基于Roy适应模式护理干预对ICU患者睡眠质量的效果评价

发布时间：2018-10-17 17:44

【摘要】：目的通过对重症医学科(Intensive Care Unit,ICU)患者实施基于Roy适应模式的护理干预,探讨改善ICU患者睡眠质量的有效措施,为今后的相关研究提供新的理论参考依据。方法采用简单随机抽样方法,将2015年10月9日至2016年10月9日符合纳入标准的48名患者按照入住ICU的先后时间顺序分组,前6个月入住的患者为对照组(n=23)和后6个月入住的患者为干预组即RAM组(n=25)。研究过程中给予对照组患者常规的ICU专科护理,RAM组在对照组的基础上同时实施基于Roy适应模式的护理干预。采用多导睡眠监测仪、医院焦虑量抑郁表、ICU意识评估量表、住院满意度调查量表等分别对两组患者干预第3天和干预第7天两个时间点的睡眠结构分期(N1期、N2期、SWS期、R期所占比例)、焦虑评分、ICU谵妄发生率及住院满意度进行效果评价。采用SPSS21.0软件包对所得数据进行统计分析,方法包括:均数、标准差、构成比、卡方检验、Fisher确切概率法、两样本非参数秩和检验、两独立样本t检验、单因素方差分析。结果1.两组患者干预前一般资料、睡眠质量、焦虑评分、急性生理和慢性健康评分,差异均无统计学差异(P0.05),患者的研究基线水平具有一致性。2.在实施干预的第3天,RAM组患者睡眠结构分期(N1期、N2期、SWS期、R期)所占比例与对照组相比均呈现显著的差异,有统计学意义(P0.05)。在实施干预第7天,RAM组与对照组相比N1期、N2期所占比例均较少(27.92±7.06 vs34.61±5.35;28.76±5.05 vs 24.31±5.55,P0.05);SWS期、R期两者相比差异不具有统计学意义,(P0.05),但是,RAM组更接近正常水平。3.两组患者在干预7天后,对照组焦虑评分较RAM组相比较高,差异具有统计学意义(12.52±2.61 vs 10.92±1.58;t=2.59,P0.001)。4.两组患者在干预7天后,RAM组谵妄发生率低于对照组,差异具有统计学意义(P0.05)。5.在住院满意度方面,对照组低于RAM组,差异具有统计学意义(Z=-2.56,P0.05)。结论基于Roy适应模式的护理干预可有效的改善ICU患者睡眠质量、缓解患者的焦虑情绪、降低ICU谵妄发生率及提升患者住院满意度。
[Abstract]:Objective to explore the effective measures to improve the sleep quality of patients with (Intensive Care Unit,ICU through the nursing intervention based on Roy adaptation mode, and to provide a new theoretical basis for the related research in the future. Methods 48 patients who met the inclusion criteria from October 9, 2015 to October 9, 2016 were grouped according to the time sequence of admission to ICU by a simple random sampling method. The first 6 months of admission was the control group (nf23) and the latter 6 months was the intervention group (RAM 25). In the course of the study, the patients in the control group were given routine ICU specialist nursing care, while the RAM group was given nursing intervention based on the adaptation mode of Roy on the basis of the control group. Polysomnography, hospital anxiety and depression scale, ICU consciousness evaluation scale were used. The sleep structure stages (N1, N2, SWS, R), anxiety score, incidence of ICU delirium and satisfaction degree of hospitalization were evaluated at the third day and the seventh day of intervention respectively. The data are analyzed by SPSS21.0 software package. The methods include mean, standard deviation, constitution ratio, chi-square test, Fisher exact probability method, non-parametric rank sum test of two samples, t-test of two independent samples, and analysis of variance of single factor. Result 1. There was no significant difference in general data, sleep quality, anxiety score, acute physiology and chronic health score between the two groups before intervention (P0.05). On the third day of intervention, the proportion of sleep structure stages (N1, N2, SWS, R) in RAM group was significantly different from that in control group (P0.05). On the 7th day of intervention, the proportion of N2 phase was lower in RAM group than that in control group (27.92 卤7.06 vs34.61 卤5.35 vs 28.76 卤5.05 vs 24.31 卤5.55); SWS, P 0.05). There was no significant difference between R phase and control group (P0.05), but RAM group was closer to normal level. After 7 days of intervention, the anxiety score of the control group was higher than that of the RAM group, and the difference was statistically significant (12.52 卤2.61 vs, 10.92 卤1.58 vs, 2.59 vs, P0.001). After 7 days of intervention, the incidence of delirium in RAM group was lower than that in control group (P0.05). In terms of hospital satisfaction, the control group was lower than RAM group, the difference was statistically significant (P 0.05). Conclusion the nursing intervention based on Roy adaptation mode can effectively improve the sleep quality of ICU patients, alleviate the anxiety of patients, reduce the incidence of ICU delirium and improve the hospital satisfaction.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473

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