阶梯式护理模式对双相障碍患者服药依从性与社会功能的影响

陈新霞; 何飞; 陈梦逸; 冯虹

doi:10.16766/j.cnki.issn.1674-4152.003053

阶梯式护理模式对双相障碍患者服药依从性与社会功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.003053

陈新霞^1, ,,
何飞¹,
陈梦逸¹,
冯虹²

1.
绍兴市第七人民医院精神科，浙江绍兴 312000
2.
绍兴市第七人民医院心身障碍科

基金项目:

浙江省医药卫生科技计划项目 2022RC279

详细信息

通讯作者:
陈新霞，E-mail：chenxinxiacxx@163.com

中图分类号: R473.5 R749.41
计量
- 文章访问数: 133
- HTML全文浏览量: 33
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-13
- 网络出版日期: 2023-08-26

Effect of ladder nursing mode on medication compliance and social function of patients with bipolar disorder

1.
Department of Psychiatry, Shaoxing Seventh People ' s Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的分析阶梯式护理模式在双相障碍患者中的应用效果，及对患者服药依从性与社会功能的影响，为临床护理提供新思路。方法选取2020年1月—2022年1月绍兴市第七人民医院收治的110例双相障碍患者作为研究对象，根据随机数字表法将其分为对照组和观察组，每组55例。对照组患者应用常规护理，观察组在对照组基础上应用阶梯式护理模式。采用汉密顿抑郁量表(HAMD)、轻躁狂自评表(HCL-32)、Morisky服药依从性量表及社会功能缺陷筛选量表(SDSS)比较2组患者干预前后临床症状、服药依从性及社会功能。结果干预后，观察组患者HAMD及HCL-32评分分别为(14.04±2.54)分、(5.02±1.16)分，均低于对照组的(16.81±3.21)分、(6.88±1.83)分，差异有统计学意义(均P＜0.05)；观察组患者服药依从率为90.9%(50/55)，高于对照组的76.4%(42/55)，差异有统计学意义(P＜0.05)；干预后，观察组SDSS量表总分为(8.18±0.20)分，低于对照组的(9.71±0.34)分(P＜0.05)。结论阶梯式护理模式能改善双相障碍患者心理状况，提高患者服药依从性，促进社会功能的恢复。
- 双相障碍 /
- 阶梯式护理模式 /
- 服药依从性 /
- 社会功能
Abstract: Objective To analyze the application effect of ladder nursing mode in patients with bipolar disorder, as well as its impact on medication compliance and social function, providing new ideas for clinical nursing. Methods A total of 110 patients with bipolar disorder admitted in Shaoxing Seventh People ' s Hospital from January 2020 to January 2022 were selected as the study subjects. According to random number table method, they were divided into control group and observation group with 55 cases each. The patients in the control group were treated with routine nursing, while the patients in the observation group were treated with ladder nursing mode on the basis of the control group. The clinical symptoms, medication compliance and social function of patients in the two groups were compared using Hamilton depression scale (HAMD), hypomania self-rating scale (HCL-32), Morisky drug compliance scale and social function deficiency screening scale (SDSS) before and after intervention. Results After intervention, the HAMD and HCL-32 scores of the observation group patients were (14.04?.54) points and (5.02?.16) points, respectively, which were lower than the (16.81?.21) and (6.88?.83) points of the control group (P < 0.05). The compliance rate of patients in the observation group was 90.9% (50/55), higher than 76.4% (42/55) in the control group (P < 0.05). The total score of the SDSS scale in the observation group was (8.18?.20) points, which was lower than the control group [(9.71?.34) points], P < 0.05. Conclusion The ladder nursing model can improve the psychological status of patients with bipolar disorder, improve the compliance of patients with medication, and promote the recovery of social function.
- Bipolar disorder /
- Ladder nursing mode /
- Medication compliance /
- Social function

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表 1 2组双相障碍患者一般资料比较(x±s)

Table 1. Comparison of general data between the two groups of patients with bipolar disorder (x±s)

组别	例数	性别(例)		年龄(x±s，岁)	双相亚型(例)		病程(x±s，年)	受教育年限(x±s，年)
组别	例数	男性	女性	年龄(x±s，岁)	Ⅰ型	Ⅱ型	病程(x±s，年)	受教育年限(x±s，年)
对照组	55	25	30	31.28±6.14	31	24	9.10±3.15	15.66±3.24
观察组	55	27	28	31.31±5.66	36	19	9.04±2.88	15.70±3.58
统计量		0.145^a		0.027^b	0.955^a		0.104^b	0.061^b
P值		0.709		0.979	0.329		0.917	0.951
注：^a为χ²值，^b为t值。

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表 2 2组双相障碍患者干预前后临床症状评分比较(x±s，分)

Table 2. Comparison of clinical symptom scores before and after intervention between the two groups of patients with bipolar disorder (x±s, points)

组别	例数	HAMD		HCL-32
组别	例数	干预前	干预后	干预前	干预后
对照组	55	20.06±3.18	16.81±3.21^a	8.46±2.29	6.88±1.83^a
观察组	55	20.01±3.11	14.04±2.54^a	8.51±2.17	5.02±1.16^a
t值		0.083	13.099	0.118	6.366
P值		0.934	<0.001	0.906	<0.001
注：与同组干预前比较，^aP<0.05。

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表 3 2组双相障碍患者服药依从性比较[例(%)]

Table 3. Comparison of medication compliance between the two groups of patients with bipolar disorder [cases (%)]

组别	例数	依从性良好	依从性中等	依从性差	服药依从
对照组	55	29(52.7)	13(23.6)	13(23.6)	42(76.4)
观察组	55	39(70.9)	11(20.0)	5(9.1)	50(90.9)
注：2组服药依从率比较，χ²=4.251，P=0.039。

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表 4 2组双相障碍患者干预前后社会功能评分比较(x±s，分)

Table 4. Comparison of social function scores before and after intervention the two groups of patients with bipolar disorder (x±s, points)

组别	例数	职业功能		婚姻职能		父母职能		社会退缩		家里活动
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	55	1.66±0.32	1.32±0.25	1.31±0.31	1.17±0.21	1.33±0.38	1.15±0.28	1.20±0.27	1.04±0.19	1.28±0.21	1.11±0.25
观察组	55	1.63±0.34	1.18±0.20	1.28±0.29	1.01±0.23	1.37±0.33	0.94±0.21	1.22±0.30	0.85±0.11	1.26±0.27	0.97±0.12
t值		0.477	3.243	0.524	3.810	0.589	4.450	0.367	6.418	0.434	3.744
P值		0.634	0.002	0.601	<0.001	0.557	<0.001	0.714	<0.001	0.665	<0.001

组别	例数	家庭职能		自我照顾		关注社会		责任心		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	55	1.31±0.35	1.20±0.28	1.06±0.31	0.91±0.16	1.15±0.28	1.02±0.18	1.44±0.30	1.24±0.29	11.88±0.65	9.71±0.34
观察组	55	1.33±0.29	0.99±0.13	1.11±0.33	0.72±0.12	1.12±0.31	0.85±0.15	1.41±0.26	1.10±0.22	11.90±0.63	8.18±0.20
t值		0.326	5.045	0.819	7.045	0.533	5.381	0.560	2.852	0.164	28.765
P值		0.745	<0.001	0.415	<0.001	0.595	<0.001	0.577	0.005	0.870	<0.001

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