健康教育和心理护理提高特发性脱髓鞘性视神经炎患者治疗效果

摘要

目的 观察健康教育和心理护理干预对特发性脱髓鞘性视神经炎(idiopathicdemyelinating optic neuritis,IDON)患者治疗效果的影响,探讨提高IDON疗效的护理措施.方法 采用随机数字表法将2008年10月至2010年10月的238例IDON住院患者分为对照组和干预组各119例,对照组给予常规护理措施,干预组在常规护理措施的基础上加强健康教育和心理护理干预.比较两组患者入院1周后的焦虑、抑郁评分、治疗依从性,出院时的疾病知晓率、护理满意率,以及出院后3个月的疾病复发率.结果 治疗1周后,两组患者的焦虑和抑郁程度均有所下降,而干预组焦虑和抑郁评分均低于对照组,差异有统计学意义(P<0.05);干预组的治疗依从性(89.1%)高于对照组(79.8%),差异有统计学意义(χ2=3.872,P<0.05).干预组患者出院时的疾病知晓率(94.1%)和护理满意率(94.6%)均高于对照组(82.4%和81.5%),差异有统计学意义(P<0 05或P<0.01);出院后3个月,干预组的疾病复发率(0.8%)低于对照组(5.9%),差异有统计学意义(χ2=4.657,P<0 05).结论 在IDON治疗过程中,应重视加强患者的健康教育和心理护理干预,以提高IDON患者的治疗效果,降低疾病的复发率.%Objective To observe the clinical influence of health education and psychological nursing intervention on the therapeutic effects of patients with idiopathic demyelinating optic neuritis(IDON) and to explore the nursing methods for IDON patients. Methods From October 2008 to October 2010,238 IDON patients were equally randomized into control group to undergo the conventional nursing and intervention group to undergo health education and psychological nursing intervention based on the conventional nursing. Comparisons were conducted on the anxiety, depression score and treatment compliance, awareness of disease at discharge and nursing satisfaction one week after admission,as well as the recurrence rate in 3 months after hospital discharge. Results After one week of treatment,the levels of anxiety and depression were decreased in both groups and the scores of anxiety and depression in the intervention group were significantly lower than those of the control group(P＜0. 0５). The satisfaction rate of medical compliance in the intervention group(89.1％)was higher than that(79.8％)in the control group(x2= 3. 872, P＜0.05). The awareness rate of disease and nursing satisfaction rate at discharge in the intervention group(94.1％, 94.6％)were significantly higher than those(82.4％ ,81.5％)in the control group(P＜0.05 or P＜0.01). In three months after discharge, the recurrence rate in the intervention group(0. 8％)was significantly lower than that(5.9％)of the control group(x2 =4. 657,P＜0.05). Conclusion During the treatment of IDON,health education and psychological nursing intervention should be emphasized to improve the clinical effect and reduce the disease's recurrence.