基于保护动机理论的早期康复运动对危重症患者ICU获得性衰弱的效果分析
|
摘要
目的探讨基于保护动机理论的早期康复运动对危重症患者ICU获得性衰弱的效果。方法选择2018年1月至6月收治的90例危重症患者为研究对象,按入院时间分为对照组和观察组,每组各45例。对照组采用常规护理,观察组在此基础上给予基于保护动机理论的早期康复运动,包括八步操、搭桥运动、悬吊运动疗法以及骑车运动等。结果观察组危重症患者ICU获得性衰弱发生率显著低于对照组;日常生活能力评分显著改善;机械通气时间和急诊ICU住院时间显著低于对照组,差异有统计学意义(P<0.01)。结论基于保护动机理论的早期康复运动能降低危重症患者ICU获得性衰弱发生率,提升日常生活能力,增强患者保护动机,促进患者康复,提高其生活质量,值得推广。
Objective To explore the effect of early rehabilitation exercise on ICU-acquired weakness(ICU-AW) among critically ill patients,based on the theory of protection motivation.Methods Totally,90 critically ill patients from January to June 2018 were enrolled for research.The patients were divided into the control group and the intervention group according to the time of admission,with each group containing 45 cases.The control group received routine nursing care.The observation group received extra nursing intervention of early rehabilitation exercise based on the theory of protection motivation,including eight steps operation,bridge movement,sling exercise therapy and bicycling.Results The incidence of ICU-AW in the observation group was significantly lower than the control group.The daily living self-care ability score of the observation group was significantly improved after the intervention.The mechanical ventilation time and the Emergency Intensive Care Unit(EICU) time in the observation group were significantly lower than those in the control group(P<0.01).Conclusion Early rehabilitation exercise based on the theory of protection motivation can lower the incidence of ICU-AW in critically ill patients,improve daily living ability,promote patient's hospitalization,and enhance patient protection motivation,which is worth promoting.
Objective To explore the effect of early rehabilitation exercise on ICU-acquired weakness(ICU-AW) among critically ill patients,based on the theory of protection motivation.Methods Totally,90 critically ill patients from January to June 2018 were enrolled for research.The patients were divided into the control group and the intervention group according to the time of admission,with each group containing 45 cases.The control group received routine nursing care.The observation group received extra nursing intervention of early rehabilitation exercise based on the theory of protection motivation,including eight steps operation,bridge movement,sling exercise therapy and bicycling.Results The incidence of ICU-AW in the observation group was significantly lower than the control group.The daily living self-care ability score of the observation group was significantly improved after the intervention.The mechanical ventilation time and the Emergency Intensive Care Unit(EICU) time in the observation group were significantly lower than those in the control group(P<0.01).Conclusion Early rehabilitation exercise based on the theory of protection motivation can lower the incidence of ICU-AW in critically ill patients,improve daily living ability,promote patient's hospitalization,and enhance patient protection motivation,which is worth promoting.
引文
[1] BASCIANI M,GRIMALDI G,AMORUSO L,et al.Long-term functional outcome and health status of patients with critical illness polyneuromyopathy[J].Acta Neurologica Scandinavica,2011,123(3):211-219.DOI:10.1111/j.1600-0404.2010.01414.x.
[2] HERMANS G,VAN DEN BERGHE G.Clinical review:intensive care unit acquired weakness[J].Critical Care,2015,19(1):274-282.DOI:10.1186/s13054-015-0993-7.
[3] WIESKE L,DETTLING-IHNENFELDT D S,VERHAMME C,et al.Impact of ICU-acquired weakness on post-ICU physical functioning:a followup study[J].Critical Care,2015,19(1):196-203.DOI:10.1186/s13054-015-0937-2.
[4] 冯金华,田永明,聂孟珍,等.某院253名ICU护士对ICU获得性衰弱认知情况现状分析[J].护理学报,2015,22(17):43-47.DOI:10.16460/j.issn1008-9969.2015.17.043.
