叙事护理对医院获得性急性肾损伤患者负性情绪和生活质量的影响(1)
【摘要】 目的：探讨叙事护理对医院获得性急性肾损伤患者负性情绪和生活质量的影响。方法：采用目的筛选法选取2015年7月-2017年7月在菏泽市立医院住院治疗被确诊为医院获得性急性肾损伤的患者90例，按照随机数字表法将其分为对照组和观察组，各45例。对照组给予常规护理，观察组在此基础上采用叙事护理模式，观察两组SAS和SDS评分、治疗依从情况以及生活质量。结果：干预后，观察组SAS、SDS评分均明显低于对照组，差异均有统计学意义(t=5.559、4.798，P<0.05)；治疗依从情况和生活质量均明显优于对照组，差异均有统计学意义(P<0.05)。结论：叙事护理有利于消除医院获得性急性肾损伤患者的负性情绪，改善患者治疗依从性和提高生活质量。
【关键词】 医院获得性； 急性肾损伤； 叙事护理； 情绪； 生活质量
Influence of Narrative Nursing on Negative Emotion and Quality of Life in Patients with Hospital-acquired Acute Renal Injury/JIANG Xiping.//Medical Innovation of China，2018，15(23)：0-078
【Abstract】 Objective：To explore the influence of narrative nursing on negative emotion and quality of life in patients with hospital-acquired acute renal injury.Method：A total of 90 patients who were diagnosed as hospital-acquired acute kidney injury treated in Heze Municiple Hospital from July 2015 to July 2017.According to the random number table method，they were divided into control group and observation group，45 cases in each group.The control group was given routine nursing，the observation group was adopted narrative nursing mode on this basis.The SAS and SDS scores，treatment compliance and quality of life of the two groups were observed.Result：After intervention，the scores of SAS and SDS in the observation group were significantly lower than those in the control group，the differences were statistically significant(t=5.559，4.798，P<0.05)；treatment compliance and quality of life were significantly better than those in the control group，the differences were statistically significant (P<0.05).Conclusion： Narrative nursing is helpful to eliminate the negative emotion of patients with hospital acquired acute renal injury，improve their treatment compliance and improve the quality of life.
【Key words】 Hospital-acquired； Acute kidney injury； Narrative nursing； Emotion； Quality of life
First-author’s address：Heze Municiple Hospital，Heze 274031，China
doi：10.3969/j.issn.1674-4985.2018.23.019
急性腎损伤(acute kidney injury，AKI)是一种常见急重症，患者入院时肾功能正常，入院后由于肾脏的低灌注、药物、手术、重症感染、缺血缺氧等医源性检查或治疗，导致患者发生AKI被称为医院获得性急性肾损伤(hospital-acquired acute kidney injury，HA-AKI)[1]。近几年来，HA-AKI的发生率在逐年上升，患者住院时间延长，医疗费用增高，是住院患者死亡的主要原因，国内早有研究显示HA-AKI病死率达63.1%[2]，也是引起医院医疗事故纠纷的潜在风险[3]。患者一旦出现HA-AKI，情绪低落、悲观失望、怨恨医院，治疗依从性差，生活质量下降。随着现代医疗技术的进步，叙事医学逐渐在护理领域得到应用。叙事即叙述故事，是赋予人们经验和意义的方法，涉及人类的行为和意向，人们在叙述自己经验或故事的背景下，主观地叙述被其主流文化过滤后的客观事实，它注重个人观念的内在情感、价值和意识的诠释[4]。护理人员通过诚心、耐心倾听患者对自身疾病、生活经历、个人故事和感受的叙述，分析并制定护理计划，继而对患者实施护理干预，从而使患者的个人性格特征、内心情感、文化背景、社会关系、复杂的经历等得到总体的理解，为患者疾病预后、和谐护患关系的构建提供了一条可行路径[5-6]。本研究将叙事护理模式应用于医院获得性急性肾损伤患者，有效改善了患者的负性情绪，提高了患者治疗依从性和生活质量。现报道如下。, http://www.100md.com(蒋喜平)
【关键词】 医院获得性； 急性肾损伤； 叙事护理； 情绪； 生活质量
Influence of Narrative Nursing on Negative Emotion and Quality of Life in Patients with Hospital-acquired Acute Renal Injury/JIANG Xiping.//Medical Innovation of China，2018，15(23)：0-078
【Abstract】 Objective：To explore the influence of narrative nursing on negative emotion and quality of life in patients with hospital-acquired acute renal injury.Method：A total of 90 patients who were diagnosed as hospital-acquired acute kidney injury treated in Heze Municiple Hospital from July 2015 to July 2017.According to the random number table method，they were divided into control group and observation group，45 cases in each group.The control group was given routine nursing，the observation group was adopted narrative nursing mode on this basis.The SAS and SDS scores，treatment compliance and quality of life of the two groups were observed.Result：After intervention，the scores of SAS and SDS in the observation group were significantly lower than those in the control group，the differences were statistically significant(t=5.559，4.798，P<0.05)；treatment compliance and quality of life were significantly better than those in the control group，the differences were statistically significant (P<0.05).Conclusion： Narrative nursing is helpful to eliminate the negative emotion of patients with hospital acquired acute renal injury，improve their treatment compliance and improve the quality of life.
【Key words】 Hospital-acquired； Acute kidney injury； Narrative nursing； Emotion； Quality of life
First-author’s address：Heze Municiple Hospital，Heze 274031，China
doi：10.3969/j.issn.1674-4985.2018.23.019
急性腎损伤(acute kidney injury，AKI)是一种常见急重症，患者入院时肾功能正常，入院后由于肾脏的低灌注、药物、手术、重症感染、缺血缺氧等医源性检查或治疗，导致患者发生AKI被称为医院获得性急性肾损伤(hospital-acquired acute kidney injury，HA-AKI)[1]。近几年来，HA-AKI的发生率在逐年上升，患者住院时间延长，医疗费用增高，是住院患者死亡的主要原因，国内早有研究显示HA-AKI病死率达63.1%[2]，也是引起医院医疗事故纠纷的潜在风险[3]。患者一旦出现HA-AKI，情绪低落、悲观失望、怨恨医院，治疗依从性差，生活质量下降。随着现代医疗技术的进步，叙事医学逐渐在护理领域得到应用。叙事即叙述故事，是赋予人们经验和意义的方法，涉及人类的行为和意向，人们在叙述自己经验或故事的背景下，主观地叙述被其主流文化过滤后的客观事实，它注重个人观念的内在情感、价值和意识的诠释[4]。护理人员通过诚心、耐心倾听患者对自身疾病、生活经历、个人故事和感受的叙述，分析并制定护理计划，继而对患者实施护理干预，从而使患者的个人性格特征、内心情感、文化背景、社会关系、复杂的经历等得到总体的理解，为患者疾病预后、和谐护患关系的构建提供了一条可行路径[5-6]。本研究将叙事护理模式应用于医院获得性急性肾损伤患者，有效改善了患者的负性情绪，提高了患者治疗依从性和生活质量。现报道如下。, http://www.100md.com(蒋喜平)
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