动态交互模型护理在颅脑损伤患者中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2023.24.037

摘要/Abstract

摘要：

目的　分析动态交互模型护理在颅脑损伤患者中的应用效果。方法　选取2020年1月至2023年1月江南大学附属中心医院收治的80例颅脑损伤患者，根据入院顺序分为对照组和观察组，各40例。对照组男25例，女15例，年龄（39.20±2.01）岁。观察组男28例，女12例，年龄（39.19±1.98）岁。对照组采用常规护理，观察组采用动态交互模型护理。于患者入院当天与干预30 d时，使用自我效能量表（ESCA）、运动功能量表（FMA）、健康调查简表（SF-36）评价两组患者自护能力、运动功能以及生活质量。采用χ²检验、t检验。结果　入院当天，对照组ESCA总分、FMA总分以及SF-36总分分别为（86.63±2.05）分、（13.24±2.65）分、（53.23±3.21）分，观察组分别为（86.07±2.11）分、（13.19±2.76）分、（53.19±3.17）分，差异均无统计学意义（t=1.204、0.083、0.056，P=0.232、0.934、0.955）；干预30 d时，对照组ESCA总分、FMA总分以及SF-36总分分别为（130.49±4.56）分、（23.16±2.38）分、（66.96±3.05）分，均低于观察组［（133.42±3.96）分、（24.81±2.16）分、（68.33±2.97）分］，差异均有统计学意义（t=3.068、3.247、2.035，P=0.003、0.002、0.045）。结论　动态交互模型护理能够明显强化颅脑损伤患者的自护能力水平，显著改善其运动功能，大幅度提升其生活质量。

关键词:

颅脑损伤, 动态交互模型, 自护能力, 运动功能, 生活质量

Abstract:

Objective　To analyze the effect of dynamic interaction model nursing care for patients with craniocerebral injury. Methods　Eighty patients with craniocerebral injury treated at Central Hospital Affiliated to Jiangnan University from January 2020 to January 2023 were selected and were divided into a control group and an observation group according to the admission order, with 40 cases in each group. There were 25 males and 15 females in the control group; they were (39.20±2.01) years old. There were 28 males and 12 females in the observation group; they were (39.19±1.98) years old. The observation group took routine nursing care, and the observation group took dynamic interaction model nursing care. The Exercise of Self-care Agency Scale (ESCA), Fugl-Meyer Assessment (FMA), and MOS 36-Item Short-Form Health Survey (SF-36) were used to evaluate the self-care ability, motor function, and quality of life in both groups. The χ² and t tests were applied. Results　On the day of admission, the total scores of ESCA, FMA, and SF-36 in the control group were (86.63±2.05), (13.24±2.65), and (53.23±3.21), and those in the observation group were (86.07±2.11), (13.19±2.76), and (53.19±3.17), with no statistical differences (t=1.204, 0.083, and 0.056; P=0.232, 0.934, and 0.955). After 30 days' intervention, the total scores of ESCA, FMA, and SF-36 in the control group were lower than those in the observation group [(130.49±4.56) vs. (133.42±3.96), (23.16±2.38) vs. (24.81±2.16), and (66.96±3.05) vs. (68.33±2.97)], with statistical differences (t=3.068, 3.247, and 2.035; and P=0.003, 0.002, and 0.045). Conclusions　Dynamic interactive model nursing care for patients with craniocerebral injury can significantly improve their self-care ability, motor function, and quality of life.

Key words:

Craniocerebral injury, Dynamic interaction model, Self-care ability, Motor function, Quality of life

苏筱斐包钟元谈碧君.

动态交互模型护理在颅脑损伤患者中的应用效果 [J]. 国际医药卫生导报, 2023, 29(24): 3695-3699.

Su Xiaofei, Bao Zhongyuan, Tan Bijun.

Dynamic interaction model nursing care for patients with craniocerebral injury [J]. International Medicine and Health Guidance News, 2023, 29(24): 3695-3699.

