淘豆网网友gd433近日为您收集整理了关于家庭赋权护理在神经外科危重症患者中应用的效果观察的文档，希望对您的工作和学习有所帮助。以下是文档介绍：河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下,由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学,试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名:雾泳眨导师签章:呈受旋二级学院领导盖章:趵悻lo只3河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生躲秘咬导师签章:;囊爱瑟上o/午年位月3.日万方数据目录Im吣吣帆呲叭哪㈣帆吣Y2730631中文摘要…………………………………………………………………1英文摘要…………………………………………………………………4研究论文家庭赋权护理在神经外科危重症患者中应用的效果观察前言……………………………………………………………………….J a…………..8日IJ吾………………………………………………………………………· …………一8资料与方法…………………………………………………………“8结果……………………………………………………………………………………….1 5附表………………………………………………………………………………….1 8讨论………………………………………………………………………………………·2l结论………………………………………………………………………………………·22参考文献……………………………………………………………24附录…………………………………………………………………27综述家庭赋权护理应用于临床护理工作中的研究及启示……………30致谢………………………………………………………………………………………………36个人简历………………………………………………..:………………·3'7万方数据中文摘要家庭赋权护理在神经外科危重症患者中应用的效果观察摘要目的:本研究旨在通过利用家庭赋权理论改变监护室现有的探视模式,减轻家属负向情绪,为患者提供强有力的精神支持,促进康复的同时和谐医患护患关系。神经外科重症监护室医护人员娴熟地运用神经外科基本理论、基础知识及基本操作技能,同时结合重症医学监测技术和重症医学理念的专科化多学科技能,利用现代重症医学的理念和监测技术、依托先进的设备、仪器对神经外科重症患者实施有效的集中治疗和护理。因此大大提高了救治能力,减少临床并发症的发生,降低死亡率,提高患者的预后效果。为了进一步提高患者的生活质量水平,减少发生临床并发症的概率,改善患者及其家属的心理状态。本课题通过开展家庭赋权护理,对住院治疗患者家属进行赋权,让他们可以尽快的进行角色改变,组成医、护、患三方治疗团队。其中运用巴西教育学家保罗菲瑞提出的赋权理论依据,按照倾听一对话一反思一行动一系列的过程,拟定家庭赋权护理计划,提供介入措施,逐步引导患者家属参与到治疗护理团队中。从患者入住监护室开始,先从入室健康宣教开始,利用开放式的谈话方式与家属进行有效的沟通交流,了解其需求,制定下一步赋权计划,并逐步在探视过程中由责任护士向患者家属逐步实施,例如:介绍监护室环境、治疗团队、治疗方案、病人的生命体征、病情、疾病相关知识等等;让家属对昏迷患者进行抚触、加满意度,和谐医护患关系,促进病人康复的目的。方法:一组124例患者按照神经外科重症病人护理常规,护理操作规范,常规模式进行护理,作为本次试验的对照组;另一组124例患者在常规方法护理的同时结合家庭赋权护理干预作为试验的实验组。应用《危重症患者家属赋权护理量表》对两组患者及其家属的心理状况进行评价,共包括5个维度,45个条目。利用健康调查简表(the MOS item short fromhealth survey,SF.36),观察两组患者的躯体功能、躯体角色、肌体疼痛、总的健康状况、活力、社会功能、情绪角色(role-emotional)和心理卫生8个维度评价生存质量。FSS)评价患者万方数据中文摘要家属满意度;并从患者家属依从性;并发症发生率多方面多角度观察予以详实记录及统计学分析、处理。结果:1.《危重症患者家属赋权心理护理量表》的信效度良好。由危重症患者家属需求量表(Critical Care Family Needs FNI)的五个维度45个条目制定而成。赋权心理护理量表内容效度指数CVI在O.88.1.oo之间;对赋权心理护理量表的各维度KMO值超过O.7;Bartlett球形检验所得X2值为1217.979;赋权心理护理量表各个维度与问卷总分之间的相关系数约为O.648.0.811;内部同质性系数约为O.851。2.实施家庭赋权护理干预后,实验组中患者家属心理评分、支持系统评价明显高于对照组。实验组患者赋权心理护理和舒适服务维度的得分分别为4.35+0.75分和4.61+0.66分,均显著高于对照组的3.87+0.73分(F=25.39,P<0.01)和4.27+0.77分(F=13.88,P<0.01)。实验组患者必要信息维度的评分为4.2+0.84分,而对照组患者的评分为3.93+1.06分,经统计学检验,实验组患者的必要信息维度评分高于对照组(F=5.16,P<0.05)。实验组患者家属的赋权心理护理和自我支持维度的得分分别为4.15+0.74分和4.5+0.77分,均显著高于对照组的3.78+0.87分(F=13.02,P<0.01)和4.05+0.87分(F=18.66,P<0.01)。实验组患者家属的情感支持维度的评分为4.23+0.76分,而对照组患者家属的评分为3.96+1.02分,经统计学检验,实验组患者家属的情感支持维度的评分高于对照组(F=5.76,P<0.05)。3.两组患者在护理干预前,生活质量8个维度评分之间相比较:实验组组患者的生理功能评分由(78.42+11.57)分提高到(87.31+11.57)分,P<0.05差异有统计学意义;总体健康评分由(36.58+7.85)分提高到(48.58+8.04)分,P<0.05差异有统计学意义;社会功能评分由(75.65+21.53)分提高到(86.13+16.09)分,P<0.05差异有统计学意义;精神健康评分由(67.63+13.59)分提高到(76.25+10.25)分,P<0.05差异有统计学意义。但是在健康变化、情绪职能、精力、躯体疼痛、生理职能、总分等方面提高幅度较小,P>0.05差异没有统计学意义。对照组患者的情绪职能、社会功能、躯体疼痛的评分均出现下降趋势,但P>0.05差异无统计学意义。对照组患者的情绪职能、社会功能、躯体疼痛的评分万方数据中文摘要均出现下降趋势,但P>O.05差异无统计学意义。实验组患者在依从性、健康教育认知率、护理满意率、并发症的发生率等各方面效果均明显优于对照组,对比差异,P<O.05差异有统计学意义。