个体化干预对糖尿病合并慢性伤口患者的焦虑情绪及疼痛的影响
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摘要
目的探讨个体化干预对糖尿病合并慢性伤口患者的焦虑情绪及疼痛的影响。方法选取2016年10月至2017年11月在开滦总医院和唐山工人医院两所三级甲等医院的88例糖尿病合并慢性伤口患者,遵循压疮愈合计分表评分分层随机分为干预组和对照组各44例,2组患者伤口均采用湿性愈合方法治疗,干预组结合综合性评估结果给予连续性个体化干预措施,对照组实施常规护理措施,通过焦虑自评量表(SAS)和疼痛数字评价量表(NRS),比较2组患者焦虑情绪及疼痛程度的改变。数据比较采用t检验和χ2检验。结果经过个体化干预后,干预组患者SAS评分为(48. 86±7. 08)分,低于对照组(56. 42±5. 38)分,差异有统计学意义(t=-5. 639,P <0. 05);干预组患者NRS评分为(3. 93±1. 82)分,明显低于对照组(4. 73±1. 93)分,差异有统计学意义(t=2. 296,P=0. 042)。干预组患者愈合时间小于中位数占比65. 9%与对照组(36. 4%)比较,差异有统计学意义(χ2=6. 545,P=0. 011)。结论通过对糖尿病合并慢性伤口患者实施个体化干预可显著改善患者焦虑情绪,并降低疼痛程度。
Objective To explore the effects of individualized intervention on anxiety and pain in patients with diabetes mellitus combined with chronic wound.Methods From October 2016 to November2017,88 patients with diabetes mellitus complicated with chronic wounds were selected from two hospitals with a grade of three A,Kailuan General Hospital and Tangshan Gongren Hospital,44 cases were randomly divided into the intervention group and the control group according to the scoring table of pressure ulcer healing.The wounds of the two groups were treated with wet healing method,and the intervention group was given continuous individualized intervention measures combined with the comprehensive evaluation results,the control group was given routine nursing care.The changes of anxiety and pain degree in the two groups were compared by the self-rating anxiety scale(SAS) and the numberical rating scale(NRS).Data were compared with t test and χ2 test.Results After individualized intervention,the SAS of patients in the intervention group was(48.86±7.08),lower than the control group(56.42±5.38),the difference was statistically significant(t=-5.639,with P values below 0.05).The NRS in the intervention group(3.93±1.82) was significantly lower than that in the control group(4.73±1.93),and the difference was statistically significant(t=2.296,P=0.042).The healing time ratio of the intervention group(65.9%)was significantly different from that of the control group(36.4%)(χ2=6.545,P=0.011).Conclusion Individualized intervention in patients with diabetes mellitus combined with chronic wounds can significantly improve anxiety and reduce pain.
Objective To explore the effects of individualized intervention on anxiety and pain in patients with diabetes mellitus combined with chronic wound.Methods From October 2016 to November2017,88 patients with diabetes mellitus complicated with chronic wounds were selected from two hospitals with a grade of three A,Kailuan General Hospital and Tangshan Gongren Hospital,44 cases were randomly divided into the intervention group and the control group according to the scoring table of pressure ulcer healing.The wounds of the two groups were treated with wet healing method,and the intervention group was given continuous individualized intervention measures combined with the comprehensive evaluation results,the control group was given routine nursing care.The changes of anxiety and pain degree in the two groups were compared by the self-rating anxiety scale(SAS) and the numberical rating scale(NRS).Data were compared with t test and χ2 test.Results After individualized intervention,the SAS of patients in the intervention group was(48.86±7.08),lower than the control group(56.42±5.38),the difference was statistically significant(t=-5.639,with P values below 0.05).The NRS in the intervention group(3.93±1.82) was significantly lower than that in the control group(4.73±1.93),and the difference was statistically significant(t=2.296,P=0.042).The healing time ratio of the intervention group(65.9%)was significantly different from that of the control group(36.4%)(χ2=6.545,P=0.011).Conclusion Individualized intervention in patients with diabetes mellitus combined with chronic wounds can significantly improve anxiety and reduce pain.
引文
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[12]Newbern S.Identifying Pain and Effects on Quality of Life from Chronic Wounds Secondary to Lower-Extremity Vascular Disease:An Integrative Review[J].Adv Skin Wound Care,2018,31(3):102-108.
[13]李梦阳,刘莉,赵岳.住院老年慢性病患者焦虑、抑郁认知与社会支持的相关性研究[J].天津护理,2017,25(6):507-510.
[2]World Health Organization.Definition,diagnosis and classification of diabetes mellitus and its complications.Report of a WHO consul-ration.Part 1.Diagnosis and classification of diabetes and mellitus[R].Geneva:World Health Organization,1999.
[3]蔡夺.综合护理干预对烧伤患者换药疼痛的影响研究[D].长春:吉林大学,2014.
[4]Zung WW.A Rating instrument for anxiety disorders[J].Psychosomatics,1971,12(6):371-379.
[5]王曙红.临床护理评价量表及应用[M].长沙:湖南科学技术出版社,2011:228-230.
[6]陶明,高静芳.修订焦虑自评量表(SAS-CR)的信度及效度[J].中国神经精神疾病杂志,1994,20(5):301-302.
[7]李瑞霞,邓琳,芦红娟,等.心理干预和健康教育对普外科手术患者焦虑情绪及术后疼痛的影响[J].护理实践与研究,2018,15(1):151-152.
[8]康宁宁,张玥.溃疡性结肠炎患者的压力管理干预[J].护理学杂志,2015,30(17):67-68.
[9]徐晓晰,张敏,方颖.基于病人需求的护理模式在门诊伤口护理应用的效果评价[J].护理研究,2016,30(3):1108-1110.
[10]王芳,袁丽,李饶,等.住院2型糖尿病患者焦虑抑郁状况及影响因素分析[J].护理学报,2015,22(14):28-31.
[11]何汶霞.慢性伤口患者伤口护理知识的影响因素研究[D].广东:暨南大学,2014.
[12]Newbern S.Identifying Pain and Effects on Quality of Life from Chronic Wounds Secondary to Lower-Extremity Vascular Disease:An Integrative Review[J].Adv Skin Wound Care,2018,31(3):102-108.
[13]李梦阳,刘莉,赵岳.住院老年慢性病患者焦虑、抑郁认知与社会支持的相关性研究[J].天津护理,2017,25(6):507-510.