基于多元回归分析结果创建目标护理模式提高门脉高压患者β受体阻滞剂应答率的研究  

Goal-directed nursing model based on multivariate regression analysis for increasing response rates of patients with portal hypertension

作　　者：林奕芬[1] 郑永平[1] 陈丽苗[1] 郑灿滨[2] 郑晓旋[1] 

机构地区：[1]广东省汕头市中心医院中山大学附属汕头医院内科,515031 [2]南方医科大学第一临床医学院2010级医学生

出　　处：《中国实用护理杂志》2012年第18期25-27,共3页Chinese Journal of Practical Nursing

基　　金：汕头市重点科技计划资助项目

摘　　要：目的从护理学角度研究影响门脉高压患者β受体阻滞剂应答率的相关因素，探讨目标护理模式对提高应答率的效果。方法83例有服药指征的患者常规用药3个月后依心率及多普勒超声结果确定有无应答。采用社会支持量表及自拟的调查表，调查患者的就医行为、服药依从性等因素，采用单因素及多因素回归分析法，筛选主要的影响指标并编制为目标护理计划表，将52例无应答的患者随机分为研究组27例与对照组25例，研究组由护士根据目标护理计划表，在Orem自理理论框架指导下，分别提供不同的补偿性护理及辅助教育；对照组行常规护理宣教，干预3个月后行相关指标对比。结果患者自护责任感、对用药目的和目标、骤停服药的危害等知识知晓度、测量心率并依心率调整剂量的技能等与应答与否密切相关，多因素回归分析结果发现自护责任感、骤停用药、对社会支持利用度及是否遵医嘱复诊是应答率的独立影响因素。采用目标护理模式后，研究组对测心率及依心率调整剂量方法的掌握及骤停用药现象等指标较对照组明显改善，应答率明显提高。结论对服用β受体阻滞剂预防门脉高压再出血无治疗反应者，应分析患者的遵医行为与服药依从性，重点做好用药目标、骤停用药危害性及遵医嘱复诊重要性的宣教，采用目标护理模式是提高应答率的有效手段。Objective To analyze factors influencing β-blocker response rates of patients with portal hypertension and to explore the effect of nursing interference for increasing response rates with goal-directed nursing model. Methods 83 cases of portal hypertension were enrolled. Questionnaire about medical visiting behaviors and medication compliance were compared and analyzed after routine medication for 3 months. Bivariate and multivariate regression analysis were performed and related factors were used to establish a goal-directed nursing model for nursing interfexence guidance. 52 non-response patients were randomly divided into the study group（27 eases）and the control group（25 cases）. In the study group, compensation system and supportive-education according to Orem model were given, while the con- trol group was given routine nursing. Response rates and related factors were compared after 3 months of nursing intervention. Results Awareness of serf-care responsibility, knowledge about the medication tar- get, risk of sudden drug withdrawal, related medical knowledge, ability for pulse rate measurement and dose adjustment according to pulse rate changes were related to the response rates. Multivariate regression analy- sis showed that awareness of serf-care responsibility, sudden drug withdrawal, utilization of social support and regular return visit were the independent factors. In the study group, ability for pulse rate measurement and dose adjustment according to pulse rate changes improved, phenomenon of sudden drug withdrawal de- clined and response rate increased, comparing with the control group. Conclusions For patients fail to re- spend to IS-blockers, compliance behavior and medication compliance should be analyzed, and much attention should be paid to the education of the related medical knowledge, risk of sudden drug withdrawal and drug us- ing targets. Goal-directed model could be a guidance for nursing intervention to increase the response rates.

关 键 词：门脉高压 Β受体阻滞剂 应答率 多因素 目标护理模式 

分 类 号：R472[医药卫生—护理学]