本文已被:浏览 378次 下载 51次
Received:January 17, 2023 Published Online:October 20, 2023
Received:January 17, 2023 Published Online:October 20, 2023
中文摘要: 目的 探讨对小切口冠状动脉搭桥术患者采用磁性理念下双心护理模式干预对其围术期身心应激和健康行为的影响。
方法 选取2021年7月至2022年10月空军军医大学第一附属医院收治拟接受微创直接冠状动脉搭桥(MIDCABG)的患者64例,按照病床号随机抽样的方式分为观察组(n=32)和对照组(n=32)。对照组采用常规护理模式,观察组在对照组的基础上采用磁性理念下双心护理模式。在入院时、术前1 d、术后3 d采用医院焦虑抑郁量表(HADS)、心理韧性量表(CD-RISC)、生理应激相关指标[去甲上腺素(NE)、血管紧张素Ⅱ(Ang Ⅱ)、醛固酮(ALD)]及健康行为量表(HPLP)对两组患者进行评估,并比较两组患者的护理满意度。
结果 与入院时比较,两组HADS各项评分、CD-RISC评分以及血清NE、AngⅡ、ALD水平在术前1 d、术后3 d均逐渐下降(P<0.05),且观察组上述评分及指标水平均低于相同时点的对照组(P<0.05)。观察组干预后各个维度健康行为评分均高于对照组(P<0.05),患者的护理满意度优于对照组(u=3.680,P<0.05)。
结论 磁性理念下双心护理模式能有效缓解MIDCAB术患者的焦虑抑郁情绪,降低其身心应激水平,增强心理弹性,改善健康行为,提高患者对护理的满意度。
Abstract:Objective To explore the application effect of healthcare failure mode and effect analysis(HFMEA) in the risk management of intraoperative acquired pressure injury(IAPI) in neurosurgery patients.
Methods A total of 160 surgical patients admitted to the Second Affiliated Hospital of Air Force Medical University from March to August 2022 were selected by convenience sampling method as the research subjects. Patients from March to May were set as control group, and those from June to August were set as experimental group. Thirty-two operating room nurses were also included. The traditional process was used to prevent IAPI during operation in control group, and a multidisciplinary management team for stress injury was established on the basis of the control group in experimental group. The HFMEA mode were used to analyze the failure reasons of the process steps, and to formulate and implement the intervention plan. The incidence of high-risk failure link and IAPI ,and the professional ability of operating room nurses in preventing IAPI were compared before and after implementation.
Results After the implementation of HFMEA, the incidence of high-risk failure mode decreased from 16.92% to 2.55%, and the incidence of IAPI decreased from 7.9% to 0,while the scores of nurses' theoretical examination increased from (84.09 ±3.48 ) to (92.97±3.32) and operation examination increased from (85.06±2.90) to (92.28±3.08) , yielding statistically significant differences (P<0.05).
Conclusion The application of HFMEA can optimize the IAPI management process of neurosurgical patients, standardize the behavior of nursing staff, and thus improve the quality of nursing.
keywords: Magnetic concept Psycho-cardiology nursing model Coronary artery disease Minimally invasive direct coronary artery bypass grafting Physical and mental stress Healthy behavior Anxiety Depression Psychological resilience Satisfaction with nursing
文章编号: 中图分类号:R473.6 文献标志码:B
基金项目:国家自然科学基金项目(82000227)
引用文本: