基于IDEAS模式的术前访视联合共情支持对严重烧伤患者生理应激、应对方式和瘢痕恢复的影响  

Effects of Preoperative Visit Based on IDEAs Mode Combined with Empathy Support on Physiological Stress,Coping Styles and Scars Recovery in Patients with Severe Burns

作　　者：余娅薇 卢小检 YU Yawei;LU Xiaojian(Department of Burn,the Third Hospital of Wuhan,Wuhan 430074,Hubei,China)

机构地区：[1]武汉市第三医院烧伤科,湖北武汉430074

出　　处：《中国美容医学》2024年第5期160-164,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:基于IDEAS模式(即识别问题、确认选项、评估并选择最佳选项、行动和检验有效性)的术前访视联合共情支持对严重烧伤患者生理应激、应对方式和瘢痕恢复的影响。方法:选取2021年2月-2023年2月笔者科室收治的90例严重烧伤患者为研究对象,按照随机数字表法分为观察组和对照组,各45例。对照组给予共情支持,观察组给予基于IDEAS模式的术前访视护理联合共情支持,比较两组生理应激[去甲肾上腺素(Norepinephrine,NE)、血管紧张素Ⅱ(Angiotensin Ⅱ,AngⅡ)水平]、心理状况[采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评估]、应对方式[采用医学应对问卷(Medical coping modes questionnaire,MCMQ)评估]、自理能力[采用自我护理能力量表(Exercise of self-care agency scale,ESCA)]和瘢痕恢复情况[采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估]。结果:干预后,观察组血清NE、AngⅡ水平低于对照组,HAMA、HAMD评分低于对照组,MCMQ评分优于对照组,ESCA各维度评分高于对照组,VSS评分及总分低于对照组,差异均有统计学意义(P<0.05)。结论:基于IDEAS模式的术前访视联合共情支持可有效减轻严重烧伤患者生理应激,改善不良心理和应对方式,提高自我护理能力,进而促进瘢痕快速恢复。Objective To explore the effects of preoperative visit based on IDEAS mode combined with empathy support on physiological stress,coping styles and scars recovery in patients with severe burns.Methods A total of 90 patients with severe burns were enrolled as the research objects between February 2021 and February 2023.According to random number table method,they were divided into observation group and control group,45 cases in each group.The control group was given empathy support,while observation group was given IDEAS mode-based preoperative visit combined with empathy support.The physiological stress[Norepinephrine(NE),Angiotensin II(Angll)],psychological status[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)],coping styles[Medical coping modes questionnaire(MCMQ)],self-care ability[Exercise of self-care agency scale(ESCA)]and scars recovery[Vancouver scar scale(VSS)]in the two groups were compared.Results After intervention,the serum NE and Angll levels in the observation group were lower than those in the control group,the HAMA and HAMD scores were lower than those in the control group,the MCMQ scores were better than those in the control group,the ESCA scores were higher than those in the control group,and the VSS scores and total scores were lower than those in the control group,with statistical significance(P<0.05).Conclusion IDEAS mode-based preoperative visit combined with empathy support can effectively relieve physiological stress,improve adverse psychology,coping styles and self-care ability,and promote the rapid recovery of scars in patients with severe burns.

关 键 词：严重烧伤 IDEAS模式 共情支持 应激 应对方式 

分 类 号：R644[医药卫生—外科学]