阅读疗法对减轻围术期患儿及家长焦虑的影响研究

目的探讨阅读疗法对围手术期患儿及家属焦虑程度的影响。方法采用随机抽样的方法将符合入选标准的住院患儿分为干预组(153例)和对照组(153例)。术前向患儿及陪伴发放统一的焦虑量表。干预组应用"住院患儿阅读疗法读本"进行阅读干预,通过"亲子阅读"、"自我管理式阅读"两种阅读方式从住院后24 h起进行阅读和讨论,按要求术前1 d再次讨论读本中相关问题。对照组采用常规健康教育方法。采用改良耶鲁围手术期焦虑量表(Mypas)、焦虑状态-特质问卷(STAI),评价两组患儿及家属的焦虑程度及影响因素。结果干预组和对照组患儿mYPAS评分结果分别是(35.875±4.4414)分和(46.796±8.6064)分,P0.01;S-AI评分结果分别是(38.125±4.3708)分和(49.901±7.42)分,P0.05;T-AI评分结果分别是(43.414±3.4188)分和(43.803±6.2741)分,P0.05。结论阅读疗法可有效降低围手术期患儿及家属的焦虑程度,确保患儿在最佳状态下进行手术,并使家属能较好的配合治疗护理。     

游戏疗法对住院儿童腰椎穿刺疼痛及操作依从性的影响

目的对住院接受腰椎穿刺及相关操作治疗的患儿实施游戏疗法护理的效果与患儿的依从性进行分析探究。方法选取在海南省人民医接受治疗的80例行腰椎穿刺及相关操作治疗的患儿作为本次研究对象,按照随机数字表法将其平均分成对照组与试验组,对照组给予常规护理,试验组在实施腰椎穿刺或相关操作治疗前开展游戏疗法,对比分析两组患儿痛苦情况及依从性。结果试验组患儿FLACC量表评分(2.37±0.42)分、Wong-Baker量表评分(3.28±0.38)分、完成腰椎穿刺时间(11.03±3.67)min、术中脉搏增快发生率(22.50%)和呼吸增快发生率(25.00%),与对照组FLACC量表评分(4.42±0.53)分、Wong-Baker量表评分(5.12±0.41)分、完成腰椎穿刺时间(23.24±7.93)min、术中脉搏增快发生率(72.50%)和呼吸增快发生率(75.00%)相比明显较低,差异有统计学意义(P0.05)。试验组患儿完全依从率(95.00%)与对照组完全依从率(60.00%)相比明显较高,差异有统计学意义(P0.05)。结论住院患儿实施腰椎穿刺治疗过程中开展游戏疗法效果显著,能缓解患儿疼痛,提高依从性,安全可靠。     

护士主导的协同一体化护理模式在尿道下裂手术患儿中的应用

目的探讨护士主导的协同一体化护理模式在尿道下裂手术患儿中的应用效果, 为协同医护患一体化, 提高护士护理水平和患儿护理质量提供借鉴。方法采用类实验研究方法, 2020年1月至2021年12月, 选取南京医科大学附属儿童医院泌尿外科行尿道下裂手术84例男性患儿的临床资料进行回顾性分析, 并将对应的84位陪护人员纳入研究对象。其中2020年1—12月入院的患儿42例及陪护人员42人作为对照组, 2021年1—12月入院的患儿42例及陪护人员42人作为干预组。对照组采用常规围手术期护理模式, 干预组采用护士主导的协同一体化护理模式。比较2组陪护人员的焦虑情绪评分及满意度, 2组患儿的医疗恐惧、医疗依从性及术后疼痛, 2组患儿的术后并发症发生率。结果干预后干预组陪护人员满意度评分为(96.46 ± 3.27)分, 患儿医疗依从性评分为(2.93 ± 0.89)分;对照组分别为(85.24 ± 5.71)、(1.75 ± 0.63)分, 2组比较差异均有统计学意义(t=9.52、-8.40, 均P<0.05)。干预后干预组陪护人员焦虑情绪评分为(44.33 ± 2.43)分, 患儿医疗恐惧...     

