儿童医疗辅导对重症肺炎患儿舒适度及心理状态的影响

黄丽; 邵梦云; 朱雷禹; 诸海燕; 姚欢迎

doi:10.16766/j.cnki.issn.1674-4152.003139

儿童医疗辅导对重症肺炎患儿舒适度及心理状态的影响

doi: 10.16766/j.cnki.issn.1674-4152.003139

1.
绍兴市人民医院儿内科，浙江绍兴 312000
2.
绍兴市人民医院社工部
3.
绍兴市人民医院护理部

基金项目:

浙江省医药卫生科技计划项目 2023KY363

详细信息

通讯作者:
黄丽，E-mail：13157505649@163.com

中图分类号: R473.72 R725.6
计量
- 文章访问数: 307
- HTML全文浏览量: 166
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2023-04-13
- 网络出版日期: 2023-09-13

Effect of medical counseling on the comfort and psychological status of children with severe pneumonia

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

摘要

摘要: 目的分析儿童医疗辅导在重症肺炎患儿中的应用效果及对患儿舒适度及心理状态的影响。方法选取2018年3月—2022年9月绍兴市人民医院收治的100例重症肺炎患儿作为研究对象，根据随机数字表法将其分为对照组(50例)和观察组(50例)。对照组患儿应用常规护理，观察组在对照组基础上应用儿童医疗辅导。采用儿童舒适度问卷、儿童焦虑性情绪障碍筛查表(SCARED)及抑郁障碍自评量表(DSRSC)比较2组患儿干预前后舒适度、心理状态，统计2组患儿治疗依从性及家长满意度。结果干预后，观察组患儿舒适度总分为(8.79±0.85)分，低于对照组[(13.83±1.54)分]，差异有统计学意义(P < 0.05)；干预后，观察组患儿SCARED、DSRSC量表得分分别为(18.72±2.41)分、(12.37±1.64)分，均低于对照组[(21.35±3.91)分、(15.48±2.10)分]，差异有统计学意义(均P < 0.05)。观察组患儿治疗依从性高于对照组(P < 0.05)。观察组患儿家长护理满意度高于对照组(P < 0.05)。结论儿童医疗辅导能有效提高重症肺炎患儿的舒适度，缓解患儿焦虑、抑郁情绪，提高患儿治疗依从性及家长满意度。
- 儿童医疗辅导 /
- 重症肺炎 /
- 舒适度 /
- 心理状态
Abstract: Objective To analyze the application effect of pediatric medical counseling in children with severe pneumonia and its impact on their comfort and psychological state. Methods A total of 100 children with severe pneumonia, who admitted to Shaoxing People' s Hospital from March 2018 to September 2022, were divided into a control group and an observation group with 50 cases each according to a random number table method. The children in the control group received routine care, while the observation group received medical guidance for children based on the control group. The comfort and psychological status of the two groups of children were compared before and after intervention using the children' s comfort questionnaire and (the screen for child anxiety related emotional disorders, SCARED) and (depression self-rating scale for children, DSRSC), and the treatment compliance and parental satisfaction of the two groups of children were calculated. Results After intervention, the total comfort score of the observation group was (8.79±0.85) points, which was lower than that in the control group [(13.83±1.54) points], P < 0.05; after intervention, the scores of SCARED and DSRSC in the observation group were (18.72±2.41) points and (12.37±1.64) points, which were less than that in the control group [(21.35±3.91) points and (15.48±2.10) points], all P < 0.05. The compliance of the children in the observation group was higher than that in the control group (P < 0.05). The care satisfaction rate of the observation group was higher than in the control group (P < 0.05). Conclusion The pediatric medical guidance can effectively improve the comfort of children with severe pneumonia, alleviate their anxiety and depression, improve their treatment compliance and parents' satisfaction with their care.
- Medical counseling for children /
- Severe pneumonia /
- Comfort /
- Mentality

HTML全文

表 1 2组重症肺炎患儿一般资料比较

Table 1. Comparison of general data between 2 groups of children with severe pneumonia

