中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2014年
14期
1651-1655
,共5页
齐越%孙宏%苏姗姗%柳迪%刘安娜%孙桂志
齊越%孫宏%囌姍姍%柳迪%劉安娜%孫桂誌
제월%손굉%소산산%류적%류안나%손계지
老年人%慢性病%护理%出院后医疗%生活质量%健康调查量表%症状自评量表
老年人%慢性病%護理%齣院後醫療%生活質量%健康調查量錶%癥狀自評量錶
노년인%만성병%호리%출원후의료%생활질량%건강조사량표%증상자평량표
Elder patients%Chronic disease%Nursing%Quality of life%SF-36%SCL-90
目的:探讨院外健康护理指导对老年慢性病患者生活及心理的影响。方法选取某院住院的年龄>60岁的老年慢性疾病患者300例,采用随机数字表法分为干预组和对照组,每组150例。出院后,对照组患者回家后正常自然生活;干预组由护理人员每半月与受试者及其家属进行沟通,予以护理指导。并分别在出院后第3个月和第6个月应用简明健康调查量表( SF-36)和SCL-90症状自评量表分别对两组患者的生活质量和心理健康状况进行评估。结果出院前,两组患者的SF-36量表各维度评分差异无统计学意义( P>0.05);出院后3个月,干预组患者的SF-36量表中,机体功能、总体健康、活力、社会功能、情感职能、精神健康维度评分分别为(76.8±9.81),(63.4±8.6),(65.2±9.2),(59.1±14.3),(59.1±8.21),(64.2±11.3)分,均高于对照组的(60.4±9.6),(53.3±11.8),(54.8±15.3),(54.3±11.3),(44.4±9.8),(55.3±15.9)分,差异有统计学意义(t值分别为14.63,8.47,7.13,3.23,14.08,5.59;P<0.01);出院后6个月,干预组患者的SF-36量表中,机体功能、总体健康、活力、社会功能、情感职能、精神健康维度评分分别为(73.5±11.4),(63.8±10.9),(64.1±17.3),(60.1±11.7),(58.3±8.7),(64.3±15.1)分,均高于对照组的(63.3±11.1),(56.7±14.7),(54.2±14.4),(59.1±10.2),(45.9±10.5),(57.1±18.7)分,差异有统计学意义( t值分别为7.85,4.75,5.39,3.79,11.10,3.67;P<0.01)。出院前,两组患者的SCL-90症状自评量表各因子得分差异无统计学意义( P>0.05);出院后3个月干预组患者的躯体化和抑郁2个因子得分分别为(1.79±0.32),(1.78±0.34)分,优于对照组的(1.89±0.34),(1.89±0.41)分,差异有统计学意义(t值分别为2.62,2.53;P<0.01);出院后6个月干预组患者的躯体化和抑郁2个因子得分分别为(1.73±0.52),(1.76±0.44)分,优于对照组的(2.02±0.51),(1.98±0.32)分,差异有统计学意义(t值分别为4.88,4.95;P<0.01)。出院后3个月和6个月干预组患者再次就诊次数分别为(0.20±0.04)和(0.33±0.11)次,均低于对照组的(0.37±0.07),(0.42±0.10)次,差异有统计学意义(t值分别为25.82,7.41;P<0.01)。出院后3个月和6个月干预组患者出院后医疗费用分别为(450.00±125.14)和(1000.00±300.11)元,均低于对照的(600.78±120.67)和(1500.00±205.56)元,差异有统计学意义( t值分别为10.62,16.83;P<0.01)。出院后两组患者的死亡人数差异无统计学意义(P>0.05)。结论出院患者进行院外护理干预支持可以改善患者的生存质量及部分心理状态,从整体而言可以减少患者的医疗花费和社会负担,节省社会医疗资源。
目的:探討院外健康護理指導對老年慢性病患者生活及心理的影響。方法選取某院住院的年齡>60歲的老年慢性疾病患者300例,採用隨機數字錶法分為榦預組和對照組,每組150例。齣院後,對照組患者迴傢後正常自然生活;榦預組由護理人員每半月與受試者及其傢屬進行溝通,予以護理指導。併分彆在齣院後第3箇月和第6箇月應用簡明健康調查量錶( SF-36)和SCL-90癥狀自評量錶分彆對兩組患者的生活質量和心理健康狀況進行評估。結果齣院前,兩組患者的SF-36量錶各維度評分差異無統計學意義( P>0.05);齣院後3箇月,榦預組患者的SF-36量錶中,機體功能、總體健康、活力、社會功能、情感職能、精神健康維度評分分彆為(76.8±9.81),(63.4±8.6),(65.2±9.2),(59.1±14.3),(59.1±8.21),(64.2±11.3)分,均高于對照組的(60.4±9.6),(53.3±11.8),(54.8±15.3),(54.3±11.3),(44.4±9.8),(55.3±15.9)分,差異有統計學意義(t值分彆為14.63,8.47,7.13,3.23,14.08,5.59;P<0.01);齣院後6箇月,榦預組患者的SF-36量錶中,機體功能、總體健康、活力、社會功能、情感職能、精神健康維度評分分彆為(73.5±11.4),(63.8±10.9),(64.1±17.3),(60.1±11.7),(58.3±8.7),(64.3±15.1)分,均高于對照組的(63.3±11.1),(56.7±14.7),(54.2±14.4),(59.1±10.2),(45.9±10.5),(57.1±18.7)分,差異有統計學意義( t值分彆為7.85,4.75,5.39,3.79,11.10,3.67;P<0.01)。