综合康复护理对老年卧床患者日常生活能力及抑郁症状的影响

目的 探讨综合康复护理对老年卧床患者日常生活活动能力及抑郁症状的应用效果。 方法 选取2018年6－9月在乌鲁木齐市养老福利院居住的128例老年卧床患者,根据卧床不起诊断标准将其分为 A、B、C 三个等级,将不同卧床级别的患者随机分为观察组和对照组。对照组给予常规治疗和护理,观察组在对照组的基础上实施综合康复护理干预,在干预前和干预之后的8周,通过Barthel指数和老年抑郁量表(Geriatric Depression Scale-30,GDS-30)来评估日常生活能力和抑郁症状。 结果 干预前各等级的对照组、观察组患者日常生活能力(activities of daily living,ADL)评分、GDS评分差异无统计学意义(P>0.05)。干预后8周,A、B、C卧床级别的观察组患者Barthel指数评定量表(Barthel Index,BI)ADL评分显著上升[A级:(68.70±5.68)vs.(83.69±8.29), t=11.247, P<0.001;B级:(52.50±5.26)vs.(74.75±9.39) , t=15.112, P<0.001; C级:(31.36±5.81) vs.(34.32±5.19), t=2.891, P=0.009],GDS评分显著下降[A级:(13.39±4.08)vs.(10.04±4.33), t=-3.076, P=0.006;B级:(15.51±4.83)vs.(11.90±4.29) , t=-5.190, P<0.001; C级:(18.23±4.93) vs.(14.50±5.46), t=-3.582, P=0.002],差异均有统计学意义(P<0.05);各级对照组干预前后ADL评分[A级:(68.81±6.51)vs.(70.00±7.07), t=1.588, P=0.135;B级:(53.64±4.92)vs.(55.45±5.96) , t=1.789, P=0.088; C级:(30.75±5.45) vs.(31.25±4.55), t=0.567, P=0.577]、GDS评分[A级:(13.52±4.78)vs.(13.10±4.39) , t=-1.752, P=0.095;B级:(16.36±5.20)vs.(15.14±5.15) , t=-1.618, P=0.121; C级:(19.10±5.95)vs.(19.30±6.03) , t=1.453, P=0.163],差异均无统计学意义(P>0.05)。干预后不同卧床级别观察组患者上述指标均显著优于对照组同期的评估结果,差异有统计学意义(P<0.05)。 结论 综合康复护理能够提高老年卧床患者的日常生活能力,延缓卧床不起的进程,减轻抑郁情绪。

Effect of integrated rehabilitation nursing on ability in activities of daily life and depressive symptoms in elderly bedridden patients

Objective To explore the application effect of integrated rehabilitation nursing on improving the ability of activity of daily living and depressive symptoms of elderly bedridden patients. Methods A total of 128 elderly bedridden patients who were selected from a geracomium in Urumqi in June-September, 2018 were randomly divided into three grades (A, B and C) according to the bedridden diagnostic criteria. Patients with different bedridden grades were randomly divided into the observation groups and the control groups. The control groups were given conventional treatment and nursing, while the observation groups received integrated rehabilitation nursing intervention on the basis of the control groups. Before and 8 weeks after the intervention, we gathered general information and evaluated activities of daily living (ADL) by Barthel index and depressive symptoms by Geriatric Depression Scale-30 (GDS-30). Results No statistically significant differences were found in the scores of ADL and GDS between the control groups and the observation groups before the intervention (P>0.05). 8 weeks after the intervention, the scores of ADL in patients with bedridden grades A, B and C in the observation groups significantly increased (grade A: (68.70±5.68) vs. (83.69±8.29), t=11.247, P<0.001; grade B: (52.50±5.26) vs. (74.75±9.39), t=15.112, P<0.001; grade C: (31.36±5.81) vs. (34.32±5.19), t=2.891, P=0.009), while the scores of GDS significantly decreased (grade A: (13.39±4.08) vs. (10.04±4.33), t=-3.076, P=0.006; grade B: (15.51±4.83) vs. (11.90±4.29), t=-5.190, P<0.001; grade C: (18.23±4.93) vs. (14.50±5.46), t=-3.582, P=0.009), showing statistically significant differences (all P<0.05). Before and 8 weeks after the intervention, the scores of ADL and GDS in patients with bedridden grades A, B and C in the control groups were as follows: grade A: ((68.81±6.51) vs. (70.00±7.07), t=1.588, P=0.135)) and ((13.52±4.78) vs. (13.10±4.39), t=-1.752, P=0.095)); grade B: ((53.64±4.92) vs. (55.45±5.96), t=1.789, P=0.088)) and ((16.36±5.20) vs. (15.14±5.15), t=-1.618, P=0.121)), and grade C: ((30.75±5.45) vs. (31.25±4.55), t=0.567, P=0.577)) and ((19.10±5.95) vs. (19.30±6.03), t=1.453, P=0.163)), without statistically significant differences (all P>0.05). 8 weeks after the intervention, the above-mentioned indicators in patients with bedridden grades A, B and C in the observation groups were significantly superior to those in the control group, with statistically significant differences (all P<0.05). Conclusions Integrated rehabilitation nursing can improve elderly bedridden patients’ ability in activity of daily living, delay the bedridden process, and reduce the depression.