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综合护理干预对重度烧伤患儿照顾者的影响

[Influences of comprehensive nursing intervention on the caregivers of severely burned children].

作者信息

Luo X F, Zhang M, Zhao D J, Lei Y, Liu J, Bai C, Zhou Q, Hu X H

机构信息

Burn Center of PLA, Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2018 Sep 20;34(9):648-652. doi: 10.3760/cma.j.issn.1009-2587.2018.09.016.

DOI:10.3760/cma.j.issn.1009-2587.2018.09.016
PMID:30293370
Abstract

To explore the influences of comprehensive nursing intervention on the caregivers of severely burned children. Eighty severely burned children, admitted to our department from November 2016 to November 2017 and conforming to the study criteria, were included in this study. They were divided into comprehensive group and control group according to the random number table, with 40 children in each group. One caregiver for each child was included in the same group. Children and caregivers in control group had routine nursing care while children and caregivers in comprehensive group had comprehensive nursing care on the base of routine nursing care, including comprehensive psychological nursing of children and caregivers, guidance of rehabilitation for caregivers throughout the entire recovery process, individualized propaganda and education for caregivers on account of disease of children, perfecting social support system, sustained attention of children during follow-up. Anxiety self-rating scale and social support rating scale were used to assess the levels of anxiety and social support of caregivers of children in the two groups at the time of admission (before intervention) and the second month after discharge (the third time follow-up, after intervention). On the day of discharge, the nursing service satisfaction questionnaire of our department was used to evaluate the nursing service satisfaction of caregivers of children. Data were processed with chi-square test and independent sample test. (1) Before intervention, the anxiety and social support scores of caregivers of children in control group were respectively (64.5±3.8) and (40.4±2.5) points, similar to (63.5±4.9) and (40.5±2.6) points in comprehensive group (=0.988, 0.177, >0.05). After intervention, the anxiety score [(47.2±1.9) points] of caregivers of children in comprehensive group was significantly lower than that of control group [(57.6±4.3) points, =13.917, <0.01], and the social support score [(45.3±1.9) points] was significantly higher than (35.9±2.1) points in control group (=-21.282, <0.01). After intervention, scores of objective support, subjective support, and social support utilization in the social support evaluation rating of caregivers of children in comprehensive group were significantly higher than those in control group (=12.678, -11.079, -10.031, <0.01). (2) At the time of discharge, scores of clinical care, propaganda and education content and form in the nursing service satisfaction questionnaire of caregivers of children in comprehensive group were significantly higher than those of control group (=-14.757, -15.627, -33.221, <0.01). Comprehensive nursing intervention method can effectively reduce the anxiety of the caregivers of severely burned children, help them to make better use of social support system, and improve the satisfaction of caregivers in nursing services.

摘要

探讨综合护理干预对重度烧伤患儿照顾者的影响。选取2016年11月至2017年11月入住我科且符合研究标准的80例重度烧伤患儿纳入本研究。根据随机数字表将其分为综合组和对照组,每组40例患儿。每组纳入1名患儿的1名照顾者。对照组患儿及照顾者接受常规护理,综合组患儿及照顾者在常规护理的基础上接受综合护理,包括对患儿及照顾者的综合心理护理、在整个康复过程中对照顾者进行康复指导、根据患儿病情对照顾者进行个性化宣教、完善社会支持系统、随访期间持续关注患儿。采用焦虑自评量表和社会支持评定量表分别评估两组患儿照顾者在入院时(干预前)及出院后第2个月(第3次随访,干预后)的焦虑水平和社会支持程度。出院当天,采用我科护理服务满意度调查问卷评估患儿照顾者对护理服务的满意度。数据采用卡方检验和独立样本t检验进行处理。(1)干预前,对照组患儿照顾者的焦虑得分和社会支持得分分别为(64.5±3.8)分和(40.4±2.5)分,与综合组的(63.5±4.9)分和(40.5±2.6)分比较,差异无统计学意义(P=0.988、0.177,均>0.05)。干预后,综合组患儿照顾者的焦虑得分[(47.2±1.9)分]显著低于对照组[(57.6±4.3)分,P=13.917,<0.01],社会支持得分[(45.3±1.9)分]显著高于对照组的(35.9±2.1)分(P=-21.282,<0.01)。干预后,综合组患儿照顾者社会支持评定中的客观支持、主观支持及社会支持利用度得分均显著高于对照组(P=12.678、-11.079、-10.031,均<0.01)。(2)出院时,综合组患儿照顾者护理服务满意度调查问卷中的临床护理、宣教内容及形式得分均显著高于对照组(P=-14.757、-15.627、-33.221,均<0.01)。综合护理干预方法可有效降低重度烧伤患儿照顾者的焦虑情绪,帮助其更好地利用社会支持系统,提高照顾者对护理服务的满意度。

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