本文選題：急性心肌梗死 + 急性應(yīng)激障礙�。� 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的分析急性心肌梗死患者發(fā)生急性應(yīng)激障礙的影響因素,為制定早期護(hù)理干預(yù)措施提供理論依據(jù)。方法1選取2015年9月至2016年8月期間就診于唐山工人醫(yī)院心內(nèi)科住院治療的急性心肌梗死患者為研究對(duì)象,于患者移出監(jiān)護(hù)室第2天,且在發(fā)病后第6~10天,病情穩(wěn)定期統(tǒng)一經(jīng)斯坦福急性應(yīng)激反應(yīng)問(wèn)卷(Stanford Acute Stress Reaction Questionnaire,SASRQ)篩選出病例組和對(duì)照組,將篩選出的138例急性心肌梗死伴急性應(yīng)激障礙患者納入病例組,將同期276例非急性應(yīng)激障礙的急性心肌梗死患者作為對(duì)照組。采用自行設(shè)計(jì)的一般人口學(xué)問(wèn)卷、家庭功能評(píng)估量表、社會(huì)支持量表、疼痛視覺(jué)模擬評(píng)分法等對(duì)兩組患者進(jìn)行評(píng)價(jià),比較分析兩組患者在疾病狀況、治療情況、胸痛程度、睡眠情況、家庭社會(huì)支持狀況等方面的分布差異。2所有數(shù)據(jù)使用Excel軟件建立數(shù)據(jù)庫(kù),SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。一般人口學(xué)資料采用描述性統(tǒng)計(jì)分析;單因素分析采用卡方檢驗(yàn),采用卡方分割法進(jìn)行組內(nèi)兩兩比較;多因素分析采用二元Logistic回歸分析。結(jié)果1影響急性心肌梗死患者急性應(yīng)激障礙的單因素分析結(jié)果顯示性別、年齡、婚姻狀況、文化程度、居住地、與誰(shuí)同住、性格、職業(yè)、月收入、醫(yī)保類(lèi)型、醫(yī)藥費(fèi)用支付、病變支數(shù)、Gensini積分、CK值、CK-Mb值、CTn I值、接受過(guò)除顫與否、住CCU的時(shí)間、并發(fā)癥與否、發(fā)病次數(shù)、胸痛程度、心功能Killip分級(jí)、有被搶救過(guò)經(jīng)歷與否、治療方式、有無(wú)冠心病史、頻發(fā)心絞痛與否、睡眠質(zhì)量、科室環(huán)境影響睡眠與否、疼痛影響睡眠與否、社會(huì)支持、家庭功能與急性心肌梗死患者急性應(yīng)激障礙的發(fā)生有關(guān),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2影響急性心肌梗死患者急性應(yīng)激障礙的多因素分析多因素Logistic回歸分析顯示,年齡、性別、心功能Killip分級(jí)、科室環(huán)境影響睡眠、疼痛影響睡眠、接受過(guò)除顫與否、病變支數(shù)、支付醫(yī)藥費(fèi)用、社會(huì)支持、家庭功能是急性心肌梗死患者急性應(yīng)激障礙的影響因素,其中女性、心功能差、科室環(huán)境影響睡眠、疼痛影響睡眠、接受過(guò)除顫、多支病變、借錢(qián)支付醫(yī)藥費(fèi)用、家庭功能存在障礙是急性心肌梗死患者發(fā)生急性應(yīng)激障礙的危險(xiǎn)因素;年齡在60~75歲、社會(huì)支持度高是急性心肌梗死患者發(fā)生急性應(yīng)激障礙的保護(hù)因素。結(jié)論急性心肌梗死患者急性應(yīng)激障礙的發(fā)生與性別、病變支數(shù)、心功能狀況、胸痛癥狀、睡眠狀況、家庭社會(huì)支持狀況等因素有關(guān),且女性、心功能差、科室環(huán)境影響睡眠、疼痛影響睡眠、接受過(guò)除顫治療、多支病變、借錢(qián)支付醫(yī)藥費(fèi)用、家庭功能障礙是危險(xiǎn)因素;年齡在60~75歲、社會(huì)支持度高為保護(hù)因素。
[Abstract]:Objective to analyze the influencing factors of acute stress disorder in patients with acute myocardial infarction and to provide theoretical basis for early nursing intervention. Methods 1 patients with acute myocardial infarction who were hospitalized in Department of Cardiology, Tangshan Workers' Hospital from September 2015 to August 2016 were selected as the study subjects. The patients were removed from the intensive care unit on the second day and the 6th to 10th day after the onset of the disease. Patients with acute myocardial infarction with acute stress disorder were selected by Stanford Acute Stress Reaction acute stress response questionnaire (Stanford Acute Stress Reaction questionnaire) and control group. 138 patients with acute myocardial infarction with acute stress disorder were included in the case group. In the same period, 276 patients with non-acute stress disorder acute myocardial infarction were used as control group. The self-designed general demography questionnaire, family function assessment scale, social support scale and pain visual analogue scale were used to evaluate the two groups of patients. 2 the distribution difference of sleep and family social support. 2 all the data were analyzed statistically by using Excel software to establish the database and SPSS 17.0 statistical software. Descriptive statistical analysis was used for general demographic data; chi-square test was used for univariate analysis and intra-group comparison was made by chi-square method; binary Logistic regression analysis was used for multivariate analysis. Results 1 the results of univariate analysis on acute stress disorder in patients with acute myocardial infarction showed that sex, age, marital status, education level, place of residence, who lived with, personality, occupation, monthly income, type of medical insurance, medical expenses; Gensini score, CK value, CK-Mb value and CTN I, duration of defibrillation, time of living in CCU, complications, number of cases, degree of chest pain, Killip grade of cardiac function, experience of being rescued, treatment method, history of coronary heart disease, etc. Frequent angina pectoris or not, sleep quality, department environment influence sleep or not, pain influence sleep or not, social support, family function are related to the occurrence of acute stress disorder in patients with acute myocardial infarction. The multivariate Logistic regression analysis showed that age, sex, cardiac function Killip grade, department environment affected sleep and pain affected sleep. Overtreatment of defibrillation, number of pathological changes, payment of medical expenses, social support, and family function were the influencing factors of acute stress disorder in patients with acute myocardial infarction. Among them, women, poor cardiac function, department environment affected sleep, and pain affected sleep. Overtreatment of defibrillation, multivessel disease, borrowing money to pay for medical expenses, and family dysfunction were risk factors for acute stress disorder in patients with acute myocardial infarction. High degree of social support is the protective factor of acute stress disorder in patients with acute myocardial infarction. Conclusion the occurrence of acute stress disorder in patients with acute myocardial infarction is related to sex, number of pathological changes, cardiac function, chest pain, sleep, family and social support, etc. Pain affects sleep, has been treated with defibrillation, has multivessel disease, borrowed money to pay for medical expenses, and family dysfunction is a risk factor.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.5

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