摘要
目的探讨强化细节管理在减少重症监护病房(ICU)清醒患者环境压力源中的应用效果.方法选择2019年3月至2020年2月温州医科大学附属第二医院ICU收治的130例清醒患者作为研究对象,以2019年3月至8月入ICU的患者作为常规护理组,以2019年9月至2020年2月入ICU的患者作为强化细节护理组,每组65例.常规护理组给予常规护理;强化细节护理组给予强化细节护理,包括加强基础护理、强化健康宣教、改变传统探视方式、注重舒适环境、加强心理护理、注重患者感受和强化细节护理质量等.比较两组患者的ICU环境压力源量表(ICUESS)、简易精神状态检查量表(MMSE)、状态-特质焦虑量表(STAI)、匹兹堡睡眠质量指数量表(PSQI)评分以及ICU综合征发生情况.结果干预前,两组间ICUESS量表各维度评分以及MMSE、STAI和PSQI评分比较差异均无统计学意义.干预后,强化细节护理组ICUESS量表中物理环境、人文环境、治疗环境、自我感觉维度评分均明显低于常规护理组〔物理环境(分):14.62±1.69比18.04±1.95,人文环境(分):15.14±2.53比18.56±2.71,治疗环境(分):16.62±1.34比17.11±1.45,自我感觉(分):13.67±1.69比16.59±1.85,均P<0.05〕,MMSE评分明显高于常规护理组〔MMSE(分):20.15±1.76比16.24±1.79,P<0.05〕,而STAI和PSQI评分则明显低于常规护理组〔STAI(分):36.38±7.92比45.26±8.67,PSQI(分):7.04±1.42比8.61±1.53,均P<0.05〕.强化细节护理组患者不良反应发生率均明显低于常规护理组〔谵妄:10.77%(7/65)比27.69%(18/65),思维错乱:7.69%(5/65)比24.62%(16/65),情感障碍:24.62%(16/65)比41.54%(27/65),智力障碍:3.08%(2/65)比13.85%(9/65),行为动作异常:21.54%(14/65)比40.00%(26/65),抑郁:27.69%(18/65)比66.15%(43/65),失眠:26.15%(17/65)比70.77%(46/65),均P<0.05〕.结论强化细节管理可有效减少ICU清醒患者环境压力源,改善患者精神状态和焦虑情绪,提高患者睡眠质量,降低ICU综合征发生率.
Objective To explore the application effects of using strengthening detail management on reducing environmental stressors of conscious patients in intensive care unit(ICU).Methods One hundred and thirty conscious patients admitted into the ICU of the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to February 2020 were enrolled as the research objects.The patients admitted to ICU from March to August 2019 were arranged in a routine nursing group,and the patients admitted to ICU from September 2019 to February 2020 were included in an intensive detail nursing group,with 65 cases in each group.The routine nursing group was given routine nursing,while the intensive detail nursing group was given strengthening detail management,including enhancing basic nursing,enforcing health education,changing traditional visit mode,paying attention to comfortable environment,strengthening psychological nursing,paying attention to patients'feelings or perception,intensifying the quality of detail nursing,etc.The examination score results of ICU environmental stressor scale(ICUESS),brief mental state scale(MMSE),state-trait anxiety inventory(STAI),Pittsburgh sleep quality index(PSQI)and the incidence of ICU syndrome were compared between the two groups.Results Before the intervention,there were no statistical significant differences between the two groups in dimension scores of ICUESS,MMSE,STAI and PSQI score.After the intervention,the scores of physical environment,humanistic environment,treatment environment and self perception in ICUESS scale of intensive detail nursing group were significantly lower than those in the routine nursing group[physical environment score:14.62±1.69 vs.18.04±1.95,humanistic environment score:15.14±2.53 vs.18.56±2.71,treatment environment score:16.62±1.34 vs.17.11±1.45,self perception score:13.67±1.69 vs.16.59±1.85,all P<0.05],while the score of MMSE in the intensive detail nursing group was significantly higher than that in the routine nursing group[MMSE score:20.15±1
作者
黄凡
王密芳
朱依筠
张帆
张丹如
Huang Fan;Wang Mifang;Zhu Yiyun;Zhang Fan;Zhang Danru(Department of Critical Care Medicine,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China;Pediatric Intensive Care Unit,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2021年第3期339-342,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省医药卫生科技计划项目(2017KYB477)
浙江省温州市科技计划项目(Y20180445)。