组别	例数	性别(例)		年龄 (x±s，岁)	病程 (x±s，d)	疾病类型(例)
组别	例数	男	女	年龄 (x±s，岁)	病程 (x±s，d)	细菌性肺炎	病毒性肺炎	支原体及衣原体肺炎
对照组	50	27	23	8.14±2.38	7.01±2.30	16	18	16
观察组	50	29	21	7.96±2.21	6.87±1.93	14	21	15
统计量		0.162^a		0.392^b	0.330^b	0.369^a
P值		0.687		0.696	0.742	0.820
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 2 2组重症肺炎患儿干预前后舒适度比较(x±s，分)

Table 2. Comparison of comfort level between 2 groups of children with severe pneumonia before and after intervention(x±s, points)

组别	例数	疼痛		饮食障碍		睡眠障碍		娱乐活动缺乏		恐惧		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	干预前	干预后
对照组	50	2.96±0.42	2.08±0.37	2.88±0.73	2.31±0.51	2.61±0.60	2.01±0.39	3.13±0.58	2.88±0.44	3.28±0.35	2.37±0.43	16.91±2.68	13.83±1.54
观察组	50	3.10±0.57	1.61±0.24	2.79±0.81	1.84±0.30	2.68±0.71	1.53±0.42	3.06±0.45	1.29±0.23	3.33±0.41	1.32±0.26	16.87±2.52	8.79±0.85
t值		1.398	7.536	0.584	5.617	0.532	5.922	0.674	22.645	0.656	14.776	0.077	20.260
P值		0.165	< 0.001	0.561	< 0.001	0.596	< 0.001	0.502	< 0.001	0.513	< 0.001	0.939	< 0.001

下载: 导出CSV

表 3 2组重症肺炎患儿干预前后心理状态比较(x±s，分)

Table 3. Comparison of psychological state of 2 groups of children with severe pneumonia before and after intervention(x±s, points)

组别	例数	SCARED量表		DSRSC量表
组别	例数	干预前	干预后	干预前	干预后
对照组	50	25.81±4.18	21.35±3.91	18.77±2.75	15.48±2.10
观察组	50	26.02±4.46	18.72±2.41	19.13±2.83	12.37±1.64
t值		0.243	4.049	0.645	8.253
P值		0.809	< 0.001	0.520	< 0.001

下载: 导出CSV

表 4 2组重症肺炎患儿治疗依从性比较[例(%)]

Table 4. Comparison of treatment compliance between 2 groups of children with severe pneumonia[cases(%)]

组别	例数	完全依从	部分依从	不依从	治疗依从性
对照组	50	20(40)	15(30)	15(30)	35(70)
观察组	50	34(68)	10(20)	6(12)	44(88)
注：2组治疗依从性比较，χ²=4.882，P=0.027。

下载: 导出CSV

表 5 2组重症肺炎患儿家长护理满意度比较[例(%)]

Table 5. Comparison of nursing satisfaction of parents of children with severe pneumonia in 2 groups[cases(%)]

组别	例数	非常满意	满意	一般	不满意	护理满意度
对照组	50	18(36)	24(48)	6(12)	2(4)	42(84)
观察组	50	27(54)	21(42)	2(4)	0	48(96)
注：2组护理满意度比较，χ²=4.000，P=0.046。

下载: 导出CSV

参考文献(20)

