School of Nursing, Binzhou Medical University, Binzhou, China.
Department of Dermatology, Binzhou Medical University Hospital, Binzhou, China.
Medicine (Baltimore). 2024 Mar 1;103(9):e37353. doi: 10.1097/MD.0000000000037353.
This study aimed to evaluate the impact of the clinical nursing pathway (CNP) on the psychological state, treatment adherence, and quality of life in patients with acute urticaria. A total of 240 patients diagnosed with acute urticaria at a tertiary hospital in Shandong Province were retrospectively assigned to either a control group, receiving standard care, or an intervention group, receiving care according to the CNP model. The primary outcomes assessed were levels of anxiety, depression, quality of life, and patient compliance. Statistical analyses were employed to evaluate the outcomes. Following the intervention, significant differences were observed in the anxiety and depression scores (P < .001), with the intervention group demonstrating lower levels of both. The control group's psychological state exhibited significant variance pre- and post-intervention (P < .001), alongside notably reduced overall compliance (P < .01). Post-intervention, patients in the intervention group showed enhanced treatment compliance, with a rapid increase within the first hour and a stable ascent over the following 10 hours, albeit with a marginally greater increase in the CNP group. Beyond 10 hours, the CNP group's compliance gradually declined, with a slight uptick in noncompliance rates. By 14 hours, the control group's overall compliance began to wane, with a sharp decline in full compliance and a rapid rise in noncompliance rates observed after 19 hours. At the 20-hour mark, the control group's noncompliance rate surpassed both the partial and full compliance rates. Conversely, post-20 hours, the CNP group maintained higher rates of full and partial compliance, with a lower noncompliance rate. No significant changes were noted in the control group's physiological or mental state, except in the domains of self-care and social ability, where notable differences were absent pre- and post-intervention. In contrast, the CNP group showed significant improvements in physiological and mental states, self-care, and social abilities post-intervention (P < .001), with noticeable differences in these domains evident 6 hours into the treatment (P < .01), leading to an enhanced quality of life. The CNP-based clinical nursing model intervention significantly benefits patients with acute urticaria by alleviating anxiety and depression, enhancing treatment adherence, and improving overall quality of life.
本研究旨在评估临床护理路径（CNP）对急性荨麻疹患者心理状态、治疗依从性和生活质量的影响。回顾性分析山东省一家三级医院诊断为急性荨麻疹的 240 例患者，将其分为对照组（接受标准护理）和干预组（根据 CNP 模式接受护理）。主要结局评估为焦虑、抑郁、生活质量和患者依从性水平。采用统计学分析评估结果。干预后，焦虑和抑郁评分有显著差异（P<0.001），干预组得分较低。对照组的心理状态在干预前后有显著变化（P<0.001），同时总依从性明显降低（P<0.01）。干预后，干预组患者的治疗依从性提高，第 1 小时内迅速增加，随后 10 小时内稳定上升，但 CNP 组的增加幅度稍大。超过 10 小时后，CNP 组的依从性逐渐下降，不依从率略有上升。到 14 小时，对照组的总体依从性开始下降，完全依从率急剧下降，19 小时后不依从率迅速上升。20 小时时，对照组的不依从率超过部分和完全依从率。相反，20 小时后，CNP 组保持更高的完全和部分依从率，不依从率较低。对照组的生理和心理状态除自我护理和社会能力领域外，干预前后无明显变化，这些领域无明显差异。相反，CNP 组干预后生理和心理状态、自我护理和社会能力显著改善（P<0.001），治疗 6 小时后这些领域差异明显（P<0.01），生活质量提高。基于 CNP 的临床护理模式干预显著改善急性荨麻疹患者的焦虑和抑郁，提高治疗依从性，改善整体生活质量。