结论:家庭赋权护理应用于神经外科危重症的临床实践中,通过《危重症患者及家属赋权心理护理量表》能够准确评价危重症患者及其家属的赋权心理状况,对赋权过程中患者或其家属存在的问题提供评判的参考依据,从而提高了护理服务质量,充分保障了患者的最大权益,调动了患者及家属主动参与的能动性,有效避免或降低了危重症患者及其家属发生不良情绪的可能性,有利于患者自身疾病的恢复;同时,通过家庭赋权护理干预,充分尊重了患者及家属的权利,让患者及家属能够积极参与到临床治疗及护理工作中,最大程度的提高了患者家属的依从性;另一方面,明显提高了患者的生活质量,在治疗及护理过程中表现了良好的依从性,能够熟练掌握健康知识,增强了自我保护防范意识,有效避免或减少了I临床并发症的发生,进而提高了危重症患者的整体护理水平,减轻了患者及其家属的心理负担及经济压力,为患者的康复提供了重要的医疗、护理以及心理等方面的支持。关键词:家庭赋权护理;神经外科;危重症;应用;效果万方数据英文摘要一—- o ·‘^‘■ p ’‘●Family empowerment observation 0n elteCt 0t applying nursing。Department“neurosurgerv in critically illpatientsinDepartment Ol neuros r e critlcalW ili Pattentsrv lnABSTRACTObjective: Condition monitoring,psychological nursing,healtheducation,emergency care,emergency care,after the early enteral nutritionsupport routine nursing in Department of neurosurgery in critically ill patients,carl effectively improve the immune function of the patients with resistantability,improve the body metabolism level of patients,reduce the plication generation,reduce mortality,improve the prognosis of patientswith effect the.In order to further improve the quality of life level of patients,reduce the probability of occurrence of plications,improve thepatients and their family members of mental state,this topic through carryingout family empowerment nursing,for hospitalized patients or their families areweighted,SO that they canparticipate in collaborative work in the process ofnursing;visit responsibility nursepatient family member to pick Shao ICUenvironment the patient’S condition,treatment options,vital signs,let thefamily members of patients a wake,touching,and guide the familymembers participate in the formulation of medical care scheme.In order todecrease the anxiety of family members,increase satisfaction,harmoniousmedical patient relationship,promote the rehabilitation of the patients.Methods:248 cases of severepatients selected during 2012.04-2013.04receive treatment in the intensive care room department of neurosurgery in ourhospital,the application puter random sampling method will be theaverage divided into two groups,Patients admitted to an odd group of order,even the order of agroup of patients admitted.take a group of 124 patientscondition monitoring,psychological nursing,health education,basic nursing,emergency care,emergency care,after the early enter-al nutrition support theroutine nursing as the control group in the test;at the same time in theconventional nursing another group of 1 24 patients with family empowerment4万方数据荚文摘要——————————————————————————————————————————————_—————一一一一一一nursing intervention as the study group trial.Application of”critically illpatients and family empowerment scale¨to evaluate the psychological nursingonpsychological status of two groups,of patients and their families,includinga total of 3 dimensions,1 2 items.The two groups were observed and thequality of life of patients,the clinical indexes of