摘要
目的探讨舒适护理联合正念疗法对肝硬化患者肝功能及心理状态的影响。方法采用回顾性研究试验。选取2020年4月至2023年4月陕西省核工业二一五医院收治的112例肝硬化患者,根据不同的护理方式分为对照组(55例)和干预组(57例)。对照组男28例,女27例;年龄(55.21±14.32)岁;病程(11.21±3.66)年;身体质量指数(23.51±3.01)kg/m^(2)。干预组男29例,女28例;年龄(54.27±15.88)岁;病程(10.47±4.39)年;身体质量指数(23.58±3.45)kg/m^(2)。对照组采取常规护理干预,干预组采取舒适护理与正念减压疗法联合护理干预。两组患者均持续护理4周。比较两组患者护理前后的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、SF-36生活质量量表评分、治疗依从性评分以及护理满意度。采用t检验、χ^(2)检验进行统计学分析。结果护理后,干预组SAS和SDS评分明显低于对照组[(23.12±9.58)分比(32.58±11.69)分、(31.52±12.03)分比(42.36±10.44分)],差异均有统计学意义(t=4.167、6.871,均P<0.05);干预组ALT及AST水平明显低于对照组[(32.55±13.88)IU/L比(58.31±21.06)IU/L、(35.81±12.03)IU/L比(59.22±23.69)IU/L](t=4.874、5.171,均P<0.05);干预组生活质量评分高于对照组[(78.69±11.33)分比(67.39±12.36)分](t=4.165,P=0.003);干预组治疗依从性评分高于对照组(P<0.05);干预组总体护理满意度明显高于对照组[96.5%(55/57)比81.8%(45/55)],差异有统计学意义(χ^(2)=5.314,P=0.009)。多元回归分析结果显示,干预组ALT水平降低(t=-3.88,P=0.001)、SAS评分显著降低(t=-3.78,P<0.001)、生活质量评分增加(t=3.95,P=0.001)、护理满意度增加(t=3.36,P=0.001),且方差膨胀因子(VIF)值为1.15,不存在严重的多重共线性问题。结论舒适护理联合正念减压疗法在减少肝硬化患者负面情绪、促进肝功能恢复、提高生活质量、增强治疗依从性和提升护理满意度方面具有显著效果。
Objective To investigate the effects of comfortable care combined with mindfulness-based stress reduction therapy on liver function and psychological state in patients with liver cirrhosis.Methods A retrospective study included 112 patients with liver cirrhosis admitted to Shaanxi Provincial Nuclear Industry 215 Hospital from April 2020 to April 2023 were divided into a control group(55 cases)and an intervention group(57 cases)based on different nursing approaches.There were 28 males and 27 females in the control group;they were(55.21±14.32)years old;the course of disease was(11.21±3.66)years;the body mass index(BMI)was(23.51±3.01)kg/m^(2).There were 29 males and 28 females in the control group;they were(54.27±15.88)years old;the course of disease was(10.47±4.39)years;the BMI was(23.58±3.45)kg/m^(2).The control group received routine nursing interventions,while the intervention group received comfortable care combined with mindfulness-based stress reduction therapy.Both groups received continuous care for 4 weeks.The scores of Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST),SF-36 quality of life scores,treatment compliance scores,and nursing satisfaction were compared between the two groups.Statistical analysis was performed using t tests andχ^(2)tests.Results After nursing care,the SAS and SDS scores in the intervention group were significantly lower than those in the control group[(23.12±9.58)ponits vs.(32.58±11.69)ponits and(31.52±12.03)ponits vs.(42.36±10.44)ponits,with statistically significant differences(t=4.167 and 6.871,both P<0.05);the levels of ALT and AST in the intervention group were lower than those in the control group[(32.55±13.88)IU/L vs.(58.31±21.06)IU/L and(35.81±12.03)IU/L vs.(59.22±23.69)IU/L](t=4.874 and 5.171,both P<0.05);the quality of life score in the intervention group was higher than that in the control group[(78.69±11.33)ponits vs.(67.39±12.36)ponits(t=4.165,P=0.003)].Treatment adherence was also significantly higher in the intervention group compared to the control group(P<0.05).The overall nursing satisfaction in the intervention group was significantly higher than that in the control group[96.5%(55/57)vs.81.8%(45/55)],with a statistically significant difference(χ^(2)=5.314,P=0.009).Finally,the multiple regression analysis showed that patients receiving comfortable care combined with mindfulness-based stress reduction therapy had a significantly lower ALT level(t=-3.88,P=0.001),a lower SAS score(t=-3.78,P=0.001),higher quality of life score(t=3.95,P=0.001),and higher nursing satisfaction(t=3.36,P=0.001).The VIF value was 1.15,indicating no serious multicollinearity issues.Conclusion Comfortable care combined with mindfulness-based stress reduction therapy has a significant effect in reducing negative emotions,promoting liver function recovery,improving quality of life,enhancing treatment adherence,and increasing nursing satisfaction in patients with liver cirrhosis.
作者
刘婷
柴晓雲
黄娜
Liu Ting;Chai Xiaoyun;Huang Na(Department of General Medicine,Shaanxi Provincial Nuclear Industry 215 Hospital,Xian yang 712000 China;Department of Spinal and Spinal Cord Surgery,Shaanxi Provincial Nuclear Industry 215 Hospital,Xian yang 712000,China;National and Local Joint Engineering Research Center of Biological Diagnosis and Treatment,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《国际医药卫生导报》
2025年第12期2103-2108,共6页
International Medicine and Health Guidance News
基金
国家自然科学基金青年项目(30901268)。
关键词
肝硬化
舒适护理
正念减压疗法
肝功能
心理状态
护理满意度
Liver cirrhosis
Comfort care
Mindfulness-based stress reduction therapy
Liver function
Psychological State
Nursing satisfaction
