家庭中心制互动式术前访视配合治疗性游戏在股骨骨折患儿围术期中的应用

Application of Family-centered Interactive Preoperative Visit Combined with Therapeutic Play in the Perioperative Period of Children with Femoral fracture

目的:探讨家庭中心制互动式术前访视配合治疗性游戏在股骨骨折患儿围术期中的应用效果。方法:选取2021年6月1日~2023年3月31日收治的120例股骨骨折患儿,按照信封法分为对照组和研究组各60例,对照组给予常规护理,研究组在对照组基础上给予家庭中心制互动式术前访视联合治疗性游戏干预,从患儿入院开始干预至出院前1 d;比较两组不同时间焦虑程度[采用改良耶鲁焦虑评分量表(mYPAS)]、医疗恐惧程度[采用儿童医疗恐惧调查量表(CMFS)]、疼痛情况[包括血清皮质醇(Cor)和P物质(SP)、Wong-Baker面部表情疼痛量表(FPS-R)评分]、干预前后依从性[采用中文版8条目Morisky服药依从性量表(MMAS-8)]及干预后家属满意度。结果:麻醉诱导时、术后第2天,两组mYPAS、CMFS评分均高于访视前(P<0.05),但研究组均低于对照组同期(P<0.01);术后第2天,两组mYPAS、CMFS评分均低于麻醉诱导时(P<0.05);术后2、24 h,两组Cor、SP水平及FPS-R评分均高于术前(P<0.05),但研究组低于对照组同期(P<0.01);术后24 h,两组Cor、SP水平及FPS-R评分均低于术前2 h(P<0.05);干预后,两组MMAS-8评分均高于干预前(P<0.05),且研究组高于对照组(P<0.01);研究组干预后家属满意度高于对照组(P<0.05)。结论:家庭中心制互动式术前访视配合治疗性游戏有利于降低围术期股骨骨折患儿的焦虑和医疗恐惧程度,提高治疗依从性和家属满意度。

Objective:To explore the application effect of family-centered interactive preoperative visit combined with therapeutic play in the perioperative period of children with femoral fracture.Methods:A total of 120 children with femoral fracture admitted from June 1,2021 to March 31,2023 were selected and divided into a control group and a study group according to the envelope method,with 60 cases in each group.The control group was given routine nursing care,and the study group was given family-centered interactive preoperative visits combined with intervention of therapeutic play on the basis of routine nursing care,and the intervention was conducted from admission to the day before discharge.The anxiety degree(mYPAS),degree of medical fear(CMFS),pain situation including serum cortisol(Cor),substance P(SP),FPS-R scores at different times,compliance(MMAS-8)before and after intervention and family satisfaction after intervention were compared between the two groups.Results:During anesthesia induction and the second day after operation,the mYPAS and CMFS scores in the two groups were higher than those before the visit(P<0.05),but the scores in the study group were lower than those in the control group at the same period(P<0.01).On the second day after operation,the mYPAS and CMFS scores of the two groups were lower than those at anesthesia induction(P<0.05).2 days and 24 hours after operation,Cor and SP,FPS-R scores in the two groups were higher than those before operation(P<0.05),but Cor and SP in the study group were lower than those in the control group(P<0.01).In 24 hours after operation,Cor and SP,FPS-R scores in the two groups were lower than those in 2 hours before operation(P<0.05).After intervention,the MMAS-8 scores in the two groups were higher than those before intervention(P<0.05),and the compliance scores in the study group were higher than those in the control group(P<0.01).The family satisfaction of the study group was higher than that in the control group(P<0.05).Conclusion:Family-centered interactive preoperative visit combined with therapeutic play can reduce the degree of anxiety and medical fear in children with femoral fractures during perioperative period,and can improve the treatment compliance and family satisfaction.