Abstract:

Objective　To observe the role of nursing intervention based on story theory applied in the nursing care of ankylosing spondylitis (AS). Methods　This study was a randomized controlled trial. A total of 90 AS patients admitted to the Department of Orthopedics of Baoji Central Hospital from January 2020 to January 2023 were selected as the study objects. The patients were divided into a control group (45 cases) and an observation group (45 cases) by the random number table method. There were 25 males and 20 females in the control group, aged 21-65 (34.26±3.79) years, and the course of disease was 1-6 (3.28±0.54) months. There were 24 males and 21 females in the observation group, aged 20-65 (34.65±3.51) years, and the course of disease was 1-6 (3.27±0.50) months. The control group received conventional nursing, and the observation group received nursing intervention based on story theory for 20 days. The clinical treatment indexes 1 day before discharge, self-care ability [Exercise of Self-care Agency Scale (ESCA)] and lumbar function [Japanese Orthopaedic Association Score (JOA)] on the day of admission and 1 day before discharge were compared between the two groups. Independent sample t test, paired t test, and χ² test were used. Results　One day before discharge, the duration of morning stiffness in the observation group was shorter than that in the control group [(21.65±2.54) min vs. (23.33±3.15) min], and the thoracic mobility and lumbar anterior flexion were higher than those in the control group [(5.04±0.36)° vs. (4.86±0.22)°, (73.65±3.65)° vs. (71.54±3.02)°] (all P<0.05). The scores of self-concept, self-responsibility, self-management skills, and health literacy level of the ESCA in the observation group were higher than those in the control group [(33.78±3.54) points vs. (32.11±3.48) points, (34.61±3.51) points vs. (32.97±3.44) points, (37.37±3.86) points vs. (35.46±3.75) points, (38.43±3.94) points vs. (36.56±3.87) points] (all P<0.05). The scores of four dimensions (subjective symptoms, clinical signs, limitations in daily activities, and bladder function) of the JOA in the observation group were higher than those in the control group [(38.55±4.98) points vs. (36.24±4.57) points, (39.72±4.41) points vs. (37.69±4.28) points, (39.47±4.11) points vs. (37.65±4.05) points, (39.43±4.94) points vs. (36.96±4.87) points] (all P<0.05). Conclusion　The implementation of nursing intervention based on story theory can significantly reduce the duration of morning stiffness in patients with AS, enhance their self-care ability, and thus improve their lumbar spine function, which is worthy of clinical promotion.

Key words:

Ankylosing spondylitis, Self-care ability, Morning stiffness time, Lumbar spine function, Nursing, Story theory

摘要：

目的　观察以故事理论为基础的护理干预对强直性脊柱炎患者自护能力的影响。方法　本研究为随机对照试验。选取2020年1月至2023年1月宝鸡市中心医院骨科收治的90例强直性脊柱炎患者作为研究对象。采用随机数字表法，将患者分为对照组（45例）和观察组（45例）。对照组男25例，女20例；年龄21～65（34.26±3.79）岁；病程1～6（3.28±0.54）个月。观察组男24例，女21例；年龄20～65（34.65±3.51）岁；病程1～6（3.27±0.50）个月。对照组采用常规护理干预，观察组采用以故事理论为基础的护理干预。两组均干预20 d。比较两组出院前1 d临床治疗指标，入院当日和出院前1 d自我护理能力［自我护理能力量表（ESCA）］、腰椎功能［腰椎功能评分量表（JOA）］。采用独立样本t检验、配对t检验和χ²检验。结果　出院前1 d，观察组晨僵时间短于对照组［（21.65±2.54）min比（23.33±3.15）min］，胸廓活动度、腰椎前屈度均大于对照组［（5.04±0.36）°比（4.86±0.22）°、（73.65±3.65）°比（71.54±3.02）°］（均P<0.05）；观察组ESCA中的自我概念、自我责任感、自我管理技能、健康知识水平评分均高于对照组［（33.78±3.54）分比（32.11±3.48）分、（34.61±3.51）分比（32.97±3.44）分、（37.37±3.86）分比（35.46±3.75）分、（38.43±3.94）分比（36.56±3.87）分］（均P<0.05）；观察组JOA 4个维度（主观症状、临床体征、日常活动受限度、膀胱功能）评分均高于对照组［（38.55±4.98）分比（36.24±4.57）分、（39.72±4.41）分比（37.69±4.28）分、（39.47±4.11）分比（37.65±4.05）分、（39.43±4.94）分比（36.96±4.87）分］（均P<0.05）。结论　以故事理论为基础的护理干预可缩短强直性脊柱炎患者晨僵时间、增大胸廓活动度及腰椎前屈度，提高自我护理能力，改善腰椎功能。

关键词:

强直性脊柱炎, 自护能力, 晨僵时间, 腰椎功能, 护理, 故事理论