【作者】 袁媛；

【导师】 屈清荣；

【作者基本信息】 郑州大学 ， 护理学， 2015， 硕士

【摘要】 目的 1.调查胆道镜取石手术患者术中舒适状况。2.分析影响胆道镜手术患者术中舒适状况的相关因素。方法 采用便利抽样的方法选取2014年9月至2015年2月期间郑州大学第一附属医院的肝胆外科符合纳入标准的患者共330例,采用一般情况调查表、疼痛量表、舒适状况量表和焦虑自评量表进行问卷调查。一般状况调查表与疼痛量表均有护士在患者手术结束时完成填写,舒适状况量表与焦虑自评量表由护士在患者术后发放于患者并在4小时内完成填写并回收。采用SPSS17.0对数据进行录入和统计学分析。结果 1.本研究共调查330名患者,回收有效问卷330例,有效回收率达到100%。2.胆道镜取石术中患者舒适度的得分为(76.19±3.99)分。条目平均分为整体(2.53±0.13)分,精神心理领域(2.56±0.23)分,生理领域(1.98±0.38)分,社会领域(2.86±0.22)分,环境领域(2.49±0.26)分。3.患者SAS评分为结果 (45.43±8.06)分,高于国内常模标准分均数(41.22±7.63)分。且患者的焦虑与生理、心理、社会文化和环境四个领域的舒适存在显著性负相关。4.不同年龄段、不同家庭经济水平和不同医疗付费方式的行胆道镜取石手术患者舒适状况差别有统计学意义(P<0.05),而不同性别、职业、文化程度、婚姻状况及是否有宗教信仰等因素之间的差别无统计学意义(P>0.05)。5.对影响患者舒适度的客观存在因素进行单因素方差分析和多元逐步回归分析,P≤0.05的纳入回归方程,结果显示,室温、冲洗盐水水温、体位、皮肤潮湿、腹胀、恶心呕吐、疼痛及焦虑是患者术中舒适度的影响因素。结论 1.胆道镜取石手术的患者术中生理领域舒适得分最低,环境和精神心理领域舒适得分其次,而社会文化领域舒适得分较高,提示护理过程中应注重满足患者的生理需求,提供心理护理,促进患者舒适。2.年龄、家庭经济、医疗付费方式对患者舒适度舒适有影响,提示在临床护理中,对年轻的、家庭经济状况比较差、自费的患者要更加关注,给予多的帮助和安慰。3.对室温、冲洗盐水水温、冲洗盐水量、体位、皮肤潮湿、腹胀、恶心呕吐、疼痛、焦虑等术中影响舒适的相关因素要及时给予干预,减轻患者的不适,提高患者的满意度。更多还原

【Abstract】 Objective: 1. To investigate comfort status of patients with choledochoscope operation. 2. To explore the influence related factors of patients with choledochoscope operation. Methods: The 330 samples from 2014 September to 2015 February in Zhengzhou University first affiliated hospital department of hepatobiliary surgery patients who met the inclusion criteria were investigated by a convenience sampling method. The patients were interviewed and administered a questionnaire that was composed of the general information, pain scale, comfortable status scale and self rating anxiety scale. The general information, pain scale questionnaire in patients were completed at the end of the operation by nurses, and comfortable status scale and self rating anxiety scale were completed by nurses in patients in 4 hours. SPSS17.0 software was used for data entry and statistical analysis. Results: 1. This study investigated a total of 330 patients, 330 valid questionnaires, the effective recovery rate of 100%. 2. The comfort score patients with choledochoscope operation was(76.19 错误!未找到引用源。3.99) points. Entry into the overall average(2.53 ± 错误!未找到 引 用 源 。 0.13), psychological domain(2.56 ± 0.23), physiological field.(1.98 ± 0.38), social studies(2.86 ± 0.22), environment(2.49 ± 0.26) points. 3. The SAS scores(45.43 ± 8.06) of the patients were higher than the national norm criteria(41.22 ± 7.63). And the four areas of anxiety and physiological, psychological, social and culture, environment had significant negative correlation. 4. The comfort status with different ages, different family economic level and different medical payment was statistically significant difference of patients with choledochoscope operation(P<0.05), while gender, occupation, education level, marital status, religious beliefs had no statistical significance(P > 0.05). 5. The impact on patients with the objective existence of comfort factors was investigated with single factor analysis of variance and multiple stepwise regression analysis.The P≤0.05 into the regression equation. The results showed that room temperature, saline temperature, posture, moist skin, abdominal distention, nausea and vomiting, and pain were comfort factors. Conclusions: 1. The lowest score in physiological field, environment and psychological field score secondly, and the social and cultural fields high score with choledochoscope operation patients.This indicated the nursing process should pay attention to meet the physiological needs of patients, provide psychological care, promote patient comfort. 2.The factors of age, family economic and medical payment methods effected the degree of comfort.This indicated that clinical nursing should pay more attention to the young, poor family economic conditions, private patients, give more help and comfort.3.The related factors affecting the comfort of room temperature saline, saline, water quantity, position, moist skin, abdominal distention, nausea and vomiting, pain in the operation were timely intervened, in order to reduce patient discomfort, improve patient satisfaction.更多还原