叙事护理对乳腺癌患者术后焦虑抑郁情绪及病耻感的影响分析

【 】 Objective To analyze the influence of narrative nursing on the bad mood and stigma of breast cancer patients. Methods Taking August 2021 to August 2022 as the time line, 60 patients with breast cancer who underwent surgery in our hospital during this period were selected as the research object. According to the order of admission, the first 30 patients were classified as the control group, and the other 30 patients were classified as the experimental group. The control group was given routine nursing care, while the experimental group was given narrative nursing care, and the changes of adverse emotions between the two groups were compared. Results The nursing satisfaction of the experimental group was higher than that of the control group (P < 0.05). Before nursing, there was no difference between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Before nursing, there was no difference in the scores of anxiety and depression between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Conclusion Narrative nursing can effectively alleviate the anxiety and shame of breast cancer patients, which is worth applying.     

精神科开放病房实施人文关怀护理管理的效果研究

目的 探讨精神科开放病房护士对精神分裂症患者实施人文关怀护理管理的临床效果.方法 选取2010年1～5月住院精神分裂症患者120例为测试对象,按住院时间段分为对照组和研究组,各60例.两组在接受抗精神病药物系统治疗的基础上,对照组接受常规护理管理,研究组接受人文关怀护理管理.于出院时,采用心理舒适感问卷调查表、症状自评量表(SCL-90)、护士用住院精神病人观察量表(NOSIE)和住院病人满意度调查表等评价工具对两组进行效果评定.结果 出院时,两组心理舒适感评估,研究组安全感为86.7%、满足感为95.6%、尊重感92.5%,对照组安全感为45.6%、满足感为57.8%、尊重感41.3%.两组比较存在显著差异(χ2值分别为23.2、49.6、36.5,P均＜0.01);两组心理健康水平评比,研究组SCL-90总均分为(1.45±0.73)分,对照组为(1.76±0.52)分,两组比较,差异显著(t=2.68,P＜0.01);两组行为障碍评比,研究组NOSIE病情总估计为(186.79±9.84)分,对照组为(165.12±9.21)分,两组比较,差异显著(t=13.10,P＜0.01);两组护士总体满意度评比,研究组为(4.87±0.77)分,对照组为(4.32±0.54)分,两组比较,差异显著(t=4.53,P＜0.01).结论 实施人文关怀护理管理,提供高品质的护理服务,一方面能够提高精神科住院病人满意度,另一方面,能够促进精神分裂症患者的心理和行为障碍的改善,对病人总体康复具有明显的促进作用.

Abstract：

Objective To explore the clinical efficacy of the humanistic nursing management that was implemented by the nurses who was in the psychiatry open ward. Methods There were 120 patients hospitalized patients with schizophrenia who were tested objects in hospital from March to December, 2009. According to the length of stays, they were devided into study group and contral group. There was 60 patients in each gruoup. Two groups were on the basis of system treatment of the antipsychotic drug, the contral group was accepted the ward conventional nursing management, the study group was accepted the humanistic nursing management. When they left the hospital, the clinincal effects were evaluated by the psychological comfort questionnaire , SCL-90, NOSIE and the hospital patient satisfaction questionnaire for both groups. Results When they left the hospital, the feeling of safety in study group was 86. 7%, satisfaction was 95.6%, feeling respect was 92. 5%. The feeling of safety in contral group was 45.6%, satisfaction was 57.8%, feeling respect was 41.3%. There were significant differences between two groups (x2 respectively was 49. 6 , 36. 5 and 23.2, P ＜ 0. 01 ). The total score of SCL - 90 in the study group was ( 1.45 ± 0. 73), it was ( 1.76 ± 0. 52) in the concral group, there was significant differences between two groups ( t = 2. 68, P ＜0. 01 ). Two groups of behavioral problems were comparied, the illness total score estimates of NOSIE in the study group was (186. 79 ±9. 84), in the contral group it was ( 165. 12 ±9. 21 ), there were sigpificant differences between two groups (t = 13. 10, P ＜0.01 ). The overall satisfaction in the study group was (4. 87 ±0. 77), in the contral group it was (4. 32 ± 0. 54), there was significant differences between two groups ( t = 4. 53, P ＜ 0. 01 ) . Conclusions Implementing humanistic nursing management, and providing the high quality nursing service could enhance psychiatric hospital patient satisfaction, and promote schizophrenia patients with mental and behavioural disorders,it would have significant positive effects for the overall recovery of schizophrenia patients.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

