脊髓损伤患者家庭护理中的持续跟踪指导

目的探讨脊髓损伤患者家庭护理指导、提高患者自我护理效能的方法。方法将87例脊髓损伤患者随机分成出院指导组和跟踪指导组,两组出院前均给予同样的常规家庭护理指导,并进行自我效能评价,出院后1周后开始由责任护士利用电话随访、门诊复诊、家庭访视等方式定期进行了持续1年的动态护理需求评估和家庭护理方法再指导,并教会患者发挥自我效能,逐渐实现生活的部分自理或自理。比较两组患者出院1年中并发症的发生例次、1年后生活自理程度,并进行自我效能再评价。结果 1年中跟踪指导组并发症发生率低于出院指导组,生活自理程度高于出院指导组,差异有统计学意义(P<0.05),跟踪指导组自我效能明显增强,出院指导组无明显变化。结论责任护士持续跟踪家庭护理指导有助于降低脊髓损伤患者并发症的发生率,增强患者自我效能,提高生活自理能力和生活质量。

Keeping track guidance in home nursing for patient with spinal cord injury

Objective To explore the methods of home nursing guidance and improve self-efficiency for patient with spinal cord injury. Methods The 87 patients with spinal cord injury were randomly divided into discharge guidance group and keeping track guidance group. Two groups were given normal home nursing guidance and self-efficiency valuation before discharge. A week after discharge the primary nurse care and care-request estimation should be regularyly and dynamicly so as to guide the care again during telephone follow-up outpatient care and home follow visit,teaching patients expressing self-efficiency to achieve looking after oneself parial and complete care. The cases of complication and its degree of care were compared between two groups and the seleefficiency again was evaluated. Results During one year cases of complication was lower and the degree of care was higher in keeping track guidance group than in discharge guidance group（P〈0.05）. Self-efficiency were significantly enhanced. Conclusion The nurse keeping track guidance in home nursing can reduce the cases of complication and enhance self-efficiency and improve the patient＇s ability of independent living and life quality.