参考文献

[1] 马蓉,高国一,江基尧. 中国和欧盟颅脑创伤救治中心工作特征比较[J]. 中华创伤杂志,2019,35(3):227-231. DOI:10.3760/cma.j.issn.1001-8050.2019.03.008.
[2] 吴毅. 脑损伤后精准康复治疗技术的研究进展[J]. 中华物理医学与康复杂志, 2021, 43(11): 1040-1043. DOI:10.3760/cma.j.issn.0254-1424.2021.11.020.
[3] 栾樱译, 姚咏明. 创伤性脑损伤研究新进展[J]. 国际外科学杂志, 2021, 48(1): 27-31. DOI:10.3760/cma.j.cn115396- 20200925-00295.
[4] 蒋锦悦,侯彩娥,张危,等. 重型颅脑损伤后吞咽障碍危险因素的病例对照研究[J]. 按摩与康复医学,2021,12(6):50-52,55. DOI: 10.19787/j.issn.1008-1879.2021.06.018.
[5] 徐兰娟,李成建,刘静,等. 颅脑损伤患者伤后早期颅内血肿进展的危险因素分析[J]. 中华神经医学杂志,2022,21(4):392-396. DOI: 10.3760/cma.j.cn115354-20211013 -00655.
[6] 向黔灵,江智霞,胡汝均,等. 颅脑损伤继发医院获得性肺炎危险因素的研究进展[J]. 中国临床神经外科杂志,2022,27(11):946-948. DOI: 10.13798/j.issn.1009- 153X. 2022.11.021.
[7] 刘玲. 基于动态交互模型的社会支持对大学生心理健康的作用机制[J]. 武汉冶金管理干部学院学报,2021,31(1):57-60. DOI: 10.3969/j.issn.1009-1890.2021.01.017.
[8] Hattori S, Komukai S, Friede T. Sample size calculation for the augmented logrank test in randomized clinical trials [J]. Stat Med,2022,41(14):2627-2644. DOI: 10.1002/sim.9374.
[9] Firsching R, Rickels E, Mauer UM, et al. Guidelines for the treatment of head injury in adults [J]. J Neurol Surg A Cent Eur Neurosurg, 2017, 78(5):478-487. DOI: 10.1055/s-0037-1599239.
[10] 刘延锦,余溯源,郭丽娜,等. 汉化修正版自我护理能力评估量表用于成年人群中的信效度研究[J]. 重庆医学,2018,47(33):4266-4269. DOI:10.3969/j.issn.1671-8348. 2018.33.017.
[11] 陈瑞全,吴建贤,沈显山. 中文版Fugl-Meyer运动功能评定量表的最小临床意义变化值的研究[J]. 安徽医科大学学报,2015,50(04):519-522.
[12] Alhaji MM, Johan NH, Sharbini S, et al. Psychometric evaluation of the Brunei-Malay SF-36 version 2 health survey[J].Asian Pac J Cancer Prev,2018,19(7):1859-1865.DOI: 10.22034/APJCP.2018.19.7.1859.
[13] 孟桂英. 重型颅脑损伤患者心电图异常相关因素分析及护理干预[J]. 护理学杂志,2006,21(10):22-23. DOI:10.3969/j.issn.1001-4152.2006.10.010.
[14] 梅义菊. 重型颅脑损伤患者发生肺部感染的危险因素分析与护理对策[J]. 护理实践与研究,2019,16(4):21-23. DOI:10.3969/j.issn.1672-9676.2019.04.008.
