护理干预在社会支持系统中对老年患者气管切开的影响  

Impacts of nursing intervention on decision-making to receive tracheotomy for old patientswith chronic diseases based on a social support system

作　　者：张俊丽[1] 张绍敏[1] 林琳[1] 赵莹[1] 王敏[1] 柴若楠[1] 

机构地区：[1]沈阳军区总医院呼吸与重症医学科,沈阳110016

出　　处：《中国中西医结合耳鼻咽喉科杂志》2016年第1期42-44,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：沈阳军区总医院青年基金项目"气道内留置吸痰管对无创正压通气效果影响研究08"(08Y-Q15)

摘　　要：目的探讨在社会支持系统中结合护理干预对老年患者气管切开决策的影响。方法对96例拒绝行气管切开术的脑血管病变合并肺部疾病老年患者家属,采用本院自行设计的"气管切开认知程度调查问卷"进行影响因素调查,针对结果进行相应的护理干预,分析认知度变化对该类患者气管切开术决策过程的影响。结果问卷调查结果显示,排前三位的影响因素分别为传统思想观念(65.6%)、术后护理难度(23.9%)及对气管切开后发生交叉感染的担心(15.6%)。经护理干预后,这类患者家属中,有18例(18.75%)家属决定接受手术。结论做为健康教育的实施主体,护理人员针对老年慢性病合并肺部感染患者家属对气管切开术重要性的认知和态度进行积极的护理干预,参与医患决策,可提高气管切开术同意率。Objective To explore the impacts of nursing intervention on decision-making to receive tracheotomy for old patients with chronic diseases based on a social support system. Method Included in this study were 96 old patients suffering from cerebrovascular disease complicated with lung infection, whose dependents refused originally to receive tracheotomy as one part of a comprehensive treatment plan for these patients. These dependents of patients were surveyed for exploring associated impacting factors with their attitude to refuse tracheotomy by using a questionnaire ＂tracheotomy awareness survey＂ designed by experts of our Hospital. Then, performed were specific nursing interventions with them following a careful analysis on the survey results to master the key impacting factors. At last, the changes in their awareness on tracheotomy as an important therapeutic measure in a comprehensive treatment plan were summed up to explore the impacts of nursing intervention on decision-making to receive such a measure for the treatment of this kind of patients. Results As shown from this survey, the associated impacting factors ranked in the top three were the traditional ideals based on the background of Chinese folk culture（65.5%）, difficulty in post-operative care（23.9%）, and worrying about cross transmission prone following tracheotomy（15.6%）. After intensive nursing intervention, dependents of 18 patients changed their attitude for decision-making to receive such an operation for patients. Discussion As the centeredness to carry out health education in social support system, nurses can play very important role in the decision-making process for performing tracheotomy for old patients with chronic diseases complicated with lung infection by active nursing intervention with patient＇s dependents to change their cognition and attitude on this kind of surgery for a jointly made decision by both of doctors and dependents of patients. Then, elevated will be the approval rate for tracheotomy to such a group o

关 键 词：社会支持系统 护理干预 气管切开术 决策 

分 类 号：R473.6[医药卫生—护理学]