本文關(guān)鍵詞： PCI術(shù)后 聚焦解決模式 負性情緒 疾病不確定感　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的運用聚焦解決模式對冠心病PCI術(shù)后患者進行臨床干預(yù),從患者自身優(yōu)勢及資源出發(fā),調(diào)動患者的積極主動性,降低患者的負性情緒及疾病不確定感,患者的負性情緒包括焦慮情緒和抑郁情緒,進而改變患者行為活動。方法選取自2015年12月-2016年6月,于青島某三甲醫(yī)院心血管內(nèi)科,收集PCI成功術(shù)后患者110例,自愿參加臨床干預(yù)研究并簽署知情同意書;采用隨機數(shù)字表法將患者分為對照組和干預(yù)組各55人,隨訪過程中,有2人自動退出,4人失訪,最終對照組和干預(yù)組各52人;對照組和干預(yù)組在干預(yù)前均填寫焦慮自評量表(SAS)、抑郁自評量表(SDS)、Mishel疾病不確定感量表(MUIS)以及一般資料量表;對照組患者術(shù)后接受常規(guī)健康宣教,干預(yù)組在接受常規(guī)健康宣教的基礎(chǔ)上予以聚焦解決模式進行臨床干預(yù)實驗;兩組患者出院當(dāng)天均填寫MUIS量表;出院后1個月內(nèi)每周電話隨訪一次并進行院外持續(xù)干預(yù),來院復(fù)查填寫SAS、SDS;出院后3個月內(nèi)每2周電話隨訪1次并進行院外持續(xù)干預(yù),回院復(fù)查患者再次填寫SAS、SDS、服藥依從性量表,及收集患者各項血脂指標(biāo)和院外吸煙、飲酒、鍛煉情況。結(jié)果1.冠心病PCI術(shù)后患者在年齡、性別、文化程度等一般資料,焦慮評分、抑郁評分、疾病不確定感評分等基線資料均無統(tǒng)計學(xué)意義(P0.05);2.冠心病PCI術(shù)后患者接受臨床聚焦解決模式干預(yù)后,出院當(dāng)天對照組和干預(yù)組患者疾病不確定感總分及其各維度比較差異有統(tǒng)計學(xué)意義(P0.01);且與術(shù)后當(dāng)天患者疾病不確定感比較,兩組患者均有統(tǒng)計學(xué)差異(P0.01);3.隨訪1個月、3個月后冠心病PCI術(shù)后患者,對照組和干預(yù)組焦慮、抑郁評分差異均有統(tǒng)計學(xué)意義(P0.01);4.隨訪3個月后復(fù)查各項危血脂指標(biāo),對照組和干預(yù)組差異無統(tǒng)計學(xué)意義(P0.05)。5.患者出院3個月來院復(fù)查,對照組和干預(yù)組患者的服藥依從性以及吸煙飲酒鍛煉情況比較,結(jié)果只有兩組患者的吸煙情況統(tǒng)計學(xué)無差異(P0.05),服藥依從性、飲酒、鍛煉情況比較結(jié)果(P0.01)。結(jié)論聚焦解決模式臨床護理干預(yù)有效的降低患者術(shù)后焦慮、抑郁情緒及疾病不確定感;聚焦解決模式可以提高患者的院外依從性,還通過緩解患者的焦慮、抑郁情緒調(diào)節(jié)患者的血脂指標(biāo)。
[Abstract]:Objective to use the focus solution model to intervene the patients with coronary heart disease (PCI) after operation, and to mobilize the positive and initiative of the patients from their own advantages and resources, so as to reduce the negative emotion and the sense of uncertainty of the patients. The negative emotion of the patients included anxiety and depression, and then changed the behavior of the patients. Methods from December 2015 to June 2016, the patients were selected in the Department of Cardiovascular Medicine of a third Class A Hospital in Qingdao. 110 successful PCI patients were enrolled in the clinical intervention study and signed informed consent. The patients were divided into control group and intervention group by random number table method. During the follow-up, 2 patients quit the interview automatically, and 52 patients in the control group and the intervention group. Before intervention, the control group and the intervention group all completed SAS, SDS / Mishel disease uncertainty scale (MUISS) and general information scale. The patients in the control group received routine health education after operation, and the intervention group underwent clinical intervention experiment on the basis of routine health education. The patients in both groups completed MUIS scale on the day of discharge. One month after discharge, the patients were followed up by telephone once a week and continued to intervene outside the hospital. Every 2 weeks after discharge, the patients were followed up by telephone every 2 weeks and continued to intervene outside the hospital. The patients who returned to the hospital filled in the SAS SDS again, took the compliance scale, and collected the blood lipid index and smoking outside the hospital. Results 1. Patients with coronary heart disease after PCI in age, sex, education and other general information, anxiety score, depression score. 2. No statistical significance was found in baseline data such as disease uncertainty score (P0.05). 2.After the intervention of clinical focus mode after coronary heart disease (PCI) operation, there were significant differences in the total score of disease uncertainty and its dimensions between the control group and the intervention group on the day of discharge (P 0.01). And compared with the patients after the day of disease uncertainty, the two groups of patients have a statistical difference (P0.01); 3. Follow up for 1 month, after 3 months of coronary heart disease PCI patients, the control group and the intervention group anxiety, depression score differences were statistically significant (P 0.01); 4. After 3 months follow-up, there was no significant difference between the control group and the intervention group. The patients were discharged from hospital for 3 months. Control group and intervention group patients' compliance to take medicine and smoking and drinking exercise, the results showed that there was no statistical difference between the two groups of smoking, P0.05, drug compliance, alcohol consumption. Conclusion the clinical nursing intervention of focus solution model can effectively reduce the anxiety, depression and uncertainty of patients after operation. The focus solution model can improve the patients' compliance outside hospital, and regulate the blood lipid index by relieving the anxiety and depression of the patients.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

【參考文獻】

相關(guān)期刊論文 前10條

1 王月華;樊玉花;董彩梅;;顱腦損傷患者家屬疾病不確定感及其影響因素研究[J];護理管理雜志;2016年10期

2 周榮;李紅軍;王振卿;;聚焦解決模式在慢性乙型肝炎患者隨訪管理中的應(yīng)用效果[J];護理管理雜志;2016年03期

3 吳麗娟;黃海香;駱建梅;招偉英;邵亞;黃敏;廖少玲;;住院早產(chǎn)兒母親疾病不確定感與育兒自我效能的相關(guān)性研究[J];中華現(xiàn)代護理雜志;2016年07期

4 范瑜;鮮玉霞;李娜;;積極心理學(xué)理論指導(dǎo)下的護理干預(yù)用于精神分裂癥患者的價值[J];海南醫(yī)學(xué);2016年02期

5 寧艷嬌;萬紫旭;侯福軍;王妍;;冠心病患者疾病不確定感現(xiàn)狀的研究進展[J];護士進修雜志;2015年24期

6 呂揚;李崢;韓美英;程艮;安鳳榮;;門診老年抑郁癥患者服藥依從性的影響因素分析[J];中華護理雜志;2015年10期

7 文莎麗;盧彥芳;金自衛(wèi);張靜平;;基于積極心理學(xué)的動機性訪談對提高直腸癌結(jié)腸造口患者自尊的作用[J];解放軍護理雜志;2015年16期

8 陳偉偉;高潤霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;鄭哲;蔣立新;胡盛壽;;《中國心血管病報告2014》概要[J];中國循環(huán)雜志;2015年07期

9 莊o勱，

本文編號：1491482