临床路径护理对垂体瘤患者术后应对方式及希望水平的影响

徐颖　程玉　王莹莹

[摘要] 目的 探讨临床路径护理对垂体瘤患者术后应对方式及希望水平的影响。 方法 选取2015年1月～2017年1月哈爾滨医科大学附属第一医院收治的垂体瘤患者98例，按照就诊时间顺序分为常规护理组（2015年1月～2016年1月）与临床路径护理组（2016年2月～2017年1月），每组各49例。比较两组患者下术前等待时间、总住院时间、住院费用、对疾病的了解度、护理满意度、术后应对方式及希望水平。 结果 临床路径护理组住院费用少于常规护理组，术前等待时间及总住院时间短于常规护理组，差异有统计学意义（P < 0.05）。临床路径护理组对疾病的了解程度及患者的护理满意度均高于常规护理组，差异有统计学意义（P < 0.05）。临床路径护理组术后应对方式评分高于常规护理组，回避及屈服评分低于常规护理组，希望水平中对现实和未来的积极态度、与他人保持亲密关系、采取积极行动评分高于常规护理组，差异有统计学意义（P < 0.05）。 结论 临床路径护理应用于垂体瘤患者中能够有效地改善围术期指标，促进改善患者术后对疾病的应对方式，提高希望水平，改善预后。

[关键词] 临床路径护理；垂体瘤；应对方式；希望水平

[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0129-04

[Abstract] Objective To explore the effect of clinical pathway nursing on postoperative behavior and social support of pituitary tumors. Methods From January 2015 to January 2017， in the First Affiliated Hospital of Harbin Medical University， 98 patients with pituitary adenoma were selected， according to the time sequence， they were divided into routine nursing group （from January 2015 to January 2016） and clinical pathway nursing group （from February 2016 to January 2017）， with 49 cases in each group. The preoperative waiting time， total length of hospital stay， hospital expenses， patients′ understanding of the disease and nursing satisfaction， postoperative coping styles and hope of patients in two groups were compared. Results In clinical pathway nursing group， the hospitalization cost was less than the conventional nursing group， the preoperative waiting time and the total hospitalization time were shorter than routine nursing group， the differences were statistically significant （P < 0.05）. The degree of understanding of the disease and nursing satisfaction of patients in clinical pathway nursing group were higher than routine nursing group， the differences were statistically significant （P < 0.05）. The postoperative coping styles scores in clinical pathway nursing group were higher than routine nursing group， the scores of avoidance and high yield in clinical pathway nursing group were lower than routine nursing group， the scores of hope on the future of reality and positive attitude， keeping close relationship with others， taking positive action in clinical pathway nursing group were higher than routine nursing group， the differences were statistically significant （P < 0.05）. Conclusion Clinical pathway nursing can effectively improve the perioperative index in patients with pituitary tumor， promote the improvement of postoperative treatment of the disease， boost the level of hope and improve the prognosis.

[Key words] Clinical pathway； Pituitary adenoma； Coping style； Hope level

垂體瘤作为临床上一类较为常见的颅内良性肿瘤性疾病，发病率占全部颅内肿瘤中的10%以上。目前针对垂体瘤的治疗仍以手术治疗为主，随着外科手术的不断发展与进步，患者对于手术治疗及临床护理提出了更高的需求[1]。由于部分患者对垂体瘤相关知识掌握情况有限，希望从不同的途径获得科学全面的知识提高对该病发生发展的正确认知，同时处于对疾病治疗及预后的恐惧，不仅担心因疾病的进展可能导致死亡，同时也害怕因疾病本身对自我社会价值及功能等多方面生活造成影响。以往临床工作中实施的常规护理方法效果一般，无法满足患者的上述需求，哈尔滨医科大学附属第一医院（以下简称“我院”）在常规护理的基础上实施临床路径护理，不仅促进了医疗服务质量的提高，同时也通过充分利用医疗护理服务资源，提高了患者对疾病的了解程度[2]。……