發(fā)布時間：2018-05-24 19:50

  本文選題：辨證施護 + 潰瘍性結(jié)腸炎��； 參考：《青島大學》2017年碩士論文

【摘要】：目的探討中醫(yī)辨證施護對潰瘍性結(jié)腸炎患者負性情緒、健康促進行為及生活質(zhì)量的影響,以期為護理人員對潰瘍性結(jié)腸炎患者進行中醫(yī)辨證施護提供參考依據(jù)。方法本試驗為類試驗性研究。采用目的抽樣法,根據(jù)納入標準選取某三級甲等中醫(yī)院脾胃病科住院的潰瘍性結(jié)腸炎患者62例作為研究對象。根據(jù)研究對象首次入院的先后時間順序進行分組,將2014年11月至2015年10月入院的研究對象作為對照組,2015年11月至2016年10月入院的研究對象作為試驗組,對照組30例,試驗組32例。對照組患者接受常規(guī)護理,試驗組患者在常規(guī)護理的基礎(chǔ)上,接受中醫(yī)辨證施護。采用醫(yī)院焦慮抑郁情緒測定表(HAD)、健康促進生活方式量表(HPLPII)和健康調(diào)查簡表(SF-36),調(diào)查兩組患者于入院時、出院時及出院后3個月時的焦慮抑郁情況、健康促進行為和生活質(zhì)量。應(yīng)用SPSS19.0軟件包對試驗數(shù)據(jù)進行統(tǒng)計學分析。結(jié)果1.最終對照組29例、試驗組30例患者完成本次研究。2.入院時,兩組患者的一般資料比較無統(tǒng)計學意義(P0.05)。3.兩組患者在入院時、出院時和出院后3個月時的焦慮和抑郁評分經(jīng)多因素重復(fù)測量方差分析結(jié)果顯示:時間效應(yīng)、組間效應(yīng)的影響均具有統(tǒng)計學意義(P0.05),交互效應(yīng)的影響無統(tǒng)計學意義(P0.05)。單因素重復(fù)測量方差分析結(jié)果顯示:(1)試驗組在出院時和出院后3個月時的焦慮評分均低于入院時(P0.01),但出院后3個月和出院時的焦慮評分比較無統(tǒng)計學意義(P0.05);試驗組患者在3個時間點的抑郁評分為出院后3個月出院時入院時;(2)對照組患者在3個時間點的焦慮評分的差異無統(tǒng)計學意義(P0.05);對照組患者出院時和出院后3個月的抑郁評分均低于入院時(P0.01),但在出院時與出院后3個月的抑郁評分比較無統(tǒng)計學意義(P0.05)。多變量方差分析顯示:兩組患者在入院時和出院時的焦慮、抑郁評分比較均無統(tǒng)計學意義(P0.05),但試驗組患者在出院后3個月的焦慮、抑郁評分低于對照組(P0.01)。4.兩組患者在3個時間點的健康促進行為6個維度得分經(jīng)多因素重復(fù)測量方差分析結(jié)果顯示:時間效應(yīng)、組間效應(yīng)的影響均具有統(tǒng)計學意義(P0.05,P0.01),交互效應(yīng)的影響無統(tǒng)計學意義(P0.05)。單因素重復(fù)測量方差分析結(jié)果顯示:(1)試驗組患者出院時的人際關(guān)系、營養(yǎng)、健康職責、壓力管理得分高于入院時(P0.05,P0.01);出院后3個月時的健康促進行為6個維度得分均高于入院時(P0.05,P0.01);出院后3個月時運動鍛煉、壓力管理得分均高于出院時(P0.05,P0.01);(2)對照組患者出院時的人際關(guān)系、營養(yǎng)得分高于入院時(P0.05,P0.01),出院后3個月時人際關(guān)系得分高于入院時(P0.01),出院后3個月時自我實現(xiàn)得分高于出院時(P0.01)。多變量方差分析顯示:兩組患者在入院時的健康促進行為6個維度得分比較均無統(tǒng)計學意義(P0.05);試驗組患者出院時的營養(yǎng)、健康職責、運動鍛煉、自我實現(xiàn)得分均高于對照組(P0.05,P0.01);試驗組患者在出院后3個月的健康促進行為6個維度得分均高于對照組(P0.05,P0.01)。5.兩組患者在3個時間點的生活質(zhì)量8個維度得分評分經(jīng)多因素重復(fù)測量方差分析結(jié)果顯示:時間效應(yīng)、組間效應(yīng)的影響均具有統(tǒng)計學意義(P0.05),交互效應(yīng)的影響無統(tǒng)計學意義(P0.05)。單因素重復(fù)測量方差分析結(jié)果顯示:(1)試驗組患者出院時和出院后3個月的生活質(zhì)量8個維度得分均高于入院時(P0.05,P0.01),出院后3個月時的總體健康、機體疼痛、社會功能得分均高于出院時(P0.05,P0.01);(2)對照組患者出院時的機體疼痛、社會功能、精神健康得分高于入院時(P0.05,P0.01),出院后3個月總體健康、機體疼痛、社會功能、精神健康得分高于入院時(P0.01);出院后3個月總體健康、機體疼痛、社會功能得分高于出院時(P0.05,P0.01)。多變量方差分析顯示:兩組患者在入院時的生活質(zhì)量8個維度得分比較均無統(tǒng)計學意義(P0.05);試驗組患者出院時的生理職能、機體疼痛、社會功能、精神健康均高于對照組(P0.05,P0.01);除生理職能外試驗組患者出院后3個月其余7個生活質(zhì)量維度得分均高于對照組(P0.05,P0.01)。結(jié)論中醫(yī)辨證施護可有效減輕潰瘍性結(jié)腸炎患者的焦慮、抑郁情緒,促進患者的健康行為,提高其生活質(zhì)量。中醫(yī)辨證施護為潰瘍性結(jié)腸炎患者提供了一種個體化的安全、可靠、有效的護理方法,能更好地發(fā)揮中醫(yī)護理的優(yōu)勢,為臨床潰瘍性結(jié)腸炎患者的護理干預(yù)提供參考依據(jù)。
[Abstract]:Objective to explore the effect of TCM syndrome differentiation on negative emotion, health promotion behavior and quality of life in patients with ulcerative colitis, so as to provide reference basis for nursing staff to carry out TCM Syndrome Differentiation for ulcerative colitis. Methods this experiment is a kind of experimental study. The sampling method is used to select a certain three grade nail according to the inclusion criteria. 62 cases of ulcerative colitis hospitalized in the spleen and stomach disease department of Chinese medicine hospital were used as the research object. According to the sequence of the first admission time in the hospital, the subjects were taken as the control group, the subjects of the study in the hospital from November 2015 to October 2016 were used as the experimental group, and the control group 30 cases were tested. The patients in the control group were treated with conventional nursing, and the patients in the experimental group were treated with traditional Chinese medicine on the basis of conventional nursing. The anxiety and depression of the hospital (HAD), the Health Promotion Lifestyle Scale (HPLPII) and the health survey simple table (SF-36) were used to investigate the anxiety and depression of the two groups at the time of admission, discharge and 3 months after discharge. Depression, health promotion behavior and quality of life. SPSS19.0 software package was used to carry out statistical analysis of experimental data. Results 1. final control group 29 cases, 30 patients in the test group completed this study.2. admission, the general data of two groups of patients were not statistically significant (P0.05).3. two patients at admission, discharge and 3 months after discharge The results of the time effect and intergroup effect were all statistically significant (P0.05), and the effect of interaction was not statistically significant (P0.05). The results of variance analysis of single factor repeated measurements showed: (1) the scores of anxiety in the experimental group were both at discharge and 3 months after discharge. It was lower than admission (P0.01), but the anxiety score of 3 months after discharge and discharge was not statistically significant (P0.05); the depression score of the test group at 3 time points was 3 months after