运动想象疗法对脑卒中偏瘫患者下肢功能的影响

目的 探讨常规康复治疗结合运动想象疗法对脑卒中偏瘫患者偏瘫侧下肢运动功能的影响.方法 选取30例病情稳定且病程<6个月的脑卒中偏瘫患者,分为治疗组(13例)和对照组(17例).治疗组进行常规康复治疗和运动想象训练,对照组只进行常规康复治疗.分别在治疗前和治疗6周后进行偏瘫侧下肢最大负重百分比(%)、Barthel指数(BI)、5m最快折返速度、Berg平衡功能量表(BBS)和Fugl-Meyer运动功能评分法(FMA)(下肢部分)评定.结果 治疗组和对照组的各项指标较治疗前均有显著提高(P<0.01),且治疗组的偏瘫侧下肢最大负重百分比(%)和5m最快折返速度优于对照组(P<0.05).结论 常规康复治疗结合运动想象疗法能更有效地提高脑卒中偏瘫患者偏瘫侧下肢的运动功能.

Abstract：

Objective To study the effect of motor imagery therapy combined with conventional physical training on hemiplegia lower extremity function in stroke patients with hemiplegia.Methods Thirty hemiplegic patients meeting the eligible criterions were randomly divided into two groups: a treatment group (n = 13 ) and a control group ( n = 17).All subjects accepted conventional rehabilitative treatment.Patients in treatment group were treated with motor imagery therapy after physical training, while the patients in control group were treated with physical training only.Motor function was measured by the percentages of changes in maximum loading on affected lower limb (PL%), Barthel index (BI), 5m maximum back and forth walking speed (5m MBFWS), Berg balance scale ( BBS), Fugl-Meyer motor assessment ( lower limb) (FMA-L) before the beginning of training and at the end of sixweek training.Results In both groups, all measurements at the end of training improved significantly ( P < 0.01 )compared to that at the beginning of training.After the whole training course, PL% and 5m MBFWS (m/s) in treatment group were significantly better compared to those in control group( P < 0.05 ), and the other measurements were not statistically significant between two groups( P > 0.05 ).Conclusion Motor imagery therapy had positive effect on hemiplegia lower extremity function of sub-acute stroke patients.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

护理干预对减轻肝移植术后精神症状的效果

Objective To investigate the effect of nursing intervention on alleviating patients'psychiatric symptoms after liver transplantation. Methods Patients who suffered from liver transplantation divided into experimental group (n = 50) and control group (n = 162 ) were studied by retrospective contrast analysis. The control group was given the normal nursing, while the experimental group, besides the normal nursing, was administered with psychological intervention and music intervention. Results There was no significant difference between both groups on the anxiety level before the intervention ( P ＞ 0. 05 ); while there was significant difference between both groups after the intervention, the anxiety level of the experimental group was obviously lower than that of the control group ( 3 days before surgery, normal: 70.00% vs 44.44%, χ2 =4.519, P ＜ 0. 05; one week after oporation, normal: 84.00% vs 60.49 %, χ2 = 3. 098, P ＜ 0. 05 ); the anxiety level of the experimental group after the intervention was decreased, compared with that before the intervention ( normal :54.00% vs 84.00%, χ2 = 3. 592, P ＜ 0. 05 ). Conclusions Nursing intervention on patients after liver transplantation could decrease their anxiety and reduce the occurrence of their psychiatric symptoms.     

放松训练对突发性耳聋患者的影响

Objective To investigate the effective nursing intervention on sudden deafness patients.Methods Sixty patients were divided into experiment group and control group,each with 30 cases.Relaxation training was exerted on experiment group patients,while the control group patients were just used usual nursing and therapy.The value of anxiety and depression,sleep quality were evaluated between them.Results The value of anxiety and depression of experiment group patients was significantly lower than that in control group (P ＜0.05) .In addition,sleep quality was obviously improved in experiment group patients.Conclusions Relaxation training is an effective nursing intervention to cure sudden deafness patients.     

一贯制责任护理模式对提高孕产妇满意度的影响研究

Objective The purpose of this study is to find the influence of conducting the consistency primary nursing model in obstetrics department for improving patients' satisfaction to nursing work.Methods A quantitative research was conducted by an investigation of two groups of subjects,with one group being given the model of nursing and the other group not being given the same model of nursing.The investigation was to investigate the degree of satisfaction of patients to nursing work.And the total score of satisfaction and each score of each item investigated were analyzed and compared.Qualitative research:to abstract the related subject issues of pregnant and postpartum women to satisfaction degree to nursing work,by using the method of visiting and discussing of focuses of the pregnant and postpartum women groups.Results Patients' overall and sub-item satisfaction with invention of new model in the research group was higher than that of the control group,and had a statistical significance (P＜0.01).And the Results from visiting and discussing the groups of patients also reflected the research group had a good satisfaction.Conclusions The consistency primary nursing model improves pregnant and postpartum women's satisfaction to nursing work,and it is worthy of extending.     