小儿外科书香病房与患儿心理健康的关系分析

目的:探讨小儿外科书香病房的创建对患儿身心健康的促进效果。方法:课题组在小儿外科创建了书香病房,实施前6个月采用随机数字表法抽取住院患儿150例作为对照组,应用疼痛行为量表(FLACC)、Wong-Baker笑脸量表、儿童焦虑性情绪障碍筛查量表(SCARED)和自制遵医行为评分表对患儿疼痛、焦虑和依从度评分;在书香病房创建实施6个月后,随机抽查150例住院患儿作为观察组,采用相同量表对患儿疼痛、焦虑和依从度进行评分。结果:观察组FLACC、Wong-Baker评分均低于对照组(P0.01);出院时,两组SCARED评分均低于入院时(P0.01),且观察组低于对照组(P0.01);观察组遵医率高于对照组(P0.01)。结论:小儿外科书香病房能降低患儿疼痛感和疼痛反应,缓解患儿焦虑状态,提高遵医率。     

循证护理在缓解小儿静脉输液疼痛中的效果观察

选取我院98例静脉输液患儿,分为循证组和对照组各49例,循证组采用循证护理,对照组采用常规护理,对比两组效果。结果循证组患儿FLACC1.04±0.05分,Wong-Baker2.15±0.37分,对照组患儿FLACC4.82±0.24分,Wong-Baker4.33±0.58分。对照组FLACC和Wong-Baker均明显高于循证组,差异具有统计学意义(P<0.05)。循证护理是一种在不影响治疗效果条件下,能够有效减轻静脉输液疼痛的新型护理方法。     

佛手柑芳香疗法对全髋关节置换患者术后焦虑的影响

目的探讨佛手柑吸入性芳香疗法对全髋关节置换患者术后焦虑的影响效果。方法纳入80例本院关节外科行全髋关节置换术患者,随机分为干预组和对照组,每组各40例。对照组给予全髋关节置换术后常规护理措施,干预组在对照组基础上给予佛手柑吸入性芳香疗法,比较两组患者术后焦虑状态和疼痛程度。结果干预组术后3 d、6 d的焦虑状态评分分别为(8.13±1.60)分、(5.0±1.69)分,低于对照组的(11.93±1.58)分、(7.07±1.53)分,两组比较差异均具有统计学意义(P0.05)。干预组术后3 d、6 d的疼痛程度评分分别(3.87±1.51)分、(1.93±0.80)分,低于对照组的(7.0±1.07)分、(4.0±1.25)分,两组比较差异均具有统计学意义(P0.05)。结论佛手柑吸入性芳香疗法可以缓解全髋关节置换患者术后焦虑状态,减轻其术后疼痛程度。     

护理干预对学龄期儿童肱骨髁上骨折术后疼痛的影响

目的了解护理干预对学龄期患儿肱骨髁上骨折术后疼痛的影响。方法将68例肱骨髁上骨折学龄期患儿分成实验组和对照组各34例。实验组患儿分别于术前0～3h,术后12h内,12～24h,〉24～48h采取针对性护理干预,对照组给予常规护理。采用视觉类比量表（VAS）、儿童手术后疼痛行为量表（FLACC）,对两组患儿疼痛程度进行评估比较。结果手术前和术后12h,两组患儿对疼痛的感受和评估,差异无统计学意义（P〉0．05）;术后12—24h实验组患儿VAS量表评分为（2．10±1．12）分,低于对照组（3．85±0．65）分,差异有统计学意义（Z=7．88,P〈0．01）;实验组患儿FLACC量表评分为（6．555±1．12）分,低于对照组（7．85±1．14）分,差异有统计学意义（Z=4．743,P〈0．01）;术后〉24—48h两组患儿VAS、FLACC量表评分比较差异均有统计学意义（P〈0．01）。结论对学龄期骨折手术患儿实施适当护理干预措施,在骨折手术12h后能够有效减少其疼痛感受程度,增加患儿的舒适度,有利于术后康复。     

跨文化背景下“医疗小丑”护理志愿服务模式的实践探讨

[目的]探讨跨文化背景下"小丑医生"志愿服务对住院患儿静脉穿刺疼痛、焦虑程度及对"小丑医生"志愿者成员(护理研究生)职业价值观的影响。[方法]将某三级甲等医院儿科东区的43例患儿设为干预组,儿科西区的38例患儿设为对照组,对照组给予常规护理,干预组在此基础上融入"小丑医生"志愿服务,采用修改版面部表情疼痛量表和学前儿童焦虑量表评估静脉穿刺时患儿疼痛程度和焦虑状况;利用护士职业价值观量表对"小丑医生"志愿者成员职业价值观进行评估,并随机选取15名进行深入访谈,将获得资料分析整理,提炼主题。[结果]干预组住院患儿静脉穿刺时疼痛评分(2.69分±0.57分)、焦虑评分(67.70分±12.37分)均优于对照组(3.45分±0.92分,80.70分±10.81分),差异有统计学意义(P0.05);"小丑医生"志愿者成员的心理体验包括加深护理职业认知、体验护理职业艰辛和护理职业的价值、感受护理传递的正向情感等方面。[结论]"小丑医生"志愿服务可降低住院患儿静脉穿刺时疼痛程度和焦虑状况,同时提升"小丑医生"志愿者成员的职业价值观。     