[5] 陈思,顾君君,冯玉兰,等.早期活动干预法预防 ICU 获得性衰弱的应用效果[J].解放军护理杂志,2018,35(17):50-52.DOI:10.3969/j.issn.1008-9993.2018.17.012.
[6] ROGERS R W,PRENTICE S.Protection Motivation Theory-handbook of health behavior research[M].New York:Plenum,1997:113-132.
[7] WEISBRODT L,MCKINLEY S,MARSHALL A P,et al.Daily interruption of sedation in patients receiving mechanical ventilation[J].American Journal of Critical Care,2011,20(4):90-98.DOI:10.4037/ajcc2011415.
[8] 王迎晓,王芳,金宗玉.护理干预在肾脏科ICU获得性衰弱预防中的应用[J].护理研究,2015,29(10A):3560-3562.DOI:10.3969/j.issn.1009-6493.2015.28.036.
[9] HERMANS G,CLERCKX B,VANHULLEBUSCH T,et al.Interobserver agreement of medical research council sum-score and handgrip strength in the intensive care unit[J].Muscle & Nerve,2012,45(1):18-25.DOI:10.1002/mus.22219.
[10] 李小峰,陈敏.改良Barthel指数评定量表的设计与应用[J].护理研究,2015,29(5A):1657-1658.DOI:10.3969/j.issn.1009-6493.2015.13.044.
[11] 周茜,耿亚琴,狄捷,等.不同运动强度器械拉力操对ICU获得性衰弱患者肌肉成分的影响[J].护理学杂志,2017,32(21):99-102.DOI:10.3870/j.issn.1001-4152.2017.21.099.
[12] 张学慧,张宁.基于保护动机理论的护理干预对2型糖尿病病人用药依从性及生活质量的影响[J].护理研究,2015,29(12B):4497-4500.DOI:10.3969/j.issn.1009-6493.2015.36.006.
[13] 朱庆捷,窦英茹,潘春芳,等.床上脚踏车运动预防慢性阻塞性肺疾病急性加重患者ICU获得性衰弱的研究[J].护理实践与研究,2018,15(20):1-4.DOI:10.3969/j.issn.1672-9676.2018.20.001.
[14] 陈泓伯,刘俊,陈利钦,等.每日唤醒在ICU机械通气镇静患者中应用效果的meta分析[J].中华护理杂志,2014,49(9):1029-1034.DOI:10.3761/j.issn.0254-1769.2014.09.001.
[15] 陈晓洁,余容容,陈慧珍.集束化护理措施在ICU获得性衰弱患者中的应用效果评价[J].浙江临床医学,2017,19(9):1733-1735.
[16] COKER R H,HAYS N P,WILLIAMS R H,et al.Bed rest promotes reductions in walking speed,functional parameters,and aerobic fitness in older,healthy adults[J].The Journals of Gerontology Series A:Biological Sciences and Medical Sciences,2015,70(1):91-96.DOI:10.1093/gerona/glu123.
[17] 傅彩峰,高朝,楚妍峰,等.超声波联合悬吊运动疗法治疗腰肌筋膜疼痛综合征的临床观察[J].中华物理医学与康复杂志,2016,38(2):153-155.DOI:10.3760/cma.j.issn.0254-1424.2016.02.019.
[18] 肖亮,吴艳平,何英,等.保护动机干预对老年骨质疏松骨折患者自我护理能力的影响[J].护理管理杂志,2014,14(2):123-124.
[19] 王桂英,张莉,苏敏谊,等.快速康复外科护理对剖宫产术后产妇早期离床活动的影响[J].护理管理杂志,2014,14(10):739-740.
[2] HERMANS G,VAN DEN BERGHE G.Clinical review:intensive care unit acquired weakness[J].Critical Care,2015,19(1):274-282.DOI:10.1186/s13054-015-0993-7.
[3] WIESKE L,DETTLING-IHNENFELDT D S,VERHAMME C,et al.Impact of ICU-acquired weakness on post-ICU physical functioning:a followup study[J].Critical Care,2015,19(1):196-203.DOI:10.1186/s13054-015-0937-2.