一贯制责任护理模式对提高孕产妇满意度的影响研究

Objective The purpose of this study is to find the influence of conducting the consistency primary nursing model in obstetrics department for improving patients' satisfaction to nursing work.Methods A quantitative research was conducted by an investigation of two groups of subjects,with one group being given the model of nursing and the other group not being given the same model of nursing.The investigation was to investigate the degree of satisfaction of patients to nursing work.And the total score of satisfaction and each score of each item investigated were analyzed and compared.Qualitative research:to abstract the related subject issues of pregnant and postpartum women to satisfaction degree to nursing work,by using the method of visiting and discussing of focuses of the pregnant and postpartum women groups.Results Patients' overall and sub-item satisfaction with invention of new model in the research group was higher than that of the control group,and had a statistical significance (P＜0.01).And the Results from visiting and discussing the groups of patients also reflected the research group had a good satisfaction.Conclusions The consistency primary nursing model improves pregnant and postpartum women's satisfaction to nursing work,and it is worthy of extending.     

一贯制责任护理模式对提高孕产妇满意度的影响研究

Objective The purpose of this study is to find the influence of conducting the consistency primary nursing model in obstetrics department for improving patients' satisfaction to nursing work.Methods A quantitative research was conducted by an investigation of two groups of subjects,with one group being given the model of nursing and the other group not being given the same model of nursing.The investigation was to investigate the degree of satisfaction of patients to nursing work.And the total score of satisfaction and each score of each item investigated were analyzed and compared.Qualitative research:to abstract the related subject issues of pregnant and postpartum women to satisfaction degree to nursing work,by using the method of visiting and discussing of focuses of the pregnant and postpartum women groups.Results Patients' overall and sub-item satisfaction with invention of new model in the research group was higher than that of the control group,and had a statistical significance (P＜0.01).And the Results from visiting and discussing the groups of patients also reflected the research group had a good satisfaction.Conclusions The consistency primary nursing model improves pregnant and postpartum women's satisfaction to nursing work,and it is worthy of extending.     

PDCA循环管理在提高脑卒中护理质量中的应用

目的探讨PDCA循环管理法在提高脑卒中患者护理质量中的应用。方法选取100例脑卒中患者,随机分为实验组和对照组各50例,对照组采用常规护理,实验组在常规护理的基础上采用PDCA循环法管理,对比分析2组患者临床疗效、依从性以及满意度。结果实验组在康复训练、生活作息、严格服药、出院复诊随访各项评分及总评分均优于对照组,差异有统计学意义(P0.05);经不同方法支持护理后,2组患者脑卒中病情均有所改善,实验组临床研究总有效率为94%,对照组患者总有效率为80%,比较差异有统计学意义(P0.05)。实验组患者临床总满意率为95.3%,对照组为83.4%,差异有统计学意义(P0.05)。结论应用PDCA循环管理法干预脑卒中患者护理,质量提高效果显著,能有效改善患者疾病症状,提高患者依从性和满意度,优于常规护理模式,有较好的临床应用价值。     

Roy适应模式用于Stanford B型主动脉夹层患者围术期的价值

目的研究罗伊（Roy）适应模式用于Stanford B型主动脉夹层患者围术期的价值。 方法选取江苏省人民医院心脏大血管外科2019年2月至2021年2月收治的100例Stanford B型主动脉夹层手术患者100例,数字表法随机分为对照组（n=50）和观察组（n=50）。对照组行常规护理,观察组在此基础上行Roy适应模式。对比2组护理前后焦虑情绪自评量表（SAS）、抑郁情绪自评量表（SDS）及自我效能（GSES）评分,比较2组护理前后生活质量（SF-36）、日常生活能力（ADL）及健康行为能力评分（SRAHP）,观察2组护理满意度。 结果2组护理后SAS、SDS评分较护理前降低（P＜0.05）,GSES评分较护理前升高（P＜0.05）;观察组护理后SAS、SDS评分低于对照组（P＜0.05）,GSES评分高于对照组（P＜0.05）。2组SF-36、ADL评分较护理前升高（P＜0.05）;观察组护理后SF-36、ADL评分高于对照组（P＜0.05）。2组护理后营养管理、健康责任、运动管理、心理安适及SRAHP总分较护理前升高（P＜0.05）;观察组护理后健康责任、心理安适及SRAHP评分高于对照组（P＜0.05）,营养管理、运动管理较对照组比较差异无统计学意义（P＞0.05）。观察组护理满意度为96.00%,高于对照组的84.00%（P＜0.05）。 结论Roy适应模式用于Stanford B型主动脉夹层患者护理中效果显著,可减轻患者抑郁、焦虑等不良情绪,提升自我管理能力和日常生活能力,且可通过提高患者自我健康行为能力,改善生活质量,提高患者护理满意度,值得推广。     