阅读疗法结合表面麻醉用于学龄前初次骨髓穿刺患儿的疼痛管理

[目的]探讨阅读疗法结合表面麻醉应用于学龄前初次骨髓穿刺患儿的疼痛效果。[方法]选取在我院儿科住院首次进行骨髓穿刺的90例患儿,采用随机数字表法将其分为观察组46例与对照组44例。对照组骨髓穿刺患儿进行常规护理,观察组骨髓穿刺患儿应用阅读疗法结合表面麻醉的干预方式。比较两组患儿的干预效果。[结果]干预之后,两组骨髓穿刺患儿骨髓穿刺中、骨髓穿刺后1 h、骨髓穿刺后2 h、骨髓穿刺后4 h的心率、呼吸、FLACC疼痛评分比较差异有统计学意义(P0.05);干预后患儿骨髓穿刺后1 h、骨髓穿刺后2 h、骨髓穿刺后4 h 3个时点的血压情况组间比较,差异有统计学意义(P0.05);干预后两组骨髓穿刺患儿儿童焦虑性情绪障碍筛查量表得分组间比较差异有统计学意义(P0.05)。[结论]阅读疗法结合表面麻醉应用于学龄前初次骨髓穿刺患儿的疼痛管理,能够有效地减轻患儿的焦虑状况,减轻患儿疼痛,同时提高患儿的骨髓穿刺配合程度,改善目前紧张的儿科医患关系。     

阅读疗法对口腔颌面-头颈部恶性肿瘤患者术后放疗焦虑的干预效果分析

目的：采用阅读疗法干预发生术后焦虑恶性肿瘤患者,以期减少患者的症状,改善生活质量。病例与方法：口腔恶性肿瘤术后放疗住院患者63例,以Rotterdam量表评价阅读干预1个月后,患者生理维度、心理维度、焦虑的变化。结果：阅读疗法干预后,患者的有关评分明显提高(P＜0.05)。结论：阅读疗法可显著改善口腔颌面-头颈恶性肿瘤术后放疗患者的焦虑状态。     

儿童医疗辅导在慢性肾脏病患儿静脉穿刺中的应用

目的探讨儿童医疗辅导在慢性肾脏病住院患儿静脉穿刺中的应用效果。方法选择学龄前期慢性肾脏病住院患儿240例,2018年10月至12月的120例患儿为对照组,2019年1月至3月的120例患儿为观察组,对照组实施留置针健康教育并发放健康教育手册,观察组在对照组基础上实施儿童医疗辅导干预。采用Wong-Baker面部表情量表和儿童疼痛行为量表评价两组患儿穿刺过程中的疼痛程度,并比较两组患儿静脉穿刺依从性和患儿家属满意度。结果与对照组相比,观察组患儿的Wong-Baker面部表情和疼痛评分均显著降低(P<0.05),患儿静脉穿刺过程依从性和患儿家属满意度均显著提高(P<0.05)。结论儿童医疗辅导应用于学龄前期慢性肾脏病住院患儿静脉穿刺,可有效降低患儿疼痛,减少哭闹,提高穿刺依从性和家属满意度。     

Hypnosis and Dental Anesthesia in Children: A Prospective Controlled Study

The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.     

腹式呼吸训练对胸部手术患者焦虑情绪及术后疼痛的影响

目的 探讨腹式呼吸训练对胸部手术患者术前焦虑情绪及术后疼痛的影响。方法 将60例行择期胸部手术患者分为实验组和对照组，实验组患者术前进行腹式呼吸训练，应用状态．特质焦虑问卷、视觉疼痛测定卡，在围术期的不同阶段对两组患者进行测试。结果 胸部手术患者术前1d的状态性焦虑水平明显高于入院初（P〈0．05）；术前1d，实验组的状态性焦虑水平低于对照组（P〈0．05）；实验组术后第3、5天疼痛评分低于对照组（P〈0．05）。结论 腹式呼吸训练能有效缓解胸部手术患者术前的焦虑情绪，减轻患者术后的疼痛反应。     

Hypnosis and dental anesthesia in children: a prospective controlled study

The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.     

家长参与的疼痛护理在先天性心脏病术后的应用

【】　目的　评价父母－护士共同参与的疼痛护理在先天性心脏病手术后期的应用。方法　随机抽取对照组患儿30例及实验组患儿30例, 用疼痛行为评估量表(FLACC) 评估两组患儿术后第2～7天的疼痛情况。对照组父母不参与疼痛评估,仅参与非药物性止痛措施,实验组父母参与疼痛评估和非药物性止痛措施。结果　　术后第2～4天,实验组患儿疼痛评分低于对照组,比较差异有统计学意义( P < 0.05);术后第5～7天疼痛评分两组比较差异无统计学意义( P > 0.05) 。结论　父母－护士共同参与的交互式疼痛护理能有效减轻先心病患儿术后疼痛。     

音乐干预对门诊肌内注射患儿心理状态和治疗配合度的影响

目的:探讨音乐干预对门诊肌内注射患儿心理状态和治疗配合度的影响.方法:将130例门诊肌内注射患儿按照随机数字表法分为观察组和对照组各65例,观察组注射时给予音乐干预,对照组注射时无任何背景音乐;比较两组干预后疼痛情况[采用Wong-Baker面部表情量表],比较两组干预前后心理状态[采用儿童焦虑性情绪障碍筛查表(SCA...     

