延续护理对完全性胸脊髓损伤患者出院后身心健康的影响  

The effect of transitional care of physical and mental health of the thoracic spinal cord injury and paraplegic patients

作　　者：陈巧灵[1] 吴慧慧[1] 李娜[1] 

机构地区：[1]解放军总医院第一附属医院脊柱脊髓损伤科,北京100048

出　　处：《中国实用护理杂志》2017年第17期1281-1286,共6页Chinese Journal of Practical Nursing

摘　　要：目的 探讨延续护理对完全性胸脊髓损伤患者出院后身心健康的影响.方法 选取2014年6月至2015年10月住院的完全性胸脊髓损伤患者65例,根据住院号尾数单双号分为观察组35例和对照组30例.对照组接受常规护理和出院指导,观察组在此基础上实施电话随访、网络平台及开展主题活动等形式的延续护理.出院时和出院3个月分别采用功能独立性评定量表（FIM）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评价2组患者的生活自理能力以及心理状态.并比较2组患者出院3个月并发症的发生情况.结果 2组患者出院时FIM、HAMA、HAMD评分比较差异无统计学意义（P〉0.05）;观察组患者出院3个月FIM、HAMA、HAMD评分分别为（72.35±4.35）、（4.80±4.50）、（12.13±7.25）分,对照组分别为（63.95±5.02）、（10.15±4.91）、（19.48±8.31）分,2组比较差异有统计学意义（t=-4.798、3.524、3.110,均P〈0.01）.2组患者出院3个月肺部感染和血栓发生率比较差异无统计学意义（P〉0.05）;观察组患者尿路感染、压疮、便秘发生率分别为8.57%（3/35）、5.71%（2/35）、17.14%（6/35）,对照组分别为40.00%（12/30）、33.33%（10/30）、63.33%（19/30）,2组比较差异有统计学意义（χ2=4.324、4.219、5.337,均P〈0.05）.结论 延续护理能显著改善完全性胸脊髓损伤患者出院后的心理状态,提高患者康复治疗依从性及自我管理能力,降低并发症的发生率,提高生命质量.Objective To investigate the effect of transitional care of physical and mental health of the thoracic spinal cord injury and paraplegic patients discharged on its recovery. Methods Randomized controlled analysis of patients in Spine and Spinal Cord Injury Surgery between June 2014 to October 2015, a total of 65 patients with thoracic spinal cord injury and paraplegic were studied, according to hospital mantissa odd and even numbers divided into observation group （35 cases） and control group （30 cases）. The observation group was instituted to extending posthospital care, not the control group. The self-care ability and psychological state were evaluated by Function Independent Measure （FIM）, Hamilton Anxiety Scale（HAMA）, Hamilton Depression Scale （HAMD）within discharge and in 3 months. And the incidence of complications between the two groups were compared. Results At discharge, the difference of FIM, HAMA, HAMD score between the observation group and the control group was not statistically significant （P〉0.05）. Discharged after 3 months, the score of FIM, HAMA, HAMD in observation group was（72.35 ± 4.35）,（4.80 ± 4.50）,（12.13 ± 7.25）points, （63.95 ± 5.02）,（10.15 ± 4.91）, （19.48 ± 8.31）points in control group. The difference between the two groups was statistically significant （t=-4.798, 3.524, 3.110, P〈0.01）. There was no significant difference in the incidence of pulmonary infection and blood clots between two groups （P 〉 0.05）; The incidence of urinary tract infection, pressure ulcers, constipation were 8.57% （3/35）, 5.71% （2/35）, 17.14% （6/35） in observation group, 40.00% （12/30）, 33.33%（10/30）, 63.33%（19/30） in control group, there were significant differences between, two groups （χ2= 4.324, 4.219, 5.337, P 〈 0.05）. Conclusions Transitional care can significantly improve the psychological state of patients with thoracic spinal cord injury and paraplegia discharged, reduce the incidence of complications and impro

关 键 词：生活质量 延续护理 胸脊髓损伤 心理状态 

分 类 号：R473.6[医药卫生—护理学]