路径式前馈控制护理模式在重型肝炎患者中的应用价值

doi:10.3760/cma.j.issn.1007-1245.2024.14.031

摘要/Abstract

摘要：

目的　探讨路径式前馈控制护理模式对重型肝炎患者治疗依从性、自护能力及生存质量的影响。方法　本研究为前瞻性研究，采用便利抽样法选取2022年7月至2023年10月西安市第八医院肝病科收治的134例重型肝炎患者，其中男71例，女53例；年龄25～68（45.16±8.16）岁；疾病分类：急性32例，亚急性27例，慢性71例；疾病分型：病毒性68例，酒精性32例，脂肪性21例，药物性13例；采用随机数字表法将患者分为两组，两组各67例，研究过程中两组各脱落2例。对照组采用常规护理模式，观察组采用路径式前馈控制护理模式。两组护理均从入院次日开始，到出院2周结束。比较两组患者入院次日和出院2周后8条目Morisky用药依从性量表（MMAS-8）评分、中文版修正版自我护理能力量表（ASAS-R-C）评分及中文版肝病生存质量量表1.0（LDQOL1.0）评分。采用独立样本t检验、配对样本t检验和χ²检验。结果　出院2周后，观察组MMAS-8评分［（6.03±1.34）分］高于对照组［（5.17±1.54）分］（P<0.05）；观察组ASAS-R-C中一般的自理需求［（19.78±4.88）分］、发展的自理需求［（16.80±3.93）分］、健康欠佳时的自理需求［（14.00±2.90）分］维度评分及总分［（50.58±7.48）分］均高于对照组［（17.89±4.39）分、（14.69±3.59）分、（12.06±3.17）分、（44.65±6.66）分］（均P<0.05）；观察组LDQOL1.0中的肝病症状［（82.46±6.27）分］、注意力［（79.32±7.93）分］、记忆力［（82.12±8.08）分］、社交质量［（80.40±7.14）分］、睡眠［（72.97±7.47）分］、孤独感［（81.82±6.86）分］、绝望感［（79.31±10.58）分］、耻辱感［（74.29±10.95）分］、性功能［（80.62±11.46）分］、性生活［（86.20±9.72）分］维度评分及总分［（79.54±2.39）分］均高于对照组［（79.89±7.68）分、（73.78±8.22）分、（78.86±8.80）分、（75.14±7.60）分、（70.03±8.45）分、（78.88±8.44）分、（74.18±9.02）分、（69.80±12.40）分、（75.08±11.68）分、（80.55±10.02）分、（75.55±2.83）分］（均P<0.05）。结论　路径式前馈控制护理模式有助于重型肝炎患者治疗依从性和自护能力的提高，对改善患者生存质量有重要作用。

关键词:

重型肝炎, 路径式前馈控制护理模式, 治疗依从性, 自护能力, 生存质量

Abstract:

Objective　To explore the effect of path feedforward control nursing mode on treatment compliance, self-care ability, and quality of life in patients with severe hepatitis. Methods　A prospective study method was used to select 134 patients with severe hepatitis admitted to the Department of Hepatology of Xi'an Eighth Hospital from July 2022 to October 2023, including 71 males and 53 females, aged 25-68 years, with an age of (45.16±8.16) years old. The disease classification was acute in 32 cases, subacute in 27 cases, and chronic in 71 cases. The disease type was viral in 68 cases, alcoholic in 32 cases, fatty in 21 cases, and drug-induced in 13 cases. The patients were divided into two groups by the random number table method, with 67 cases in each group. During the research process, 2 cases were lost in each group. The control group implemented routine nursing mode, while the observation group implemented path feedforward control nursing mode. The nursing in both groups began on the next day after admission and ended 2 weeks after discharge. The scores of the 8-item Morisky Medication Adherence Scale (MMAS-8), the Chinese version of the Revised Self-Care Ability Assessment Scale (ASAS-R-C), and the Chinese version of the Liver Disease Quality of Life Scale 1.0 (LDQOL1.0) were compared between the two groups on the next day after admission and 2 weeks after discharge. Independent sample t test, paired t test, and χ² test were used. Results　Two weeks after discharge, the MMAS-8 score of the observation group [(6.03±1.34) points] was higher than that of the control group [(5.17±1.54) points] (P<0.05). The scores of general self-care needs [(19.78±4.88) points], developmental self-care needs [(16.80±3.93) points], and self-care needs when in poor health status [(14.00±2.90) points] and total score of the ASAS-R-C [(50.58±7.48) points] in the observation group were higher than those in the control group [(17.89±4.39) points, (14.69±3.59) points, (12.06±3.17) points, and (44.65±6.66) points] (all P<0.05). The scores of liver disease symptoms [(82.46±6.27) points], attention [(79.32±7.93) points], memory [(82.12±8.08) points], social quality [(80.40±7.14) points], sleep [(72.97±7.47) points], loneliness [(81.82±6.86) points], feeling of hopelessness [(79.31±10.58) points], feeling of shame [(74.29±10.95) points], sexual function [(80.62±11.46) points], and sexual life [(86.20±9.72) points] and total score [(79.54±2.39) points] of the LDQOL1.0 in the observation group were higher than those in the control group [(79.89±7.68) points, (73.78±8.22) points, (78.86±8.80) points, (75.14±7.60) points, (70.03±8.45) points, (78.88±8.44) points, (74.18±9.02) points, (69.80±12.40) points, (75.08±11.68) points, (80.55±10.02) points, and (75.55±2.83) points] (all P<0.05). Conclusion　The path feedforward control nursing mode is helpful to improve the treatment compliance and self-care ability in patients with severe hepatitis, and plays an important role in improving the patients' quality of life.

Key words:

Severe hepatitis, Path feedforward control nursing mode, Treatment compliance, Self-care ability, Quality of life

丁雪丽贾莉霞李存存.

路径式前馈控制护理模式在重型肝炎患者中的应用价值 [J]. 国际医药卫生导报, 2024, 30(14): 2437-2441.

Ding Xueli, Jia Lixia, Li Cuncun.

Effect of path feedforward control nursing mode on patients with severe hepatitis [J]. International Medicine and Health Guidance News, 2024, 30(14): 2437-2441.

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