阅读疗法对女性长期住院精神病患者的影响

目的探讨阅读疗法对长期住院女性精神病患者的影响。方法将60例女性精神病患者随机分为实验组(n=30)和对照组(n=30),实验组在日常精神病护理常规的基础上实行阅读治疗;对照组同期仅按精神科护理常规护理。干预前后分别对两组患者用护士用住院患者观察(NOSIE)量表进行评定。结果干预前两组NOSIE量表评分分值无显著差异(P>0.05);干预后实验组NOISS量表评分分值明显提高,差异有统计学意义(P<0.01);干预后实验组NOISS量表分值高于对照组,差异有显著性意义(P<0.01)。结论阅读疗法可显著改善女性精神病患者的身心状况,减轻病痛,提高生活质量。     

Effect of Lavender Aromatherapy On Arteriovenous Fistula Puncture Pain and the Level of State and Trait Anxiety in Hemodialysis Patients: A Randomized Controlled Trial

BackgroundPatients undergoing haemodialysis suffer from anxiety and pain due to the insertion of haemodialysis needles, estimated totally 320 times per year.AimsThis randomized controlled trial was conducted in order to determine the effect of lavender aromatherapy, performed through inhalation for five minutes three times a week, on pain and anxiety experienced by patients undergoing haemodialysis after needle insertion into a fistula.DesignPatient information form, Numeric Rating Scale (NRS) and State-Trait Anxiety Inventory (STAI) were applied to patients in the intervention group at the first follow up (the first interview before aromatherapy administration).SettingsThe researcher completed the data collection forms by conducting face-to-face interview with the patients and applied lavender oil to all the patients in the intervention group at the last hour of every dialysis session.Participants/SubjectsTotally three sessions were carried out as three times for one week in accordance with protocol of aromatherapy inhalation.MethodsIt took 5 minutes to complete each session. Olive oil was applied to the placebo group since it has no therapeutic value. At the end of the application, NRS and STAI were applied to the patients again.ResultsThe use of lavander aromatherapy significantly reduced the scores of arteriovenous fistula (AVF) puncture-related pain, which was 6.24±1.24 in the first session, to 3.56±1.28 in the second session (p=0.002). It was found that scores of STAI obtained at the first follow-up) were higher in the intervention group than the placebo group but the difference between them was not statistically significant (p>0.05). The STAI mean scores of the patients in the intervention group after aromatherapy were 39.12±6.71 in the state anxiety subscale and30.04±1.39 in the trait anxiety subscale. All subscale scores of STAI decreased significantly in the intervention group in the second follow-up compared to the first follow-up (p<0.05).ConclusionsLavender inhalation could be used as a safe, simple, and low-cost method in nursing care if it is proved to be effective in reducing anxiety and relieving pain after needle insertion into a fistula in patients undergoing haemodialysis.     

Clinical validation of FLACC: preverbal patient pain scale

PURPOSE: To test the validity of the Faces, Legs, Activity, Cry and Consolability (FLACC) pain assessment tool by measuring changes in scores in response to analgesics. METHOD: METHODS: Pediatric nurses used the FLACC scale to assess pain in 147 children under 3 years of age who were hospitalized in the pediatric intensive care unit (PICU), post-anesthesia care unit (PACU), surgical/trauma unit, hematology/oncology unit, or infant unit. FLACC is an observational tool for quantifying pain behaviors. Facial expression, leg movement, activity, cry, and consolability are each scored 0-2, for a total FLACC score of 0-10. The FLACC measurements were done pre-analgesia, at predicted onset of analgesia, and at predicted peak analgesia. FINDINGS: Pre-analgesia FLACC scores were significantly higher than post-analgesic scores and significantly higher for patients who received opioids than patients who received non-opioids. Peak analgesia FLACC scores across analgesia groups were not significantly different and reflect effective pain relief for patients regardless of analgesic choice. CONCLUSIONS: The FLACC pain assessment tool is appropriate for preverbal children in pain from surgery, trauma, cancer, or other disease processes. The results support pediatric nurses' clinical judgment to determine analgesic choice rather than providing distinct FLACC scores to guide analgesic selection.