评判性思维在老年性痴呆病人护理中的应用

目的通过评判性思维的临床实践,探讨老年性痴呆病人的护理模式。方法采用对照研究的方法,对49例早、中期实验组AD病人进行心理护理、3 R训练、服药指导、安全护理、五常法环境管理、饮食调整、社会活动等进行评判性护理干预(住院—社区—家庭),不断完善具体护理措施;晚期20例实验组AD病人实施饮食、大小便、防褥疮、安全方面护理指导,同时争取家庭照顾者的支持,让照顾者帮助和督促病人进行各种护理活动。对照组60例不实施评判性护理干预。结果对两组病人进行MMSE、ADL、SF-36调查,早、中期AD病人实验组MMSE、ADL、SF-36明显高于对照组,差异有显著性意义(P<0.01、P<0.05、P<0.01);晚期AD病人并发症的发生率,实验组明显低于对照组,差异有显著性意义(P<0.05)。结论实施对AD病人住院—社区—家庭的全程护理干预,能延缓早、中期AD病程进展,提高病人的生存质量,降低晚期AD病人的并发症。

Study on the application of appraisal thought on the nursing for patients with senile dematia

Objective To study the nursing model for patients with senile dematia by applied appraisal thought clinical practice. Methods Based on contrast method,49 patients with senile dematia were divided into early stage and middle stage group,the following method were used for critical nursing intervention(hospital,community and family),such as psychological nursing,3R training,administration instruction,safe nursing,five routine environment management,dietary adjustment etc.20 patients were selected as later stage group,and dietary adjustment,home support,safe nursing instruction and supervision of patients' nursing were adapted.60 patients without appraisal intervention.Results The MMSE,ADL,SF-36 for patients in early stage and middle stage group were significant higher than that of control groups(P<0.01 and P<0.05);the occurrence rate of complication for patients at later stage in experimental group were lower than that of control group(P<0.05). Conclusions By applying the hospital-community-family whole nursing intervention,the course of diseases for patients at early and middle stage will be delayed,Quality of living will be improved,and complication will reduced for patients at later stage.