基于冰山理论的精细化护理在颅内动脉瘤围术期的实践研究

目的 探讨基于冰山理论的精细化护理在颅内动脉瘤围术期的作用效果。方法 回顾性分析31例行颅内动脉瘤术患者的临床资料,围术期接受常规护理,设为常规组;另外31例行颅内动脉瘤术患者的临床资料,围术期接受常规护理基础上的基于冰山理论的精细化护理,设为研究组。对比干预前后2组患者抑郁和焦虑状况,并对比干预期间遵医行为及不良事件发生率;对比干预前后生存质量。结果 干预前2组Zung抑郁(SDS)和焦虑(SAS)自评量表评分比较差异均无统计学意义,干预后2组SDS和SAS平均均低于干预前,且研究组低于常规组;2组遵医行为等级分布比较,差异有统计学意义,且研究组完全依从率高于常规组;2组恶心/呕吐、引流管堵塞及感染不良事件发生率比较,差异无统计学意义,而研究组不良事件总发生率低于常规组;干预前2组躯体、精神、社交能力、环境适应能力评分比较差异均无统计学意义,干预后2组上述生存质量评分均高于干预前,且研究组高于常规组。结论 基于冰山理论的精细化护理有助于改善颅内动脉瘤围术期间抑郁和焦虑状况,提高遵医行为,降低不良事件发生率。

Practical study of elaborate nursing based on iceberg theory in perioperative period of intracranial aneurysms

Objective To explore the effect of elaborate nursing based on iceberg theory in the perioperative period of intracranial aneurysms. Methods The clinical data of 31 patients with intracranial aneurysms were retrospectively analyzed. The patients receiving routine nursing during the perioperative period were divided into routine group. The clinical data of the other 31 patients with intracranial aneurysms were retrospectively analyzed. They given the perioperative elaborate nursing based on iceberg theory was established as the research group. The depression and anxiety of the two groups before and after the intervention were compared, and the compliance behavior and the incidence of adverse events during the intervention were compared. The life quality before and after comparative intervention of the 2 groups were compared. Results There were no significant differences in the scores of SDS and SAS between the two groups before intervention. The average scores of SDS and SAS in the two groups after intervention were lower than those before intervention, and the study group were lower than those in the conventional group. There was significant difference in the grade distribution of compliance behavior between the two groups, and the complete compliance rate of the study group was higher than that of the conventional group. There was no significant difference in the incidence of nausea/vomiting, blockage of drainage tube and adverse events between the two groups, but the total incidence of adverse events in the study group was lower than that in the conventional group. There was no significant difference in the scores of physical, mental, social and environmental adaptability between the two groups before intervention. The scores of quality of life in the two groups after intervention were higher than those before intervention, and the scores in the study group were higher than those in the conventional group. Conclusion The elaborate nursing based on the iceberg theory could improve the depression, anxiety and the compliance behavior during the perioperative period of intracranial aneurysms, and reduce the incidence of adverse events.