[1]	LEE K L, LEE C M, YANG T L, et al. Severe Mycoplasma pneumoniae pneumonia requiring intensive care in children, 2010-2019[J]. J Formos Med Assoc, 2021, 120(1 Pt 1): 281-291.
[2]	NASCIMENTO-CARVALHO C M. Community-acquired pneumonia among children: the latest evidence for an updated management[J]. J Pediatr (Rio J), 2020, 96 Suppl 1(Suppl 1): 29-38.
[3]	时仙芝, 郭洁, 邵彤, 等. 个性化护理对重症肺炎患儿呼吸功能及康复效果的影响[J]. 保健医学研究与实践, 2022, 19(12): 191-194. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202212045.htm SHI X Z, GUO J, SHAO T, et al. Effect of personalized nursing on respiratory function and rehabilitation efficacy in children with severe pneumonia[J]. Health Medicine Research and Practice, 2022, 19(12): 191-194. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202212045.htm
[4]	李雪, 杨立利, 沈怡, 等. 儿童医疗辅导在住院患儿中的应用效果[J]. 护理实践与研究, 2022, 19(9): 1373-1377. doi: 10.3969/j.issn.1672-9676.2022.09.026 LI X, YANG L L, SHEN Y, et al. The application effect of child life specialist in hospitalized children[J]. Nursing Practice and Research, 2022, 19(9): 1373-1377. doi: 10.3969/j.issn.1672-9676.2022.09.026
[5]	张晓乐, 余艮珍. 儿童医疗辅导在慢性肾脏病患儿静脉穿刺中的应用[J]. 护理管理杂志, 2021, 21(2): 132-135. https://www.cnki.com.cn/Article/CJFDTOTAL-HLGL202102017.htm ZHANG X L, YU G Z. Application of Child Life intervention in venipuncture of children with chronic kidney disease[J]. Journal of Nursing Administration, 2021, 21(2): 132-135. https://www.cnki.com.cn/Article/CJFDTOTAL-HLGL202102017.htm
[6]	张顺娣, 顾莺, 胡菲, 等. 儿童医疗辅导照护缓解患儿腰椎穿刺疼痛和父母焦虑研究[J]. 护理学杂志, 2020, 35(24): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202024011.htm HANG S D, GU Y, HU F, et al. Relief of children′s pain level and parents′anxiety level during pediatric lumbar punctures Child Life service model[J]. Journal of Nursing Science, 2020, 35(24): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202024011.htm
[7]	李熙鸿. 儿童重症肺炎诊断标准的优缺点[J]. 中华实用儿科临床杂志, 2017, 32(6): 408-411. doi: 10.3760/cma.j.issn.2095-428X.2017.06.003 LI X H. Merits and demerits of diagnostic code of severe pneumonia in children[J]. Journal of Applied Clinical Pediatrics, 2017, 32(6): 408-411. doi: 10.3760/cma.j.issn.2095-428X.2017.06.003
[8]	朱丽霞, 高凤莉, 罗虹辉, 等. 舒适状况量表的信效度测试研究[J]. 中国实用护理杂志, 2006, 22(13): 57-59. https://www.cnki.com.cn/Article/CJFDTOTAL-SYHL200613036.htm ZHU L X, GAO F L, LUO H H, et al. The study of testing the content validity and the internal consistency of general comfort questionnaire[J]. Chinese Journal of Practical Nursing, 2006, 22(13): 57-59. https://www.cnki.com.cn/Article/CJFDTOTAL-SYHL200613036.htm
[9]	焦敏, 杜亚松. 儿童焦虑性情绪障碍筛查量表的临床应用[J]. 上海精神医学, 2005, 17(2): 72-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI200502002.htm JIAO M, DU Y S. The clinical application of screen for anxiety related emotional disorders[J]. Shanghai Archives of Psychiatry, 2005, 17(2): 72-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI200502002.htm
[10]	苏林雁, 王凯, 朱焱, 等. 儿童抑郁障碍自评量表的中国城市常模[J]. 中国心理卫生杂志, 2003, 17(8): 547-549. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS200308010.htm SU L Y, WANG K, ZHU Y, et al. Norm of The Depression Self-rating Scale for Children in Chinese Urban Children[J]. Chinese Mental Health Journal, 2003, 17(8): 547-549. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS200308010.htm
[11]	DE BENEDICTIS F M, KEREM E, CHANG A B, et al. Complicated pneumonia in children[J]. Lancet, 2020, 396(10253): 786-798.
