基于循证的集束化护理对服用非典型抗精神病药的女性精神分裂症患者代谢的影响  

Effect of evidence-based cluster nursing on metabolism of female schizophrenics taking atypical antipsychotics

作　　者：朱萍[1] 季彩芳 吉封 杜侠 杨静宜 吴菊[1] 王盛岚 朱峰[1] 陆心传 孔凡贞[1] ZHU Ping;JI Caifang;JI Feng(Suzhou Guangji Hospital,Suzhou 215137,China)

机构地区：[1]苏州市广济医院,江苏苏州215137

出　　处：《精神医学杂志》2024年第2期133-137,共5页Journal of Psychiatry

基　　金：苏州市科技发展计划-民生科技-医疗卫生应用基础研究项目(编号:SYSD2017139);苏州市姑苏卫生人才计划科研项目(编号:GSWS2021051)。

摘　　要：目的探讨基于循证的集束化护理干预对服用非典型抗精神病药的女性精神分裂症患者代谢的影响。方法将服用非典型抗精神病药(氯氮平、奥氮平)的女性精神分裂症患者120例,按数字随机法分为干预组和对照组各60例。对照组实施精神分裂症常规护理,干预组除常规护理外增加基于循证的改善代谢异常的集束化护理,所有被试在干预前及干预后第1、2、6、12个月末均完成体质量指数(BMI)、糖脂指标[糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2 h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、一般自我效能感量表(GSES)的测评,出院时完成护理质量满意度调查表。结果对照组干预后2、6、12个月末BMI、腰臀比较干预前升高(P<0.05),干预组干预后第6、12个月末BMI、腰臀比低于对照组(P<0.05)。对照组干预后第2、6、12个月末FBG、2hPG、HbAlc、TG、TC、HDL均较干预前升高,LDL降低(P<0.05),干预组干预后第2、6、12个月末FBG、2hPG、HbAlc、TG、TC、HDL均低于对照组,LDL高于对照组(P<0.05)。干预后第6、12个月末,干预组GSES评分均较干预前升高(P<0.01),且干预组GSES评分均高于对照组(P<0.01);出院时干预组护理质量满意度评分高于对照组(P<0.01)。结论基于循证的集束化护理干预可改善服用非典型抗精神病药的女性精神分裂症患者的代谢指标,提高自我效能及对护理质量的满意度。Objective To explore the effect of evidence-based cluster nursing on metabolism of female schizophrenics taking atypical antipsychotics.Methods 120 female schizophrenics taking atypical antipsychotics(clozapine,olanzapine)were selected and randomly divided into intervention group(60 cases)treated with evidence-based cluster nursing for improving metabolic abnormalities in addition to routine nursing and control group(60 cases)treated with routine nursing for schizophrenia.All subjects completed the assessment of body mass index(BMI),glycolipid indexes(HbAlc,FBG,2hPG,TC,TG,LDL and HDL),General Self-Efficacy Scale(GSES)at baseline and at the ends of 1st,2nd,6th,and 12th months after intervention,and completed the nursing quality satisfaction questionnaire at discharge.Results In control group,the BMIs,waist hip ratios,levels of FBG,2hPG,HbAlc,TG,TC,HDL at the ends of 2nd,6th,and 12th months after intervention were increased and the LDL levels decreased compared with those before intervention(P<0.05).In intervention group,the BMIs,waist hip ratios at the ends of 6th and 12th months after intervention were lower than those in control group(P<0.05),and levels of FBG,2hPG,HbAlc,TG,TC,HDL at the ends of 2nd,6th,and 12th months after intervention were lower and LDL levels were higher than those in control group(P<0.05).At the ends of 6th and 12th months after intervention,the GSES scores in intervention group increased compared with that before intervention(P<0.01),and were higher than those in control group(P<0.01).At discharge,the satisfaction score of nursing quality in intervention group was significantly higher than that in control group(P<0.01).Conclusion Evidence-based cluster nursing can improve the metabolic indicators of female schizophrenics taking atypical antipsychotics,improve self-efficacy and satisfaction with nursing quality.

关 键 词：集束化护理 非典型抗精神病药 女性精神分裂症 代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]