health education,a'pliance,and make analysis,the detailed record and statistical treatment.Results:Reliability and validity of the test is good,empowermentdimensions and total score of psychological nursing care scale co,elationbetween O.61—0.78;Cronbach’a factor is about O.88:the split half reliabilitywas about O.83(P<O.05);the test—retest reliability of about O.84(P<o.05).Theaverage score of psychological nursing in patients of the study groupempowerment for(4.58+O.23);the average score of weight controlpsychological nursing were(3.46+O.54)points,respectively,and the weightedscore of pared to the best effect of psychological empowerment,thepatmnts in study group received psychological nursing score level at a highlevel,me advantages of clear,there was statistical significance differences inP<0.05.Study group fortable service dimensions mean score of(4.69+0.37points,the necessary information dimension mean score of(,4.54+0.43);the control group fortable service dimensions mean score of(3.88+O.29)points,the necessary information dimension mean scoreof(3.79+O.56),the contrast between the two groups with significant differences,therewas statistical significance in P<0.05.At the same time.也e patients inintensive care period corresponding to the family empowerment also obvious'●,一●●一一·●difference exists between psychological nursing score.Research on the familyempowerment group psychological nursing scored an average of(4.3 1+O.22);the control group families empowerment psychological nursing scored anaverage of(3.76+O.63),in the range of weighting score 1-5 points inpsychological theory,research group family empowerment psychologicalscoring at a high level,P<O.05 had statistical significance.Research group offamilies of self support dimension mean scoreof(4.58+O.34)points,emotional support dimensions mean score of(4.14+O.66);the control group5万方数据英文摘要families self support dimension mean scoreof(3.85+0.42)points,emotionalsupport dimensions mean score of(3.77+0.46),there was significant pared to two there was statistical significance between the groups,P<0.05.The SF-36 scale of quality of life survey showed:two groups of patients innursing before intervention,quality of life score between 8 dimensions parison,no statistically significant differences in P>0.05.After the nursingintervention,the physiological function of the patients in the study groupsscore by(78.42+1 1.57)points improved to(87.3 1+1 1.57),the differencewas statistically significant P<0.05;general health score by(36.58+7.85)points improved to(48.58+8.04),the difference was statistically significant(P<0.05;social function scoreby 75.65+21.53)points improved to(86.13+1 6.09),the difference was statistically significant P<0.05;mental health scoreby(67.63+13.59)points improved to(76.25+1 0.25),the difference wasstatistically significant P<0.05.But the smaller increase in health changes,emotional function,energy,physical