【摘要】：目的 1.調(diào)查膽道鏡取石手術(shù)患者術(shù)中舒適狀況。2.分析影響膽道鏡手術(shù)患者術(shù)中舒適狀況的相關(guān)因素。方法 采用便利抽樣的方法選取2014年9月至2015年2月期間鄭州大學(xué)第一附屬醫(yī)院的肝膽外科符合納入標(biāo)準(zhǔn)的患者共330例,采用一般情況調(diào)查表、疼痛量表、舒適狀況量表和焦慮自評量表進行問卷調(diào)查。一般狀況調(diào)查表與疼痛量表均有護士在患者手術(shù)結(jié)束時完成填寫,舒適狀況量表與焦慮自評量表由護士在患者術(shù)后發(fā)放于患者并在4小時內(nèi)完成填寫并回收。采用SPSS17.0對數(shù)據(jù)進行錄入和統(tǒng)計學(xué)分析。結(jié)果 1.本研究共調(diào)查330名患者,回收有效問卷330例,有效回收率達到100%。2.膽道鏡取石術(shù)中患者舒適度的得分為(76.19±3.99)分。條目平均分為整體(2.53±0.13)分,精神心理領(lǐng)域(2.56±0.23)分,生理領(lǐng)域(1.98±0.38)分,社會領(lǐng)域(2.86±0.22)分,環(huán)境領(lǐng)域(2.49±0.26)分。3.患者SAS評分為結(jié)果 (45.43±8.06)分,高于國內(nèi)常模標(biāo)準(zhǔn)分均數(shù)(41.22±7.63)分。且患者的焦慮與生理、心理、社會文化和環(huán)境四個領(lǐng)域的舒適存在顯著性負相關(guān)。4.不同年齡段、不同家庭經(jīng)濟水平和不同醫(yī)療付費方式的行膽道鏡取石手術(shù)患者舒適狀況差別有統(tǒng)計學(xué)意義(P0.05),而不同性別、職業(yè)、文化程度、婚姻狀況及是否有宗教信仰等因素之間的差別無統(tǒng)計學(xué)意義(P0.05)。5.對影響患者舒適度的客觀存在因素進行單因素方差分析和多元逐步回歸分析,P≤0.05的納入回歸方程,結(jié)果顯示,室溫、沖洗鹽水水溫、體位、皮膚潮濕、腹脹、惡心嘔吐、疼痛及焦慮是患者術(shù)中舒適度的影響因素。結(jié)論 1.膽道鏡取石手術(shù)的患者術(shù)中生理領(lǐng)域舒適得分最低,環(huán)境和精神心理領(lǐng)域舒適得分其次,而社會文化領(lǐng)域舒適得分較高,提示護理過程中應(yīng)注重滿足患者的生理需求,提供心理護理,促進患者舒適。2.年齡、家庭經(jīng)濟、醫(yī)療付費方式對患者舒適度舒適有影響,提示在臨床護理中,對年輕的、家庭經(jīng)濟狀況比較差、自費的患者要更加關(guān)注,給予多的幫助和安慰。3.對室溫、沖洗鹽水水溫、沖洗鹽水量、體位、皮膚潮濕、腹脹、惡心嘔吐、疼痛、焦慮等術(shù)中影響舒適的相關(guān)因素要及時給予干預(yù),減輕患者的不適,提高患者的滿意度。
[Abstract]:Objective 1. To investigate the comfort of the operation of patients with choledochoscopy. To analyze the factors that influence the comfort of the operation of the patients with choledochoscope. Methods A total of 330 patients with hepatobiliary surgery of the first affiliated hospital of Zhengzhou University from September 2014 to February 2015 were selected by means of a convenient sampling method. The general condition questionnaire, the pain scale, the comfort status scale and the anxiety self-rating scale were used in the questionnaire. The general condition questionnaire and the pain scale were filled in by the nurse at the end of the patient's operation, and the comfort status scale and the anxiety self-rating scale were issued to the patient after the patient's operation and completed and recovered within 4 hours. The data were recorded and analyzed by SPSS17.0. Results 1. In this study,330 patients were investigated,330 effective questionnaires were collected, and the effective recovery rate was 100%. The degree of comfort of the patients was divided into (76.19-3.99) points. The entries were divided into the whole (2.53-0.13), the mental-psychological field (2.56-0.23), the physiological field (1.98-0.38), the social field (2.86-0.22) and the environment (2.49-0.26). The results of the SAS (45.43-8.06) scores were higher than that in the national norm (41.22-7.63). There was a significant negative correlation between the patient's anxiety and the comfort of physiology, psychology, social culture and environment. The difference of comfort of the patients with different age groups, different family economic level and different medical payment methods was statistically significant (P0.05), while the different sex, occupation and culture degree were different. There was no significant difference between the marital status and the religious beliefs (P0.05). A single-factor analysis of variance and multiple stepwise regression analysis were performed on the objective factors that affected the comfort of the patient, and the regression equation was included in P-0.05. The results showed that the water temperature, body position, skin damp, abdominal distention, and nausea and vomiting were observed at room temperature. Pain and anxiety are the factors of comfort in the operation of the patient. Conclusion 1. In the operation of cholelithiasis, the comfort score in the physiological field is the lowest, the comfort score in the area of environment and mental psychology is the second, while the comfort score in the social and cultural field is high, and it is suggested that the nursing process should pay attention to meeting the physiological needs of the patient, provide the psychological nursing, and promote the patient's comfort. The age, family economy, medical payment method have an effect on the comfort and comfort of the patient, and it is suggested that in the clinical nursing, the situation of the young and the family is poor, the patients at their own expense should pay more attention and give more help and comfort. The factors that affect the comfort of the room temperature, the water temperature of the wash brine, the amount of wash salt, the body position, the damp of the skin, the abdominal distention, the nausea, the vomiting, the pain, the anxiety and the like should be timely given to the intervention to relieve the discomfort of the patient and to improve the patient's satisfaction.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R473.6

【引證文獻】

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1 王夢娜;秦德芳;夏瑾;王小梅;;復(fù)合保溫措施預(yù)防膽道鏡聯(lián)合鈥激光碎石治療膽道難取性殘余結(jié)石低體溫的效果觀察[J];激光雜志;2016年05期

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本文編號：2478224