discharge to hospital; (2) there was no statistical difference between the control group and the 3 time points (P0.05); the control group was discharged from discharge and out of hospital. The depression score of 3 months after hospital was lower than that of admission (P0.01), but there was no statistical significance (P0.05) in the depression score of the hospital and 3 months after discharge. The multivariable analysis of variance analysis showed that there was no statistical significance between the two groups at the time of admission and discharge, and the depression score was not statistically significant (P0.05), but the patients in the test group were in the 3 months after discharge. The score of depression was lower than that of the control group (P0.01) group.4. two. The scores of 6 dimensions of health promotion behavior at 3 time points were analyzed by multiple factor repeated measurements. The results showed that the effect of time effect was statistically significant (P0.05, P0.01), and the effect of interaction was not statistically significant (P0.05). The results of the difference analysis showed that: (1) the scores of interpersonal relationship, nutrition, health responsibility and stress management of the patients in the experimental group were higher than those at admission (P0.05, P0.01); the scores of 6 dimensions of health promotion behavior at 3 months after discharge were all higher than those at admission (P0.05, P0.01), and the scores of exercise and stress management were higher than those at discharge (P0.05, P0.0) at the time of discharge. 1) (2) the interpersonal relationship in the control group was higher than that of admission (P0.05, P0.01), the score of interpersonal relationship was higher than that of admission (P0.01) at 3 months after discharge, and the score of self realization was higher than that of discharge (P0.01) at 3 months after discharge. Multivariate analysis of variance analysis showed that the score of health promotion behavior in the two groups was compared to the 6 dimensions. There was no statistical significance (P0.05). The scores of nutrition, health responsibility, exercise and self realization were higher in the patients in the experimental group than in the control group (P0.05, P0.01). The scores of 6 dimensions of health promotion behavior in the experimental group 3 months after discharge were all higher than those of the control group (P0.05, P0.01).5. two patients in the 3 time points of life quality 8 dimensions. The result of multiple factor repeated measurement of variance analysis showed that the effect of time effect and intergroup effect had statistical significance (P0.05), and the effect of interaction effect was not statistically significant (P0.05). The results of variance analysis of single factor repeated measurement showed that: (1) the quality of life of the patients in the experimental group at discharge and 3 months after discharge was 8 dimensions The scores were higher than that of admission (P0.05, P0.01). The overall health, body pain and social function scores were higher than that of discharge (P0.05, P0.01) at 3 months after discharge. (2) the pain, social function and mental health scores of the control group were higher than those at admission (P0.05, P0.01), and the overall health, body pain, social function, and spirit after discharge were 3 months after discharge. The score of health was higher than that of admission (P0.01); the total health, body pain and social function were higher than that of discharge (P0.05, P0.01) at 3 months after discharge. The multivariate analysis of variance analysis showed that there was no significant difference between the 8 dimensions of the quality of life of the two groups at admission (P0.05); the physiological functions of the patients in the experimental group, the pain of the body, and the society in the experimental group. The function and mental health were higher than that of the control group (P0.05, P0.01), and the other 7 quality of life scores were higher than those of the control group (P0.05, P0.01) in the 3 months after discharge from the physiological function test group. Conclusion the TCM syndrome differentiation can effectively reduce the anxiety, depression, healthy behavior and life of the patients with ulcerative colitis. Quality. TCM syndrome differentiation provides an individualized safe, reliable and effective nursing method for patients with ulcerative colitis. It can give full play to the advantages of traditional Chinese medicine and provide reference for the nursing intervention of patients with ulcerative colitis.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R248.1

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