叙事护理对冠状动脉搭桥术患者焦虑抑郁干预效果的观察  

The study of narrative medicine on anxiety and depression in patients undergoing coronary artery bypass grafting

作　　者：孙妞妞 史素玲 李转珍[1,2] 陈海燕 雷晓静[3] 张洛灵 孟海英[1,4] 郑雪洋 Sun Niuniu;Shi Suling;Li Zhuanzhen;Chen Haiyan;Lei Xiaojing;Zhang Luoling;Meng Haiying;Zheng Xueyang(Department of Humanities,College of Nursing,Henan University of Science and Technology,Luoyang 471000,China;Department of Nursing,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China;School Hospital,Henan University of Science and Technology,Luoyang 471000,China;Department of Cardiologycardiac Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学护理学院人文教研室,洛阳471000 [2]河南科技大学第一附属医院护理部,洛阳471003 [3]河南科技大学校医院,洛阳471000 [4]河南科技大学第一附属医院心外科,洛阳471003

出　　处：《中国实用护理杂志》2019年第31期2407-2411,共5页Chinese Journal of Practical Nursing

基　　金：河南省科技厅科技发展计划(152102310086)。

摘　　要：目的探讨叙事护理对冠状动脉搭桥术患者焦虑、抑郁水平的干预效果,为临床护理工作提供参考。方法采用焦虑自评量表(SAS)和抑郁自评量表(SDS)筛选出拟行非体外循环冠状动脉搭桥术合并焦虑抑郁的患者63例,采用随机数字表法将患者分为研究组31例和对照组32例。对照组实施心外科冠状动脉搭桥围手术期常规护理;研究组在心外科冠状动脉搭桥围手术期常规护理的基础上开展叙事护理。分别于入院当日、术后7 d、术后14 d采用抑郁自评量表、焦虑自评量表评估患者抑郁、焦虑水平,并进行数据分析。结果最终61例完成研究,住院期间无死亡病例。2组患者一般资料、入院当日SAS、SDS评分比较差异均无统计学意义。SAS评分研究组入院当日、术后7 d、术后14 d分别为(57.9±4.2)、(50.8±4.9)、(47.1±5.0)分,对照组分别为(58.4±3.7)、(57.9±5.2)、(55.7±6.2)分,2组比较干预后差异有统计学意义(t=5.490、5.973,P<0.01);研究组SAS评分术后7 d、术后14 d与本组入院当日比较均下降,差异有统计学意义(t=6.125、9.209,P<0.01)。SDS评分研究组入院当日、术后7 d、术后14 d评分分别为(54.3±4.6)、(49.4±4.7)、(42.7±4.8)分,对照组分别为(54.1±5.1)、(52.3±5.6)、(51.6±5.2)分,2组干预后比较差异有统计学意义(t=2.194、6.949,P<0.05或0.01);研究组SDS评分术后7 d、术后14 d与本组入院当日比较均下降,差异有统计学意义(t=4.148、9.715,P<0.01)。结论叙事护理可显著改善冠状动脉搭桥术患者焦虑、抑郁情绪水平,对患者身心康复具有重要意义。Objective To investigate and summarize the effect of narrative nursing on anxiety and depression in patients undergoing coronary artery bypass grafting,and to provide reference for the formulation of clinical nursing plan.Methods A total of 61 patients underwent coronary artery bypass grafting were selected.31 cases of narrative nursing were taken as the research group,and routine nursing was used in the other 30 cases as control group.Depression and anxiety were assessed by Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)before,7 days after and 14 days after surgery.Results Totally 61 patients were successfully operated and no case died during hospitalization.There was no significant difference in SAS and SDS scores between the 2 groups before surgery.The SAS scores in the study group were 57.9±4.2,50.8±4.9,47.1±5.0 on the day of admission,7 days after operation and 14 days after operation,respectively,while those in the control group were 58.4±3.7,57.9±5.2,55.7±6.2.There were significant differences between the two groups after intervention(t=5.490,5.973,P<0.01).The SAS score of the study group decreased 7 days after operation and 14 days after operation compared with that of the admission day(t=6.125,9.209,P<0.01).The SDS scores in the study group were 54.3±4.6,49.4±4.7,42.7±4.8 on the day of admission,7days after operation and 14 days after operation,respectively,while those in the control group were 54.1±5.1,52.3±5.6,51.6±5.2.There were significant differences between the two groups after intervention(t=2.194,6.949,P<0.01).SDS scores in the study group decreased 7 days after operation and 14 days after operation compared with the day of admission in this group,with significant differences(t=4.148,9.715,P<0.01).Conclusions Narrative nursing is helpful to relieve anxiety and depression in patients undergoing coronary artery bypass grafting.

关 键 词：冠状动脉搭桥术 叙事医学 护理 焦虑 抑郁 

分 类 号：R47[医药卫生—护理学]