基于微信平台的延续护理在急诊压力性损伤患者中应用的效果

殷晓菁 丛燕 房晨斐 李智颖 张晓瑛

摘 要 目的：评价基于微信平台的延续护理在急诊压力性损伤患者中应用的效果。方法：选择2018年10月-2019年12月在华东医院急诊科就诊的92例压力性损伤患者作为研究对象，其中男性59例，女性33例。平均年龄（78.92±9.57）岁。在患者就诊时和出院后采用微信平台对其主要照护者进行压力性损伤照护知识的宣教与技能的指导，评估患者的压力性损伤的转归情况以及照护者对护理满意度和压力性损伤知识的掌握情况。结果：1期、2期、3期和4期压力性损伤的平均愈合时间分别为（6.25±1.52）d、（23.18±2.69）d、（35.00±3.78）d和（75.00±4.76）d。深部组织损伤和不明确分期的平均愈合时间分别为（85.00±5.00）d和（76.00±8.04）d。照护者对压力性损伤的知识掌握情况及满意度明显优于干预前，差异有统计学意义（P<0.05）。结论：基于微信平台管理的延续护理干预可促进压力性损伤的愈合，改善照护者压力性损伤照顾的知识与技能水平，提高照护者的满意度。

关键词 压力性损伤；微信；急诊患者；照护者；延续护理

中图分类号：R473 文献标志码：A 文章编号：1006-1533（2021）06-0044-04

The effect of application of continuing care for patients with emergency pressure injury based on WeChat platform

YIN Xiaojing， CONG Yan， FANG Chenfei， LI Zhiying， ZHANG Xiaoying

（Department of Emergency of Huadong Hospital Affiliated to Fudan University， Shanghai 200040， China）

ABSTRACT Objective： To evaluate the effect of application of continuing care for patients with emergency pressure injuries based on WeChat platform. Methods： Ninety-two patients with pressure injuries who were treated in the Emergency Department of Huadong Hospital from October 2018 to December 2019 were selected as the research objects， among them， there were 59 males and 33 females. Their average age was （78.92±9.57） years old. The WeChat platform was used to conduct the pressure injury care knowledge and skills guidance for the main caregivers of the patients during the visiting and after discharge， assess the outcome of pressure injuries of the patients， care satisfaction and the knowledge of caregivers about pressure injury. Results： The average healing times of stage 1， 2， 3 and 4 pressure injury were （6.25±1.52） days， （23.18±2.69） days， （35.00±3.78） days， and （75.00±4.76） days. The average healing times of deep tissue injury and non-staged were （85.00±5.00） days and（76.00±8.04） days. The knowledge of caregivers about pressure injury and care satisfaction were significantly better than those before the intervention， and the difference was statistically significant（P<0.05）. Conclusion： Continuing nursing intervention based on the management of the WeChat platform can promote the healing of pressure injuries， improve the caregivers knowledge and skills about pressure injury， and increase the care satisfaction.

KEY WORDS pressure injury； WeChat； emergency patient； caregiver； continuing care

*基金項目：2018年度中国社区健康联盟护理中心PSBH科研课题（美国健康基金会PSBH2018039）

压力性损伤是由于皮下组织受到摩擦力或复合剪切力作用而导致骨隆突处局限性损伤所致[1]。急诊带入（在急诊室收治就诊时已出现）的压力性损伤往往比较严重，且以老年长期卧床的患者居多[2]。由于病情急，常伴有多系统的器官疾病，营养缺失，发生压力性损伤的严重程度明显高于普通病房。而患者在急诊停留的时间比较短，患者或被收入院，或至家中康复[3]。对于至家中康复的患者，居家护理至关重要。但由于主要照顾者缺乏针对性的知识与技能，影响了患者压力性损伤的愈合，严重的可合并全身感染，甚至危及生命，迫切需要专业的居家护理的指导。……