Application effect of diversified nursing based on crisis awareness in patients with cerebrovascular disease undergoing MRI

doi:10.3760/cma.j.issn.1007-1245.2023.15.022

Abstract

Abstract:

Objective　To investigate the application effect of diversified nursing based on crisis awareness in patients with cerebrovascular disease undergoing MRI. Methods　This study was a randomized controlled trial. A total of 500 patients with cerebrovascular diseases who underwent MRI examination in Hubei No. 3 People's Hospital of Jianghan University from 2019 to 2021 were selected, and were assigned to a control group (249 cases) and an observation group (251 cases) according to the random number table method. The control group included 142 males and 107 females, aged (53.23±4.62) years. The observation group included 150 males and 101 females, aged (53.49±4.82) years. The control group received routine MRI examination nursing intervention, and the observation group received diversified nursing intervention based on crisis awareness. The scores of Connor-Davidson Resilience Scale (CD-RISC), the Chinese version of the Perceived Stress Scale (CPSS), and Trait Coping Style Questionnaire (TCSQ), levels of epinephrine (EPH), norepinephrine (NE), and 5-hydroxytryptamine (5-HT), and incidences of adverse events were compared between the two groups. t test and χ² test were used. Results　After intervention, the scores of strength, tenacity, and optimism and the total score of CD-RISC in both groups were significantly increased (all P<0.05), and those in the observation group [(33.45±7.11), (43.46±7.15), (11.76±1.57), and (88.01±9.16) points] were significantly higher than those in the control group [(29.74±6.45), (32.35±8.11), (9.77±1.25), and (71.43±7.17) points] (all P<0.05). After intervention, the scores of tension and feeling of losing control and the total score of CPSS were significantly decreased in both groups (all P<0.05), and those in the observation group [(15.19±2.10), (16.20±4.01), and (31.50±5.13) points] were significantly lower than those in the control group [(20.36±2.36), (21.58±3.73), and (41.05±4.25) points] (all P<0.05). After intervention, the positive coping scores of the two groups were significantly increased, and the negative coping scores were significantly decreased (all P<0.05); the positive coping score of the observation group was significantly higher than that of the control group [(35.16±5.39) points vs. (27.90±4.82) points], and the negative coping score was significantly lower than that of the control group [(17.57±3.12) points vs. (25.71±3.84) points] (both P<0.05). After intervention, the levels of EPH, NE, and 5-HT in both groups were significantly decreased (all P<0.05), and those in the observation group [(51.90±5.63), (199.94±14.17), and (139.41±11.97) ng/L] were significantly lower than those in the control group [(55.71±6.03), (209.01±6.23), and (146.22±3.17) ng/L] (all P<0.05). The incidence of adverse events in the control group was significantly higher than that in the observation group [9.64% (24/249) vs. 4.78% (12/251)] (P<0.05). Conclusion　Diversified nursing based on crisis awareness can relieve the psychological stress in patients with cerebrovascular disease undergoing MRI examination, encourage the positive coping, improve the levels of neurotransmitters, and reduce the incidence of adverse events.

Key words:

Cerebrovascular disease, MRI, Crisis awareness, Diversified nursing, Psychological stress, Adverse events

摘要：

目的　探究基于危机意识的多元化护理在脑血管病MRI检查患者中的应用。方法　本研究为随机对照试验。选取2019年至2021年江汉大学附属湖北省第三人民医院收治的500例行MRI检查的脑血管病患者，随机数字表法将患者分为对照组（249例）、观察组（251例）。对照组男142例，女107例，年龄（53.23±4.62）岁；观察组男150例，女101例，年龄（53.49±4.82）岁。对照组患者予以常规MRI检查护理干预，观察组予以基于危机意识的多元化护理干预。比较两组患者心理弹性量表（CD-RISC）、中文版压力知觉量表（CPSS）、特质应对方式问卷（TCSQ）评分，肾上腺素（EPH）、去甲肾上腺素（NE）、5-羟色胺（5-HT）水平及不良事件发生情况。采用t检验、χ²检验。结果　干预后两组力量、坚韧、乐观评分及CD-RISC总分均显著升高（均P<0.05），且组间比较观察组［（33.45±7.11）、（43.46±7.15）、（11.76±1.57）、（88.01±9.16）分］显著高于对照组［（29.74±6.45）、（32.35±8.11）、（9.77±1.25）、（71.43±7.17）分］（均P<0.05）。干预后两组紧张感、失控感评分及CPSS总分均显著降低（均P<0.05），且组间比较观察组［（15.19±2.10）、（16.20±4.01）、（31.50±5.13）分］显著低于对照组［（20.36±2.36）、（21.58±3.73）、（41.05±4.25）分］（均P<0.05）。干预后两组积极应对评分显著升高，消极应对评分显著降低（均P<0.05），且组间比较观察组积极应对评分显著高于对照组［（35.16±5.39）分比（27.90±4.82）分］，消极应对评分显著低于对照组［（17.57±3.12）分比（25.71±3.84）分］（均P<0.05）。干预后两组EPH、NE、5-HT水平显著降低（均P<0.05），且组间比较观察组［（51.90±5.63）、（199.94±14.17）、（139.41±11.97）ng/L］显著低于对照组［（55.71±6.03）、（209.01±6.23）、（146.22±3.17）ng/L］（均P<0.05）。对照组不良事件发生率显著高于观察组［9.64%（24/249）比4.78%（12/251）］（P<0.05）。结论　基于危机意识的多元化护理能提升脑血管病MRI检查患者心理应激水平，缓解其内心压力同时促进积极应对方式的采取，改善体内神经递质水平，降低不良事件发生率，具有临床推广应用价值。

关键词:

脑血管病, 磁共振, 危机意识, 多元化护理, 心理应激, 不良事件

Chen Jing, Zhao Jun.

Application effect of diversified nursing based on crisis awareness in patients with cerebrovascular disease undergoing MRI [J]. International Medicine and Health Guidance News, 2023, 29(15): 2162-2167.

陈静赵俊.

基于危机意识的多元化护理在脑血管病MRI检查患者中的应用 [J]. 国际医药卫生导报, 2023, 29(15): 2162-2167.

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