pain,physical function,the total scoreand other aspects,no statistically significant differences in P>0.05.Patients inthe control group the emotional function,social function,bodily pains coreswere declining trend,but the difference was not statistically significant in尸>O.05.Effect of various aspects of the study group patients pliance,health education,nursing satisfaction rate,the awareness rate plications was significantly better than the control group,significantdifferences in contrast P<0.05Conclusion:Clinical practice family empowerment nursing applied tocritically ill patients in Department of Neurosurgery,through”critically illpatients and family empowerment scale"psychological nursing callcriticallyill patients and their families Can accurately evaluate Fu psychological status,provide evaluation reference exists in the process of empowerment of patientsor their families,in order to facilitate the nursing service quality improved,fully guarantee the maximum rights of patients,to mobilize the initiative ofpatients and their family members participate actively,effectively avoid orreduce the occurrence of critically i11 patients and their families of bad mood6万方数据英文摘要may,in favor of the patient’S own disease recovery.At the same time,weighted by the family nursing intervention,with full respect for the rights ofpatients and their families,for patients and their families Can be activelyinvolved in the clinical treatment and nursing work,to the maximum extentimprove pliance of patients.On the other hand,significantly improvethe quality of life of patients,the treatment and nursing process showed pliance,Can skilled grasp the health knowledge,enhance self-protectionawareness of prevention,avoid or reduce the plications,andimprove the overall level of nursing care of critically ill patients,reduce thepatients and their families the psychological burden and economic pressure,provides medical,nursing and psychological aspects of important support forthe rehabilitation of the patients.Keyword:Family empowerment nursing;Department of Neurosurgery;Critically ill patients;Application;Effect7万方数据研究论文家庭赋权护理在神经外科危重症患者中应用的效果观察.‰!釜莉昌神经外科危重症患者主要包括急性脑血管病患者;颅脑外伤患者及脊髓损伤患者;围手术期神经外科重症患者;神经系统感染,癫痫持续状态等神经系统急危重症患者。由于神经外科重症患者起病急,病情重,预后不良,固给家庭经济及情感上以沉重的打击,往往造成患者及家属紧张焦虑等诸多负向情绪,并无所适从。但与此同事患者又非常需要家庭强有力地情感精神支持。家庭赋权护理既是一个过程又是一个结果。与传统常规护理模式不同,赋权护理更着重于赋权发生时一组特定的过程。护理人员应该对赋权的过程承担一定的责任,不但重视患者赋权护理的结果,而且还应重视赋权护理的过程。赋权护理过程中,护患双方处于平等地位,改变了传统护理模式中患者被动服从的局面,患者及其家属享有更多的决定权及选择权,从而提高了患者或其家属的信心。赋权护理以尊重、信任为护理工作的前提,帮助患者正确识别其权力及能力,鼓励患者对自身所患疾病的康复效果承担责任,加强自我健康的选择。同时,赋权护理具有共同参与的特点,护理人员尽可能鼓励、帮助患者或其家属参与治疗及护理工作中目标的设定、决策、效果评价,以利于患者及时、有效的调整自我护理的行为及方法。现择取2012.1 1-2013.08期间在我院神经外科重症监护室接受治疗的248例危重症患者,针对家庭赋权护理应用于神经外科危重症患者的作用效果进行深入探究,具体如下。资料与方法1一般资料择取2013.04.2014.04期间在我院神经外科重症监护室接受治疗的248例危重症患者。年龄范围为30.60岁,平均年龄(41.63+5.28)岁。其中,各种神经系统肿瘤手术后病情危重者64例,重型颅脑损伤者50例,重度脑梗死者58例,高血压脑出血者76例。万方数据

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