[4] 冯金华,田永明,聂孟珍,等.某院253名ICU护士对ICU获得性衰弱认知情况现状分析[J].护理学报,2015,22(17):43-47.DOI:10.16460/j.issn1008-9969.2015.17.043.
[5] 陈思,顾君君,冯玉兰,等.早期活动干预法预防 ICU 获得性衰弱的应用效果[J].解放军护理杂志,2018,35(17):50-52.DOI:10.3969/j.issn.1008-9993.2018.17.012.
[6] ROGERS R W,PRENTICE S.Protection Motivation Theory-handbook of health behavior research[M].New York:Plenum,1997:113-132.
[7] WEISBRODT L,MCKINLEY S,MARSHALL A P,et al.Daily interruption of sedation in patients receiving mechanical ventilation[J].American Journal of Critical Care,2011,20(4):90-98.DOI:10.4037/ajcc2011415.
[8] 王迎晓,王芳,金宗玉.护理干预在肾脏科ICU获得性衰弱预防中的应用[J].护理研究,2015,29(10A):3560-3562.DOI:10.3969/j.issn.1009-6493.2015.28.036.
[9] HERMANS G,CLERCKX B,VANHULLEBUSCH T,et al.Interobserver agreement of medical research council sum-score and handgrip strength in the intensive care unit[J].Muscle & Nerve,2012,45(1):18-25.DOI:10.1002/mus.22219.
[10] 李小峰,陈敏.改良Barthel指数评定量表的设计与应用[J].护理研究,2015,29(5A):1657-1658.DOI:10.3969/j.issn.1009-6493.2015.13.044.
[11] 周茜,耿亚琴,狄捷,等.不同运动强度器械拉力操对ICU获得性衰弱患者肌肉成分的影响[J].护理学杂志,2017,32(21):99-102.DOI:10.3870/j.issn.1001-4152.2017.21.099.
[12] 张学慧,张宁.基于保护动机理论的护理干预对2型糖尿病病人用药依从性及生活质量的影响[J].护理研究,2015,29(12B):4497-4500.DOI:10.3969/j.issn.1009-6493.2015.36.006.
[13] 朱庆捷,窦英茹,潘春芳,等.床上脚踏车运动预防慢性阻塞性肺疾病急性加重患者ICU获得性衰弱的研究[J].护理实践与研究,2018,15(20):1-4.DOI:10.3969/j.issn.1672-9676.2018.20.001.
[14] 陈泓伯,刘俊,陈利钦,等.每日唤醒在ICU机械通气镇静患者中应用效果的meta分析[J].中华护理杂志,2014,49(9):1029-1034.DOI:10.3761/j.issn.0254-1769.2014.09.001.
[15] 陈晓洁,余容容,陈慧珍.集束化护理措施在ICU获得性衰弱患者中的应用效果评价[J].浙江临床医学,2017,19(9):1733-1735.
[16] COKER R H,HAYS N P,WILLIAMS R H,et al.Bed rest promotes reductions in walking speed,functional parameters,and aerobic fitness in older,healthy adults[J].The Journals of Gerontology Series A:Biological Sciences and Medical Sciences,2015,70(1):91-96.DOI:10.1093/gerona/glu123.
[17] 傅彩峰,高朝,楚妍峰,等.超声波联合悬吊运动疗法治疗腰肌筋膜疼痛综合征的临床观察[J].中华物理医学与康复杂志,2016,38(2):153-155.DOI:10.3760/cma.j.issn.0254-1424.2016.02.019.
[18] 肖亮,吴艳平,何英,等.保护动机干预对老年骨质疏松骨折患者自我护理能力的影响[J].护理管理杂志,2014,14(2):123-124.
[19] 王桂英,张莉,苏敏谊,等.快速康复外科护理对剖宫产术后产妇早期离床活动的影响[J].护理管理杂志,2014,14(10):739-740.