function,promote the efficiency of emergency treatment,and raise the de-gree of family members'satisfaction with nursing in emergency patients with TBI.