基于二元应对理论的护理干预在脊髓损伤患者及其配偶中的应用  

Application of nursing intervention based on dyadic coping theory in patients with spinal cord injury andtheirspouses

作　　者：杨娜 刘安诺[1] 王宗桂[2] Yang Na;Liu Annuo;Wang Zonggui(School of Nursing,Anhui Medical University,Hefei 230601,China;Department of Orthopedics,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学护理学院,合肥230601 [2]安徽医科大学第二附属医院骨科,合肥230601

出　　处：《中华现代护理杂志》2024年第26期3535-3541,共7页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2022-2023年护理学科研究课题(CMAPH-NRP2022011);安徽省高校自然科学研究重大项目(2023AH040085);安徽医科大学护理学院研究生青苗培育项目(hlqml2023069)。

摘　　要：目的构建脊髓损伤患者及其配偶二元应对护理干预方案, 并探讨应用方案改善脊髓损伤患者及其配偶应对能力和生活质量的效果。方法通过查阅文献、课题小组讨论、德尔菲法等, 基于二元应对理论指导构建脊髓损伤患者及其配偶护理干预方案。采用方便抽样法, 选取2023年1-8月在安徽医科大学第二附属医院脊柱外科接受手术治疗的90对脊髓损伤患者及配偶为研究对象。按照随机数字表法, 将研究对象分为对照组(n=46)和观察组(n=44), 对照组采用常规护理模式进行护理, 观察组在对照组基础上实施二元应对护理干预方案, 共干预3个月。两组患者及其配偶在入院时、干预3个月后采用二元应对问卷(DCI)、WHO生活质量简表、家庭功能亲密度和适应性量表对研究对象进行评估。结果干预3个月后, 观察组患者DCI得分为(117.80±0.88)分, 配偶DCI得分为(121.50±3.29)分;患者生活质量得分为(80.50±1.77)分, 配偶生活质量得分为(81.09±1.58)分;患者家庭功能亲密度得分为(65.70±0.95)分, 适应性得分为(48.68±1.03)分, 配偶家庭功能亲密度得分为(67.02±0.88)分, 适应性得分为(49.55±1.27)分。均高于对照组患者及配偶的各项得分, 差异均有统计学意义(P<0.05)。结论基于二元应对理论构建的护理干预方案有利于提高脊髓损伤患者及其配偶的二元应对能力, 改善双方生活质量及家庭功能。Objective To construct a nursing intervention program based on dyadic coping theory for patients with spinal cord injury(SCI)and their spouses,and to explore the effects of the program on improving their coping abilities and quality of life.Methods The nursing intervention program was developed through literature review,expert panel discussions,and the Delphi method,guided by dyadic coping theory.Using convenience sampling,90 pairs of patients with SCI and their spouses who underwent surgery in the Department of Orthopedics at the Second Affiliated Hospital of Anhui Medical University from January to August 2023 were selected.Participants were randomly divided into control group(n=46)and observation group(n=44).The control group received standard nursing care,while the observation group received the dyadic coping-based nursing intervention program in addition to standard care for three months.Both groups were assessed at admission and three months post-intervention using the Dyadic Coping Inventory(DCI),WHO Quality of Life-BREF(WHOQOL-BREF),and Family Adaptability and Cohesion Evaluation Scale(FACES I).Results After three months,the DCI scores for patients and spouses in the observation group were(117.80±0.88)and(121.50±3.29),respectively.The WHOQOL-BREF scores for the patients and spouses were(80.50±1.77)and(81.09±1.58),respectively.The FACES II scores for the patients were(65.70±0.95)and(48.68±1.03),respectively,and for their spouses were(67.02±0.88)and(49.55±1.27),respectively.All scores were significantly higher in the observation group compared to the control group(P<0.05).Conclusions The nursing intervention program based on dyadic coping theory effectively improves the dyadic coping abilities,quality of life,and family functioning of patients with SCI and their spouses.

关 键 词：脊髓损伤 二元应对 配偶 生活质量 应对能力 家庭功能 干预方案 

分 类 号：R473.6[医药卫生—护理学]