个性化访谈结合团体活动护理模式对烧伤患者术后恢复效果及满意度的影响

张菊　税方　何谦　冯素英　陈滟

[摘要]目的：探究个性化访谈和团体活动两种心理干预措施对烧伤患者术后疼痛情况、自我效能感评分及患者满意度的影响。方法：将70例患者随机分为两组，各35例，对照组采用常规舒适护理模式，观察组则实施个性化访谈结合团体活动进行护理。比较两组疼痛评分、焦虑抑郁评分及患者满意度等情况。结果：觀察组患者的疼痛评分明显低于对照组，观察组患者的一般自我效能感评分（General self-efficacy scale，GSES）明显高于对照组，差异均有统计学意义（P<0.05）。干预后两组汉密顿焦虑量表（Hamilton anxiety scale，HAMA）和汉密顿抑郁量表（Hamilton depression scale，HAMD）评分明显下降，且观察组评分明显低于对照组，差异有统计学意义（P<0.05）。两组生活质量综合评定问卷-74评分（Generic quality of life inventory-74，GQOL-74）明显上升，且观察组评分显著高于对照组，差异有统计学意义（P<0.05）。观察组满意度为94.3%（33/35）高于对照组的74.3%（26/35），差异有统计学意义（P<0.05）。结论：对烧伤患者采用个性化访谈结合团体活动护理模式能降低患者的疼痛程度，提高生活质量及患者满意度，值得在临床上推广应用。

[关键词]中重度烧伤;心理干预;个性化访谈;团体活动;疼痛;焦虑;抑郁;生活质量

[中图分类号]R473.6    [文献标志码]B    [文章编号]1008-6455（2020）08-0170-04

Effect of Personalized Interview Combined with Group Activity Nursing Mode on  Postoperative Recovery and Satisfaction in Burn Patients

ZHANG Ju1，SHUI Fang1，HE Qian1，FENG Su-ying2，CHEN Yan3

（1.Wound Ostomy Clinic;2.Department of Internal Medicine;3.Department of Stomatology Burn Plastic

Surgery，Suining Central Hospital，Suining 629000，Sichuan，China）

Abstract： Objective  The purpose of this study is to investigate the effects of personalized interview combined with group activity nursing mode on postoperative pain， self-efficacy score and patient satisfaction in burn patients. Methods  70 patients treated in the burn unit were randomly divided into two groups， 35 in each group. The control group adopted the conventional comfort care mode， while the observation group implemented personalized interview combined with group activities for nursing. The pain score， anxiety and depression score and patients' satisfaction were compared between the two groups. Results  The pain score of the observation group was significantly lower than that of the control group， and GSES score of the observation group was significantly higher than that of the control group（P<0.05）. After intervention， the scores of HAMA and HAMD decreased significantly in the two groups， and the score of the observation group was significantly lower than thoseof the control group（P<0.05）. The GQOL-74 score of the two groups increased significantly， and the score of the observation group was significantly higher than that of the control group（P<0.05）. The satisfaction rate of the observation group was 94.3% （33/35） higher than that of the control group （74.3%， 26/35， P<0.05）. Conclusion  Personalized interview combined with group activity nursing mode can reduce the degree of pain， improve the quality of life and patients' satisfaction， which is worthy of clinical application.

Key words： moderate to severe burns; psychological intervention; personalized interview; group activity; pain; anxiety; depression; quality of life

临床上，烧伤患者的创伤不仅表现在生理上，心理问题也尤为突出，主要表现为害怕、焦虑、孤独感、自我否定、无助感等心理变化，甚至会有轻生的念头[1-2]。况且患者还需经受一次甚至多次手术，以及术后换药、康复训练中的不适感和疼痛，往往变得焦躁易怒、情绪多变或悲观多疑等，出现不配合治疗、甚至是自我伤害，对家人陪护和临床护理带来了极大的困难[3-4]。中重度烧伤患者多采用早期整形手术治疗，可减轻患者的临床症状，减少创面感染，改善患处功能，促进患者恢复健康[5-6]。烧伤手术患者的护理难题除了术后伤口感染和术后功能恢复外，减轻患者疼痛和改善患者心理环境对患者术后恢复也有促进作用，且对患者预后和生活质量的提高有一定帮助[7]。术后一般采用口服或注射止痛药缓解疼痛，药物具有胃肠道损伤等副作用，而且烧伤患者具有特殊的生理情况，往往会带来不利影响[8]。……