齣院前,兩組患者的SCL-90癥狀自評量錶各因子得分差異無統計學意義( P>0.05);齣院後3箇月榦預組患者的軀體化和抑鬱2箇因子得分分彆為(1.79±0.32),(1.78±0.34)分,優于對照組的(1.89±0.34),(1.89±0.41)分,差異有統計學意義(t值分彆為2.62,2.53;P<0.01);齣院後6箇月榦預組患者的軀體化和抑鬱2箇因子得分分彆為(1.73±0.52),(1.76±0.44)分,優于對照組的(2.02±0.51),(1.98±0.32)分,差異有統計學意義(t值分彆為4.88,4.95;P<0.01)。齣院後3箇月和6箇月榦預組患者再次就診次數分彆為(0.20±0.04)和(0.33±0.11)次,均低于對照組的(0.37±0.07),(0.42±0.10)次,差異有統計學意義(t值分彆為25.82,7.41;P<0.01)。齣院後3箇月和6箇月榦預組患者齣院後醫療費用分彆為(450.00±125.14)和(1000.00±300.11)元,均低于對照的(600.78±120.67)和(1500.00±205.56)元,差異有統計學意義( t值分彆為10.62,16.83;P<0.01)。齣院後兩組患者的死亡人數差異無統計學意義(P>0.05)。結論齣院患者進行院外護理榦預支持可以改善患者的生存質量及部分心理狀態,從整體而言可以減少患者的醫療花費和社會負擔,節省社會醫療資源。
목적:탐토원외건강호리지도대노년만성병환자생활급심리적영향。방법선취모원주원적년령>60세적노년만성질병환자300례,채용수궤수자표법분위간예조화대조조,매조150례。출원후,대조조환자회가후정상자연생활;간예조유호리인원매반월여수시자급기가속진행구통,여이호리지도。병분별재출원후제3개월화제6개월응용간명건강조사량표( SF-36)화SCL-90증상자평량표분별대량조환자적생활질량화심리건강상황진행평고。결과출원전,량조환자적SF-36량표각유도평분차이무통계학의의( P>0.05);출원후3개월,간예조환자적SF-36량표중,궤체공능、총체건강、활력、사회공능、정감직능、정신건강유도평분분별위(76.8±9.81),(63.4±8.6),(65.2±9.2),(59.1±14.3),(59.1±8.21),(64.2±11.3)분,균고우대조조적(60.4±9.6),(53.3±11.8),(54.8±15.3),(54.3±11.3),(44.4±9.8),(55.3±15.9)분,차이유통계학의의(t치분별위14.63,8.47,7.13,3.23,14.08,5.59;P<0.01);출원후6개월,간예조환자적SF-36량표중,궤체공능、총체건강、활력、사회공능、정감직능、정신건강유도평분분별위(73.5±11.4),(63.8±10.9),(64.1±17.3),(60.1±11.7),(58.3±8.7),(64.3±15.1)분,균고우대조조적(63.3±11.1),(56.7±14.7),(54.2±14.4),(59.1±10.2),(45.9±10.5),(57.1±18.7)분,차이유통계학의의( t치분별위7.85,4.75,5.39,3.79,11.10,3.67;P<0.01)。출원전,량조환자적SCL-90증상자평량표각인자득분차이무통계학의의( P>0.05);출원후3개월간예조환자적구체화화억욱2개인자득분분별위(1.79±0.32),(1.78±0.34)분,우우대조조적(1.89±0.34),(1.89±0.41)분,차이유통계학의의(t치분별위2.62,2.53;P<0.01);출원후6개월간예조환자적구체화화억욱2개인자득분분별위(1.73±0.52),(1.76±0.44)분,우우대조조적(2.02±0.51),(1.98±0.32)분,차이유통계학의의(t치분별위4.88,4.95;P<0.01)。출원후3개월화6개월간예조환자재차취진차수분별위(0.20±0.04)화(0.33±0.11)차,균저우대조조적(0.37±0.07),(0.42±0.10)차,차이유통계학의의(t치분별위25.82,7.41;P<0.01)。출원후3개월화6개월간예조환자출원후의료비용분별위(450.00±125.14)화(1000.00±300.11)원,균저우대조적(600.78±120.67)화(1500.00±205.56)원,차이유통계학의의( t치분별위10.62,16.83;P<0.01)。출원후량조환자적사망인수차이무통계학의의(P>0.05)。결론출원환자진행원외호리간예지지가이개선환자적생존질량급부분심리상태,종정체이언가이감소환자적의료화비화사회부담,절성사회의료자원。
Objective To study the effect of on the healthcare instructions outside the hospital on the quality of life and psychology of elderly patients with chronic diseases .Methods A total of 300 patients over 60 years old suffering from chronic diseases without mental illness and obvious damage to the memory and intelligence , with the ability of taking care of themselves and the expected survival of greater than 12 months were recruited.Research subjects were randomly divided into the control group and the intervention group .After discharge , maintaining the communication with the participants and their families and the healthcare instructions were given every half month .Then the Short Form 36 ( SF-36 ) and the Symptom Checklist ( SCL-90 ) were used to assess the quality of life and the situation of mental at 3 month and 6 month after discharge .Results The scores of SF-36 had no difference between groups before discharge (P>0.05).3 month after discharge, the scores of SF-36 on Physical Functioning, General Health Perception, Vitality, Social Functioning, Role Function-Emotional and Mental Health were (76.8 ± 9.81), (63.4 ±8.6), (65.2 ±9.2), (59.1 ±14.3), (59.1 ±8.21) and (64.2 ±11.3) in the intervention group, which were significantly higher than (60.4 ±9.6), (53.3 ±11.8), (54.8 ±15.3), (54.3 ±11.3), (44.4 ±9.8) and (55.3 ±15.9) in the control group (t=14.63,8.47,7.13,3.23,14.08,5.59, respectively;P<0.01).6 month after discharge, the scores of SF-36 on Physical Functioning, General Health Perception, Vitality, Social Functioning, Role Function-Emotional and Mental Health were (73.5 ±11.4), (63.8 ± 10.9), (64.1 ±17.3), (60.1 ±11.7), (58.3 ±8.7), (64.3 ±15.1) in the intervention group, which were significantly higher than (63.3 ±11.1), (56.7 ±14.7), (54.2 ±14.4), (59.1 ±10.2), (45.9 ±10.5), (57.1 ±18.7) in the control group (t=7.85,4.75, 5.39, 3.79, 11.10, 3.67, respectively;P<0.01).The scores of SL-90 had no difference between groups before discharge ( P>0.05).3 month after discharge, the somatization and depression scores of SCL-90 were (1.79 ±0.32) and (1.78 ±0.34), which were significantly higher than (1.89 ±0.34) and (1.89 ±0.41).The differences were significant (t=2.62,2.53, respectively;P<0.01).6 month after discharge, the somatization and depression scores of SCL-90 were (1.73 ±0.52) and (1.76 ±0.44), which were significantly higher than (2.02 ±0.51) and (1.98 ±0.32).The differences were significant (t=4.88,4.95, respectively;P<0.01).3 month and 6 month after discharge, the readmission in the intervention group were (0.20 ±0.04) and (0.33 ±0.11), which were significantly lower than (0.37 ± 0.07) and (0.42 ±0.10) in the control group (t =25.82,7.41, respectively; P <0.01).3 month and 6 month after discharge, the medical costs in the intervention group were (450.00 ±125.14) and (1 000.00 ± 300.11) RMB, which were significantly lower than (600.78 ±120.67) and (1 500.00 ±205.56) RMB in the control group (t=25.82,7.41, respectively;P<0.01).Conclusions The nursing intervention of healthcare instructions outside the hospital can improve patients'quality of life and the psychological state of some patients . On the whole, it can reduce the healthcare costs and social burden of patients , and save the medical resource for the society.