脑卒中后抑郁的循证护理干预效果观察  

Evidence-based nursing interventions in the prevention and treatment of post-stroke depression

作　　者：窦蕊 耿庆文[2] 杨菲 DOU Rui;GENG Qingwen;YANG Fei(Xuanwu Hospital Capital Medical University,Beijing,100053;Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing,100700;Beijing Hospital of Traditional Chinese Medicine,Beijing,100010)

机构地区：[1]首都医科大学宣武医院,北京100053 [2]北京中医药大学东直门医院,北京100700 [3]首都医科大学附属北京中医医院,北京100010

出　　处：《中西医结合护理》2024年第7期7-13,共7页Chinese Journal of Integrative Nursing

基　　金：中国中医药研究促进会科研项目(202304)。

摘　　要：目的探讨循证护理干预在预防和管理脑卒中后抑郁(PSD)中的应用效果。方法于2022年1月1日—6月30日在临床试点病房开展循证护理实践,共分为现状审查、证据引入和证据应用后的效果评价3个阶段。分别选取2022年1月1日—2月28日和2022年5月1日—6月30日住院的脑卒中患者为研究对象。采用汉密尔顿抑郁量表(HAMD)评估患者抑郁状态,对比证据应用前和应用后PSD发生率。评估循证护理实践前后护士PSD知识得分和循证能力。结果培训前14名护士PSD知识得分(62.50±7.53)分,培训后提高到(86.07±5.26)分,差异有统计学意义(t=-13.926,P<0.01)。培训后,护士证据生成、证据汇总、证据传播与评估和证据应用等循证能力得分均得到提升,差异有统计学意义(P<0.05)。循证证据应用前87例脑卒中患者中共有32例(36.78%)发生PSD;循证证据应用后75例脑卒中患者中共有17(22.67%)例发生PSD,证据应用后PSD发生率较应用前降低,差异有统计学意义(P<0.05)。结论PSD预防及管理的循证护理实践应用于临床试点病房后,有效降低了患者PSD的发生率,规范了临床护士PSD预防及管理行为和护理流程,提升护士PSD相关知识水平,提高临床护理质量。Objective To investigate the effects of evidence-based nursing interventions in the prevention and management of post-stroke depression.Methods The evidence-based nursing practice had been carried in three phases:current conditions investigation,evidence introduction and effectiveness evaluation.Stroke patients with hospital administration between January and February 2022 and between May and June 2022 were recruited as the research objects.The Hamilton Depression Scale(HAMD)was used to evaluate the depression state of patients,and incidence of post-stroke depression before and after implementation of evidence-based nursing practice was compared.Nurses’knowledge level and practice skills of evidence-based nursing were evaluated before and after evidence-based nursing practice.Results Nurses has achieved a higher score of knowledge level assessment after implementation of evidence-based nursing practice(86.07±5.26 vs.62.50±7.53,t=-13.926,P<0.01).The practice skills of nurse in generating evidence,evidence aggregation,evidence dissemination and evidence evaluation and application had been improved after implementation of evidence-based nursing practice(P<0.05).The incidence of PSD was 36.78%(32/87)before implementation of evidence-based nursing practice,and it dropped to 22.67%(17/75)after implementation of evidence-based nursing practice,with a statistically significant difference(P<0.05).Conclusion The evidence-based practice of PSD prevention and management could effectively reduce the incidence of PSD,standardized the PSD prevention and management behavior and nursing process of clinical nurses,improved the knowledge level of PSD of nurses,enriched the relevant knowledge materials of the department,and effectively improved the quality of clinical nursing.

关 键 词：脑卒中 脑卒中后抑郁 循证护理 健康宣教 

分 类 号：R473.5[医药卫生—护理学]