基于ADOPT问题解决模式的个体化护理对正颌手术患者心理健康和适应能力的影响

目的探讨基于ADOPT问题解决模式的个体化护理对正颌手术患者心理健康和适应能力的影响。方法采用便利抽样法,选取2017年1月—2019年4月郑州大学第一附属医院口腔颌面外科150例正颌手术患者,分为观察组和对照组各75例。干预前先调查患者的心理健康状况,与国内成人常模比较。对照组采取常规住院护理,观察组采取ADOPT问题解决模式的个体化护理。干预时间从患者入院至随访3个月。比较两组患者症状自评量表(SCL-90)、社会心理适应量表(SPAS)评得分情况。结果干预前150例患者的SCL-90量表中的强迫症状、人际敏感、焦虑、敌对、偏执5个维度得分高于国内成人常模,差异有统计学意义(P<0.05)。干预后,观察组患者的强迫症状、人际敏感、焦虑、敌对、偏执5个维度得分均低于对照组,两组比较差异有统计学意义(P<0.05)。干预后观察组患者SPAS总分和各维度得分均高于对照组,两组比较差异有统计学意义(P<0.05)。结论对正颌手术患者实施基于ADOPT问题解决模式的个体化护理,能在一定程度上改善患者的心理健康,尤其是强迫症状、人际敏感、焦虑、敌对、偏执等不良心理。

Effect of ADOPT-based individualized nursing on mental health and adaptive ability of patients undergoing orthognathic surgery

Objective To explore the effect of individualized nursing based on the ADOPT problem solving model on the mental health and adaptive ability of patients undergoing orthognathic surgery.Methods 150 patients undergoing orthognathic surgery from January 2017 to April 2019 in the Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University was selected as subjects by convenient sampling,they were divided into observation group and control group with 75 cases each.The mental health of patients before the intervention was surveyed and compared with the domestic adult norms.The control group received routine inpatient care,and the observation group received ADOPT model individualized care.Intervention was continuous from admission to 3-month follow-up.Symptom Check List-90(SCL-90)and Social Psychological Adjustment Scale(SPAS)were performed to evaluate and compare psychological health symptoms and adaptability in both groups.Results The scores of the five dimensions of obsessive-compulsive symptoms,interpersonal sensitivity,anxiety,hostility,and paranoia on the SCL-90 of 150 patients before the intervention were higher than those of domestic adult norms,the differences were statistically significant(P<0.05).After the intervention,the obsessive-compulsive symptoms,interpersonal sensitivity,anxiety,hostility,and paranoia in the observation group were lower than those in the control group with statistically significant differences(P<0.05).The dimissions scores and total scores of SPAS of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusions The application of individualized nursing based on ADOPT problem-solving model in patients undergoing orthognathic treatment can improve their mental health,especially obsessive-compulsive symptoms,interpersonal sensitivity,anxiety,hostility,and paranoia.