摘要:
Objective To study the therapeutic value of using mind map (MM) as a basis for developing individualized nursing scheme for patients in Intensive Care Unit (ICU). Methods Seventy severe patients admitted to the Department of Transplant ICU of Tianjin First Center Hospital from December 2015 to February 2017 were enrolled, and they were divided into a control group and an observation group by different nursing methods, each group 35 cases. The observation group was treated with individualized nursing based on MM; while the control group followed the doctor's instruction. After nursing, the changes of acute physiology and chronic health evaluationⅡ(APACHEⅡ), predictive mortality, complication situations and quality of life were observed in the two groups. Results After nursing, the APACHE Ⅱ scores and predictive mortalities in the two groups were significantly lower than those before nursing [control group: APACHEⅡ scores was 29.5±7.5 vs. 37.8±9.2, predict of mortality was (40.6±9.9)% vs. (63.1±11.5)%;observation group: APACHEⅡscores was 25.9±6.3 vs. 38.4±9.6, predict of mortality was (33.2±10.8)% vs. (40.6±9.9)%], and in the observation group, after nursing the above indicators were significantly lower than those in the control group [APACHEⅡscores: 25.9±6.3 vs. 29.5±7.5, predictive mortality: (33.2±10.8)% vs. (40.6±9.9)%, both P < 0.05]. The complication rate of the observation group was obviously lower than that of the control group [8.57% (7/35) vs. 20.00% (3/35), P < 0.05]. After intervention, the indexes of life quality such as social function, psychological function, physical function and material life scores in the observation group were all significantly higher than those of the control group (social function scores: 23.1±3.1 vs. 19.0±2.5, psychological function scores: 23.6±5.1 vs. 20.1±5.7, physical function scores: 25.2±3.2 vs. 21.1±3.7, material life scores: 25.8±3.1 vs. 20.1±3.3, all P < 0.05). Conclusion MM can transform complex and tedious nursing information into intuitive content, which may facilitate understanding, effectively reduce the pressure of ICU nursing work, improve nursing efficiency and patients' quality of life, and decrease their mortality.%目的 观察以思维导图为基础制定的个体化护理方案在重症加强治疗病房(ICU)患者中的应用价值.方法 选择2015年12月至2017年2月天津市第一中心医院移植ICU收治的70例重症患者,将患者按护理方式不同分为对照组和观察组,每组35例.观察组采用以思维导图为基础的个体化护理;对照组根据医嘱进行护理.护理2周后观察两组患者护理后急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、预期病死率、并发症情况以及生活质量的变化.结果 两组护理后APACHEⅡ评分、预期病死率均较护理前明显降低〔对照组:APACHEⅡ评分(分)为29.5±7.5比37.8±9.2,预期病死率为(40.6±9.9)%比(63.1±11.5)% ;观察组:APACHEⅡ评分(分)为25.9±6.3比38.4±9.6,预期病死率为(33.2±10.8)%比(40.6±9.9)%,均P<0.05〕,且观察组护理后上述指标均明显低于对照组〔APACHEⅡ(分):25.9±6.3比29.5±7.5,预期病死率(%):33.2±10.8比40.6±9.9,均P<0.05〕.观察组并发症发生率明显低于对照组〔8.57%(7/35)比20.00%(3/35), P<0.05〕.观察组干预后生活质量各指标社会、心理、躯体和物质生活评分均显著高于对照组〔社会功能评分(分):23.1±3.1比19.0±2.5,心理功能评分(分):23.6±5.1比20.1±5.7,躯体功能评分(分):25.2±3.2比21.1±3.7,物质生活评分(分):25.8±3.1比20.1±3.3,均P<0.05〕.结论 思维导图能将复杂繁琐的护理信息转化成直观内容,方便理解,有效减轻ICU护理工作压力,提高护理效率和患者生活质量,降低预期病死率.