基于循证理论的疼痛护理干预在输尿管结石微创手术患者中的应用效果

Efficacy of evidence-based nursing intervention for pain in treatment of patients with minimally invasive surgery for ureteral calculi

  • 摘要:
      目的  分析基于循证理论的疼痛护理干预在输尿管结石微创手术患者中的应用效果。
      方法  选取行微创手术的116例输尿管结石患者作为研究对象,以区组随机法分为循证组和常规组,每组58例。常规组接受微创手术的常规护理干预,循证组在常规组基础上接受基于循证理论的疼痛护理干预,2组均干预至出院,并随访6个月。观察2组术后第1、2、3小时的疼痛程度,比较2组术后康复情况(下床活动时间、住院时间)及随访结束后遵医行为、知识知晓情况,并比较2组术后第5天的疼痛控制满意度及自我管理能力。
      结果  术后第1、2、3小时,2组视觉模拟评分法(VAS)评分逐渐降低,且循证组术后第2、3小时的VAS评分低于常规组,差异有统计学意义(P < 0.05)。术后第5天,循证组疼痛对日常生活的影响、疼痛期望、疼痛对情绪的影响、疼痛经历评分均低于常规组,而生活习惯、饮食控制、服药、情绪管理评分和疼痛控制教育感知状况、疼痛控制感知状态评分均高于常规组,差异有统计学意义(P < 0.05)。循证组下床活动时间、住院时间短于常规组,差异有统计学意义(P < 0.05);随访结束后,循证组遵医行为率、知识知晓率为94.83%、96.55%,分别高于常规组的75.86%、77.59%,差异有统计学意义(P < 0.05)。
      结论  基于循证理论的疼痛护理干预可减轻输尿管结石微创手术患者术后疼痛程度,提高疼痛控制满意度、自我管理能力、遵医行为率及知识知晓率,从而促进术后康复。

     

    Abstract:
      Objective  To analyze the efficacy of evidence-based nursing intervention for pain in treatment of patients with minimally invasive surgery for ureteral calculi.
      Methods  Totally 116 patients with minimally invasive surgery for ureteral calculi were selected and divided into evidence-based group (n=58) and routine group (n=58) by block random method. The routine group received routine nursing intervention for minimally invasive surgery, while the evidence-based group received evidence-based nursing intervention for pain on the basis of the routine group. Both groups were intervened until discharge, and were followed up for 6 months. The pain degrees at 1 hour, 2 and 3 hours after operation were observed in both groups, and the postoperative rehabilitation condition (time to bed-off activity and hospital stay) as well as the compliance behavior and knowledge awareness after follow-up were compared between two groups. Pain control satisfaction degree and self-management ability on the 5th day after operation were compared between two groups.
      Results  At 1 hour, 2 and 3 hours after operation, the Visual Analogue Scale (VAS) scores in both groups decreased gradually, and the VAS scores of the evidence-based group at 2 and 3 hours after operation were significantly lower than those of the routine group (P < 0.05). On the 5th day after operation, the scores of pain affecting daily life, pain expectation, pain affecting emotion and pain experience in the evidence-based group were significantly lower than those in the routine group, while the scores of living habits, diet control, medication, emotion management, perception status of pain control education and perception status of pain control were significantly higher than those in the routine group (P < 0.05). The time to bed-off activity and hospital stay in the evidence-based group were significantly shorter than those in the routine group (P < 0.05). After follow-up, the compliance behavior rate and knowledge awareness rate in the evidence-based group were 94.83% and 96.55% respectively, which were significantly higher than 75.86% and 77.59% in the routine group (P < 0.05).
      Conclusion  Evidence-based nursing intervention for pain can alleviate the postoperative pain of patients with minimally invasive surgery for ureteral calculi, improve pain control satisfaction degree, self-management ability, compliance rate and knowledge awareness rate, so as to promote postoperative rehabilitation.

     

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