基于生态系统理论的家庭-医院综合康复护理在肾病综合征患儿中的应用

Application of home-hospital comprehensive rehabilitation nursing based on ecosystem theory in children with nephrotic syndrome

目的探究基于生态系统理论的家庭-医院综合康复护理在肾病综合征患儿中的应用效果。方法选取2022年9月至2024年3月郑州大学第一附属医院收治的120例肾病综合征患儿作为研究对象,按随机数表法分为观察组和对照组各60例。对照组患儿采用常规康复护理,观察组患儿则采用基于生态系统理论的家庭-医院综合康复护理。比较两组患儿护理3个月后的复发情况、诱因;比较两组患儿护理前和护理3个月后的生活质量(采用少儿生活质量问卷评估认知、情感和总体水平)、儿童自尊量表(CSES)评分(公德与助人、纪律、成就感、能力、外表、体育运动);比较两组患儿家属对护理的满意度。结果观察组患儿复发率为8.33%,明显低于对照组的51.67%,复发诱因中的感染、饮食、家庭环境、运动程度的占比明显低于对照组,差异均有统计学意义(P<0.05);护理3个月后,两组患儿的认知、情感和总体水平评分较护理前均明显升高,且观察组的认知、情感和总体水平评分分别为(99.35±11.21)分、(79.48±7.31)分、(179.25±12.68)分,明显高于对照组的(90.51±10.26)分、(70.56±7.84)分、(163.43±11.35)分,差异均有统计学意义(P<0.05);护理3个月后,两组患儿的公德与助人、纪律、成就感、能力、外表、体育运动评分较护理前均显著升高,且观察组的公德与助人、纪律、成就感、能力、外表、体育运动评分分别为(19.26±2.15)分、(16.33±2.04)分、(19.36±2.07)分、(25.14±3.82)分、(16.27±1.74)分、(15.29±1.93)分,明显高于对照组的(18.02±2.14)分、(15.84±1.82)分、(17.82±1.95)分、(22.73±3.27)分、(15.23±1.48)分、(13.32±2.06)分,差异均有统计学意义(P<0.05);观察组患儿家属对护理的满意度为95.00%,明显高于对照组的83.33%,差异均有统计学意义(P<0.05)。结论肾病综合征患儿应用基于生态系统理论的家庭-医院综合康复护理,可以降低患儿的复发率,提高其生活质量和自尊心,且家属的满意度较高,值得推广应用。

Objective To explore the application effect of home-hospital comprehensive rehabilitation nursing based on ecosystem theory in children with nephrotic syndrome.Methods A total of 120 children with nephrotic syn-drome treated in the First Affiliated Hospital of Zhengzhou University from September 2022 to March 2024 were select-ed and divided into an observation group and a control group according to random number table method,with 60 chil-dren in each group.Patients in the control group were treated with routine rehabilitation nursing,while those in the obser-vation group were treated with home-hospital comprehensive rehabilitation nursing based on ecosystem theory.The re-currence situation and inducement were compared between the two groups after 3 months of nursing.The quality of life(cognitive,emotional and general levels were assessed by the children's Quality of Life questionnaire)and the scores of the Children's Self-esteem Scale(CSES,including social ethics and helping others,discipline,achievement,ability,ap-pearance,and sports)were compared between the two groups before and after 3 months of care.The satisfaction of fami-ly members with nursing was compared between the two groups.Results The recurrence rate of the observation group was 8.33%,which was significantly lower than 51.67%of the control group;the proportion of recurrence causes such as infection,diet,family environment,and exercise was significantly lower than that of the control group;the differences were statistically significant(P<0.05).After 3 months of nursing,the cognitive,emotional,and overall level scores of the two groups were significantly higher than those before nursing,and the scores of the observation group were(99.35±11.21)points,(79.48±7.31)points,(179.25±12.68)points,which were significantly higher than(90.51±10.26)points,(70.56±7.84)points,(163.43±11.35)points of the control group,with statistically significant differences(P<0.05).After 3 months of nursing,the scores of public ethics and helping others,discipline,sense of achievement,ability,appearance,and sports in both groups were significantly higher than those before nursing,and the scores of the observation group were(19.26±2.15)points,(16.33±2.04)points,(19.36±2.07)points,(25.14±3.82)points,(16.27±1.74)points,(15.29±1.93)points,which were significantly higher than(18.02±2.14)points,(15.84±1.82)points,(17.82±1.95)points,(22.73±3.27)points,(15.23±1.48)points,(13.32±2.06)points of the control group,with statistically significant differences(P<0.05).The satisfaction rate of family members with nursing in the observation group was 95.00%,which was significant-ly higher than 83.33%in the control group(P<0.05).Conclusion The application of family-hospital comprehensive re-habilitation nursing based on ecosystem theory can reduce the recurrence rate of children with nephrotic syndrome,im-prove their quality of life and self-esteem,with high satisfaction of family members,which is worthy of promotion and application.