老年膝关节置换术患者围手术期护理风险管理的研究

目的 探讨老年膝关节置换术患者围手术期的护理风险及管理,以降低护理风险的发生.方法 将110例老年膝关节置换术患者根据住院时间顺序分为对照组48例和观察组62例,对照组按传统关节置换术常规护理;观察组采用风险流程管理对护理风险进行预防.结果 两组患者在出院前1 d比较护理缺陷（x2=4.21,P＜0.05）、患者满意度（t=11.78,P＜0.01）、膝关节评分（t=20.09,P＜0.01）、术后并发症发生率（t=5.30,P＜0.01）、平均住院日（t=8.01,P＜0.01）、护理文书合格率（t=7.70,P＜0.01）,差异均有统计学意义.结论 对老龄关节置换术患者在围手术期进行流程化风险管理,可以降低护理缺陷、术后并发症发生和平均住院日,提高患者满意度、膝关节功能活动度和护理文书合格率.     

心理护理对脑卒中后焦虑、抑郁患者预后的影响

目的 探讨心理护理对脑卒中后焦虑、抑郁患者预后的影响及其临床意义.方法 将102名脑卒中患者随机分为对照组53例,干预组49例.两组均采取脑卒中后常规治疗和护理,同时干预组实施心理护理.在治疗前,治疗后1个月,治疗后6个月分别对两组患者进行综合医院焦虑抑郁量表(HADS),改良爱丁堡斯堪的那维亚卒中量表(MESSS)评定.结果 治疗前,焦虑抑郁评分干预组明显高于对照组(P＜0.05),余无明显差异(P＞0.05).1个月后,焦虑抑郁评分和卒中量表评分两组差异无显著性(P＞0.05).6个月后,卒中量表评分,干预组明显低于对照组(P＜0.05),余差异无显著性(P＞0.05).结论 心理护理不仅明显改善脑卒中后焦虑和抑郁状态,同时对神经功能的恢复有积极的促进作用.     

自护模式对脑卒中康复期患者自护能力和日常生活活动能力的影响

目的讨自护健康教育对脑卒中康复期患者自护能力和日常生活活动能力的影响。方法研究对象选取哈尔滨某三甲医院神经内科2008年10月至2009年9月住院的符合入组对象标准的脑卒中康复期患者62例,随机分为实验组（32例）和对照组（30例）,对照组患者进行常规健康教育,干预组患者在此基础上进行自护健康教育。采用自护能力测定量表和日常生活活动能力量表评价患者的自护能力和日常生活活动能力。结果干预前两组患者在自护能力和日常生活活动能力两方面得分比较差异无统计学意义（P〉0．05）;干预后实验组患者自护责任感评分（13．59±4．66）分高于对照组（10．87±4．73）分,差异有统计学意义（t=20287,P〈0．05）,ADL评分（76．25±14．81）分高于对照组评分（62．33±15．58）分,差异有统计学意义（t=3．606,P〈0．01）,自我概念、自护技能、健康知识水平、自护能力方面评分也显著高于对照组,差异均有统计学意义（P〈0．01）。结论自护健康教育与常规的健康教育相比,能更有效地提高脑卒中康复期患者的自护能力和日常生活活动能力,值得在临床工作中推广应用。     

品管圈在脊柱骨科手术中的应用

目的探讨品管圈管理在脊柱骨科手术中的护理应用价值。方法 2015年1-6月,采用便利抽样法选择冀中能源邢台矿业集团总医院住院拟行脊柱外科手术患者90例为对照组。同法选择2015年7-12月的90例患者为观察组。对照组予以常规护理,2015年7月,开展品管圈活动,分析脊柱骨科手术中存在的护理问题发生原因,制定改进措施;观察组患者按改进后的护理措施进行日常护理。比较两组患者的手术护理质量、护理满意度以及护理人员能力。结果观察组在医护配合、护理文书、器械维护、标本送检、患者安全等护理质量方面的评分均高于对照组,差异均有统计学意义(均P0.05)。观察组患者的满意度高于对照组,差异有统计学意义(P0.05)。观察组护士开展活动后的护理理论培训、护理技能培训成绩明显高于活动前,差异有统计学意义(P0.05)。结论品管圈管理在脊柱骨科手术护理应用中能够有效提高护理工作质量,提升了护理人员能力,增强了手术室护理品质以及患者满意度。     

