问题解决模式配合分级阶段性护理干预在上消化道出血患者中的应用  

Application of Problem-solving Nursing Model Combined with Graded and Staged Intervention in Patients with Upper Gastrointestinal Bleeding

作　　者：黄晓励[1] Huang Xiaoli(The First Hospital of Sanming City,Sanming Fujian 365000,China)

机构地区：[1]三明市第一医院,福建三明365000

出　　处：《齐鲁护理杂志》2024年第19期26-30,共5页Journal of Qilu Nursing

摘　　要：目的:探讨问题解决模式(又称ADOPT模式)配合分级阶段性护理干预在上消化道出血患者中的应用效果。方法:将2021年10月1日~2022年11月30日收治的45例上消化道出血患者作为对照组,接受分级阶段性护理干预,将2022年12月1日~2023年12月31日收治的45例上消化道出血患者作为干预组,接受分析ADOPT模式配合分级阶段性护理干预;比较两组止血效果(包括住院期间出血次数、止血时间)、胃肠功能恢复时间、正常饮食恢复时间、住院时间和干预前后营养状况指标(包括血红蛋白、白蛋白、血清总蛋白)、自我管理能力[应用成年人健康自我管理能力测评量表(AHSMSRS)]、生活质量[应用世界卫生组织生活质量测评量表简表(WHOQOL-BREF)]、并发症发生情况。结果:干预组止血时间、住院期间出血次数、胃肠功能恢复时间、正常饮食恢复时间、住院时间均优于对照组(P<0.01);出院前,两组AHSMSRS评分、WHOQOL-BREF评分及营养状况指标水平均高于护理前(P<0.05),且干预组高于对照组(P<0.05,P<0.01);干预组并发症发生率与对照组比较差异无统计学意义(P>0.05)。结论:对上消化道出血患者在治疗的同时实施分析ADOPT模式配合分级阶段性护理干预能缩短止血时间,减少出血次数,促进胃肠功能和正常饮食的恢复,改善营养状况、自我管理能力及生活质量。Objective:To explore the application effect of problem-solving nursing model combined with graded and staged intervention in patients with upper gastrointestinal bleeding.Methods:Fourty-five patients with upper gastrointestinal bleeding treated from October 1,2021 to November 30,2022 were selected as the control group,and received graded and staged nursing intervention.Fourty-five patients with upper gastrointestinal bleeding treated from December 1,2022 to December 31,2023 were selected as the intervention group,and received analytical problem-solving nursing model combined with graded and staged nursing intervention.The hemostatic effect(including bleeding times and hemostatic time during hospitalization),gastrointestinal function recovery time,normal diet recovery time,hospitalization time,nutritional status indicators(hemoglobin,albumin,total serum protein),self-management ability(AHSMSRS),quality of life(WHOQOL-BREF)and occurrence of complications were compared between the two groups.Results:The hemostasis time,the number of bleeding episodes during hospitalization,the recovery time of gastrointestinal function,the recovery time of normal diet,and the length of hospital stay in the intervention group were better than those in the control group(P<0.01).Before discharge,the AHSMSRS score,WHOQOL-BREF score and nutritional index levels of the two groups were higher than those before nursing care(P<0.05),and those in the intervention group were higher than the control group(P<0.05,P<0.01).There was no significant difference in the incidence of complications between the intervention group and the control group(P>0.05).Conclusion:For patients with upper gastrointestinal hemorrhage,the implementation of problem-solving nursing model combined with graded and staged intervention can shorten the hemostasis time and reduce the number of bleeding,promote the recovery of gastrointestinal function and normal diet,and improve the nutritional status,self-management ability and quality of life.

关 键 词：上消化道出血 问题解决护理模式 分级阶段性干预 止血效果 

分 类 号：R473.57[医药卫生—护理学]