[12]	刘瑶, 吴金桓, 范铭兴, 等. 动态监测降钙素原对重症社区获得性肺炎患儿抗感染治疗的临床研究[J]. 中华全科医学, 2023, 21(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002841 LIU Y, WU J H, FAN M X, et al. Clinical study of dynamic monitoring of serum procalcitonin for anti-infection treatment in children with severe community acquired pneumonia[J]. Chinese Journal of General Practice, 2023, 21(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002841
[13]	张倩, 郭锦丽, 黄永波, 等. 医疗游戏辅导对学龄期四肢骨折患儿心理状态及疼痛的影响[J]. 护理研究, 2022, 36(19): 3549-3553. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202219033.htm ZHANG Q, GUO J L, HUANG Y B, et al. Effects of medical game counseling on mental state and pain in school-age children with limb fractures[J]. Chinese Nursing Research, 2022, 36(19): 3549-3553. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202219033.htm
[14]	周晓楠, 高迎霞, 曹春艳, 等. 基于萨提亚模式的医疗情景游戏对住院银屑病患儿及家属生活质量和遵医行为的影响[J]. 中国麻风皮肤病杂志, 2022, 38(2): 122-127. https://www.cnki.com.cn/Article/CJFDTOTAL-MALA202202018.htm ZHOU X N, GAO Y X, CAO C Y, et al. Effect of therapeutic games based on Satya model on hospitalized children with psoriasis and their parents[J]. China Journal of Leprosy and Skin Diseases, 2022, 38(2): 122-127. https://www.cnki.com.cn/Article/CJFDTOTAL-MALA202202018.htm
[15]	张冠珣, 李蓉蓉, 阐玉英, 等. 基于儿童医疗辅导理念的急性白血病患儿化疗期症状群干预方案的构建[J]. 中国护理管理, 2022, 22(5): 708-712. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202205008.htm ZHANG G X, LI R R, CHAN Y Y, et al. Construction of intervention program for chemotherapy symptom group of children with Acute Leukemia based on the Child Life concept[J]. Chinese Nursing Management, 2022, 22(5): 708-712. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202205008.htm
[16]	黄华, 张元元, 吴丽芬. 基于拓展-构建理论的医疗游戏干预对血液肿瘤患儿情绪行为的影响[J]. 护理学杂志, 2021, 36(24): 20-24. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202124006.htm HUANG H, ZHANG Y Y, WU L F. Effect of the medical game intervention based on the broaden-and-build theory on emotional behavior of children with hematological tumor[J]. Journal of Nursing Science, 2021, 36(24): 20-24. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202124006.htm
[17]	张冠珣, 李蓉蓉, 阐玉英, 等. 基于儿童医疗辅导理念的急性白血病患儿化疗期症状群干预方案的构建[J]. 中国护理管理, 2022, 22(5): 708-712. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202205008.htm ZHANG G X, LI R R, CHAN Y Y, et al. Construction of intervention program for chemotherapy symptom group of children with Acute Leukemia based on the Child Life concept[J]. Chinese Nursing Management, 2022, 22(5): 708-712. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202205008.htm
[18]	凌芳, 顾莺, 胡菲, 等. 儿童医疗游戏辅导在学龄期重症肺炎患儿中的应用研究[J]. 上海护理, 2021, 21(2): 6-10. https://www.cnki.com.cn/Article/CJFDTOTAL-SHHL202102004.htm LING F, GU Y, HU F, et al. Application of Child Life Training in School-age Children with Severe Pneumonia[J]. Shanghai Nursing, 2021, 21(2): 6-10. https://www.cnki.com.cn/Article/CJFDTOTAL-SHHL202102004.htm
[19]	顾莺, 张晓波, 傅丽丽, 等. 儿童医疗游戏辅导护理专业队伍的建设与管理[J]. 中国护理管理, 2019, 19(5): 761-764. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL201905036.htm GU Y, ZHANG X B, FU L L, et al. The construction and operating of a professional nursing team of Child Life programme[J]. Chinese Nursing Management, 2019, 19(5): 761-764. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL201905036.htm
[20]	庞芳, 杨彬. 医疗游戏在住院儿童治疗中的人文实践[J]. 解放军医院管理杂志, 2018, 25(12): 1193-1195. https://www.cnki.com.cn/Article/CJFDTOTAL-JFYG201812029.htm PANG F, YANG B. Humanistic Practice and Experience of Therapeutic Games in the Treatment of Hospitalized Pediatric Patients[J]. Hospital Administration Journal of Chinese People's Liberation Army, 2018, 25(12): 1193-1195. https://www.cnki.com.cn/Article/CJFDTOTAL-JFYG201812029.htm