目的:探讨系统护理在躁狂症患者中的应用及对患者治疗依从性和生活质量的影响。
方法:使用随机数表方法,将91例双相情感障碍躁狂发作患者分为对照组(n=46,接受常规护理)和观察组(n=45,结合包括健康教育在内的系统护理,病房环境,心理健康护理,和康复训练,精神状态评估以及家庭和社会支持)。Morisky药物依从性量表(MMAS)的治疗依从性,Bech-Rafaelsdn躁狂量表(BRMS)的躁狂状态,汉密尔顿抑郁量表(HAMA)和汉密尔顿抑郁量表(HAMD),通用生活质量量表-74(GQOLI-74)的生活质量,患者促进健康策略的自我效能感(SUPPH),比较干预前和干预后3个月的韦氏成人智力量表中文版(WAIS-RC)的认知功能。
结果:干预后,两组患者的BRMS评分均显著降低,观察组低于对照组(均P<0.05)。干预后,观察组患者的MMAS评分明显高于对照组(P<0.05)。干预后,观察组GQOLI-74、SUPPH、WAIS-RC评分均显著高于对照组(均P<0.05)。干预后,两组HAMA和HAMD评分均下降,观察组低于对照组(均P<0.05)。
结论:对躁狂症患者进行系统护理,可以明显缓解其不良情绪,控制他们的躁狂状态,提高他们的自我效能感,生活质量和治疗依从性。
OBJECTIVE: To explore the application of systematic nursing in patients with maniac access of bipolar disorder and its impact on treatment compliance and quality of life.
METHODS: Using a random number table method, 91 patients with manic episodes of bipolar disorder were divided into a control group (n=46, received conventional nursing) and an observation group (n=45, combined with systematic care including health education, ward environment, mental health nursing, and rehabilitation training, mental state assessment and family and social support). The treatment compliance of Morisky Medication Adherence Scale (MMAS), the manic state of Bech-Rafaelsdn Mania Rating Scale (BRMS), the mental state of Hamilton Depression Scale (HAMA) and Hamilton Depression Scale (HAMD), the quality of life of Generic Quality of Life Inventory-74 (GQOLI-74), the self-efficacy of Strategies Used by Patients to Promote Health (SUPPH), and the cognitive function of the Chinese Version of the Wechsler Adult Intelligence Scale Revised (WAIS-RC) before and 3 months after intervention were compared.
RESULTS: After intervention, the BRMS scores of the patients in both groups were significantly decreased, and those in the observation group were lower than those in the control group (all P<0.05). After intervention, the MMAS scores of patients in the observation group were significantly higher than those in the control group (P<0.05). After intervention, the scores of GQOLI-74, SUPPH and WAIS-RC in the observation group were significantly higher than those in the control group (all P<0.05). After intervention, the scores of HAMA and HAMD in both groups decreased, and those in the observation group were lower than those in the control group (all P<0.05).
CONCLUSIONS: Systematic nursing for patients with maniac access of bipolar disorder can clearly relieve their bad moods, control their manic state, and improve their self-efficacy, quality of life and treatment compliance.