[15] 杜晟洁. 重症颅脑损伤患者预后影响因素分析及护理对策[J]. 中国乡村医药,2019,26(12):80-81. DOI:10.3969/j.issn. 1006-5180.2019.12.047.
[16] 徐璐, 陈若. 老年重症颅脑损伤患者术后颅内感染的危险因素及防护对策[J]. 国际医药卫生导报, 2020, 26(22): 3415-3417. DOI: 10.3760/cma.j.issn.1007-1245. 2020.22.015.
[17] 贺瑾,冯丽娜,朱晓萌,等. 症状管理动态模型在淋巴瘤化疗患者全程管理中的应用研究[J]. 中国护理管理,2022,22(1):111-117. DOI: 10.3969/j.issn.1672-1756.2022.01.023.
[18] 王惠君,廖媛媛,杨娟,等. 动态交互模型在颅脑损伤后自我护理和运动干预中的应用[J]. 国际护理学杂志,2020,39(5):794-797. DOI:10.3760/cma.j.issn.1673-4351. 2020.05.010.
[19] 李景姗,朱倩云,吴言芬,等. 集束化管理策略在重型颅脑损伤患者早期康复护理中的应用[J]. 护理实践与研究,2021,18(9):1278-1282. DOI: 10.3969/j.issn.1672-9676. 2021.09.004.
[20] 朱琼瑶,罗慧,赫为. 前瞻性护理模式对重型颅脑损伤合并多发伤患者的影响[J]. 齐鲁护理杂志,2021,27(6):133-136. DOI: 10.3969/j.issn.1006-7256.2021.06.053.
[21] 吴清,李裕淑. 急性颅脑损伤患者发生早期精神障碍的影响因素及相关护理措施[J]. 国际护理学杂志, 2021, 40(9): 1571-1574. DOI: 10.3760/cma.j.cn221370-20190805- 00457.
[22] 常连霞,王春梅. 重型颅脑损伤患者照顾者生活质量现状及其影响因素分析[J]. 天津护理, 2020, 28(4): 417-421. DOI:10.3969/j.issn.1006-9143.2020.04.011.
[23] 刘艳妮. ICU重度颅脑损伤患者术后肺部感染的危险因素及护理情况分析[J]. 临床医学研究与实践,2020,5(8):13-14. DOI:10.19347/j.cnki.2096-1413.202008006.
[24] 刘青松,王静,程鑫. 颅脑损伤患者发生急性应激障碍的影响因素分析及护理对策[J]. 齐鲁护理杂志, 2021, 27(10): 140-142. DOI: 10.3969/j.issn.1006-7256.2021.10.056.
[25] 邹志斌,邹国荣,胡友珠,等. 重型颅脑损伤患者死亡影响因素分析及综合康复训练对神经功能影响[J]. 社区医学杂志,2020,18(1):40-43. DOI: 10.19790/j.cnki.JCM.2020.01.11.
[26] 柳英,赵伟,狄艳. 医护-家庭一体化护理对急性颅脑损伤手术病人功能康复、心理健康和自我护理能力的影响[J]. 全科护理,2021,19(33):4686-4689. DOI: 10.12104/j.issn.1674-4748.2021.33.021.
[27] 孙静群,石倩倩,刘美娜,等. 早期综合康复护理运用于重症颅脑损伤术后肢体偏瘫患者中的效果[J]. 中国实用医药,2021,16(5):179-181. DOI: 10.14163/j.cnki.11-5547/r.2021.05.071.
[28] 赵美超. 路径式护理预防颅脑损伤患者肌肉废用性萎缩的效果[J]. 中国民康医学,2021,33(4):142-143,147. DOI: 10.3969/j.issn.1672-0369.2021.04.057.
[29] 张利芳. 失效模式与效应分析理论护理在重型颅脑损伤患者中的应用效果[J]. 中国民康医学,2021,33(12):154-156. DOI:10.3969/j.issn.1672-0369.2021.12.063.
[30] 朱霞. 照护小组干预应用于中重度颅脑损伤患者照顾者中的效果观察[J]. 国际医药卫生导报,2020,26(24):3871-3874. DOI: 10.3760/cma.j.issn.1007-1245. 2020.24.046.