THRIVE理论下的护理干预在重症烧伤整形患者中的应用

Application of Nursing Intervention under THRIVE Theory in Patients with Plastic Surgery for Severe Burns

目的:探讨THRIVE理论下的护理干预在重症烧伤整形患者中的应用及对患者创伤后成长的影响。方法:选取262例重症烧伤患者,随机分为对照组和观察组各131例。对照组给予围手术期常规护理干预,观察组在此基础上加予THRIVE理论下的护理干预,比较两组患者干预前及干预2周后的心理韧性[心理韧性量表(Connor-davidson resilience scale,CD-RISC)]、创伤后成长评分(创伤后成长评定量表)、心理状况[心理症状自评量表(Symptom checklist-90,SCL-90)],调查两组护理满意度。结果:干预后,两组CD-RISC量表中关于坚韧性、力量及乐观共3个维度评分均高于干预前(P<0.05),两组创伤后成长量表中关于个人力量、人际关系、新可能性、精神变化、欣赏生活共5个维度评分均高于干预前(P<0.05),两组SCL-90量表中关于躯体化、强迫症状、焦虑、抑郁、敌对、人际关系敏感、偏执、恐怖、精神病性共9项评分和总分均低于干预前(P<0.05),以上评分观察组均优于对照组(P<0.05);观察组的护理满意度高于对照组(P<0.05)。结论:THRIVE理论下的护理模式应用于重症烧伤患者的基础护理中,能明显提高患者的心理韧性,促进其创伤后成长,改善其心理状况,提升其护理满意度。

Objective To explore the application of nursing intervention under THRIVE theory in patients with plastic surgery for severe burns and its influence on post-traumatic growth.Methods 262 patients with severe burns were selected and randomly divided into control group and observation group,131 cases in each group.The control group was given perioperative routine nursing intervention while the observation group was additionally given nursing intervention under THRIVE theory.The psychological resilience[connor-davidson resilience scale(CD-RISC)],post-traumatic growth scale(posttraumatic growth inventory)and psychological status[symptom checklist-90(SCL-90)]were compared before intervention and after 2 weeks of intervention,and the nursing satisfaction of the two groups was investigated.Results After intervention,the scores of the three dimensions of toughness,strength and optimism of CD-RISC scale in the two groups were higher than those before intervention(P<0.05),and the scores of five dimensions such as personal strength,relationship,new possibilities,mental changes and appreciation of life of post-traumatic growth scale were also higher in both groups than those before intervention(P<0.05).The scores of nine items of somatization,obsessive-compulsive symptoms,anxiety,depression,hostility,interpersonal sensitivity,paranoia,terror and psychosis and total score of SCL-90 scale in both groups were lower than those before intervention(P<0.05),and the above scores of observation group were better than those of control group(P<0.05).The nursing satisfaction in observation group was higher than that in control group(P<0.05).Conclusion Nursing model under THRIVE theory is applied to the basic nursing of patients with severe burns,which can enhance the psychological resilience,promote the post-traumatic growth,improve the psychological status,and enhance the nursing satisfaction.