循证护理干预对脑卒中患者生活质量、认知水平及日常生活能力的影响

目的探讨循证护理干预对脑卒中患者生活质量及认知水平的影响。方法选取确诊的脑卒中患者100例,根据入院就诊编号平均分组,单号为对照组(采用常规护理),双号为研究组(在对照组护理基础上实施循证护理),对比2组患者护理效果。结果护理干预后,研究组患者社会功能、精神健康、情感职能、活动力、躯体疼痛、生理职能、生理功能、总体健康各项评分均高于对照组(P0.05)。护理干预前,2组患者间MMSE、NCSE评分差异无统计学意义(P0.05);护理干预后,研究组MMSE、NCSE评分均高于对照组(P0.05)。护理干预前,2组Barthel指数评分差异无统计学意义(P0.05);护理干预后,2组Barthel指数评分均高于干预前(P0.05),且研究组Barthel指数评分高于对照组(P0.05)。结论对脑卒中患者实施循证护理干预效果显著,不仅能改善生活质量,还能提高认知水平,值得在临床推广应用。     

床旁康复护理单对髋关节置换术后康复的影响

目的：探讨应用床旁康复护理单对髋关节置换手术患者康复的影响.方法：将80例髋关节置换手术患者随机分为试验组和对照组各40例.对照组采取传统的康复训练形式,试验组应用床旁康复护理单的康复训练形式.术后2周比较两组患者第1次下地时间、单次最远行走距离、髋关节功能评分、疼痛评分及对护理工作满意度.结果：试验组患者第1次下地时间早于对照组（P＜0.05）,术后2周单次最远行走距离长于对照组（P＜0.05）,髋关节功能评分高于对照组（P＜0.05）,疼痛评分低于对照组,对护理工作满意度高于对照组（P＜0.05）.结论：床旁康复护理单在临床的试用中,缩短了患者的康复进程,适应优质护理服务,值得在临床推广使用.     

信息化健康教育模式在肺癌患者围手术期中的应用

目的 探讨信息化健康教育模式在肺癌患者围手术期中的应用效果。 方法 选取2017年1-9月我科收治的232例肺癌手术患者为对照组,选取2017年10月-2018年6月我科收治的245例肺癌手术患者为观察组,对照组给予传统宣教模式;观察组在对照组的基础上增加信息化手段进行健康宣教。比较2组健康宣教知识掌握掌握情况、术后首次下床活动时间、胸腔引流管留置时间、术后平均住院日及患者对护理工作的满意度。 结果 干预后,观察组肺癌相关知识及疾病自我管理知识得分均高于对照组(t=3.210,P=0.010;t=2.021,P=0.014)。 观察组首次下床活动时间早于对照组(t＝2.210,P=0.031)、胸腔引流管留置时间及术后平均住院日均短于对照组(t=5.209,P＜0.001;t=5.512,P＜0.001)。观察组患者对护理工作的满意度明显高于对照组(Z=-4.530,P＜0.001)。 结论 信息化宣教模式在肺癌手术患者中应用效果显著,可提高宣教效果,促进了患者的术后恢复,提高患者满意度。     

家庭护理干预对社区血液透析患者生活满意度的影响

目的探讨家庭护理干预对血液透析患者生活满意度的影响。方法将在我院进行血液透析的128例患者随机分为实验组和对照组,每组64例,对照组采用常规护理方法护理,实验组进行家庭护理干预。采用Neugarten生活满意度量表调查患者满意度,比较两组患者的生活满意度、营养指标、肾功能情况。结果干预前两组患者的生活满意度量表评分、尿素氮、肌酐、白蛋白、血红蛋白比较差异均无统计学意义（P〉0．05）;干预后实验组生活满意度量表评分（20．07±1．39）分,生活满意度指数A量表评分为（17．35±1．04）分,生活满意度指数B量表评分为（18．49±1．10）分,对照组分别为（14．71±0．81）,（15．00±0．75）,（15．49±0．85）分,差异均有统计学意义（t=22．43,2．10,10．30;P〈0．05）;干预后实验组尿素氮、肌酐、白蛋白、血红蛋白情况均优于对照组（P〈0．05）。结论家庭护理干预能提高社区血液透析患者的生活满意度,从而提高其生活质量。