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目的探讨综合护理干预对脑卒中后患者失眠伴焦虑的影响。方法选取2013年12月—2016年7月台州医院神经内科收治的脑卒中后失眠伴焦虑患者168例,按随机数字表法分组,对照组84例予以常规护理,研究组84例在对照组基础上予以综合护理干预,包括心理护理、康复训练、饮食护理、睡前护理以及药物护理。干预后观察并记录2组间心理状态、睡眠质量、认知功能、神经功能及运动功能,同时对比临床疗效。结果与对照组比较,研究组干预后汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)、Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS)评分较低,干预后醒觉次数、入睡潜伏期时间及匹兹堡睡眠质量指数(PSQI)评分较低,睡眠总时间、睡眠效率较高,干预后简明精神状态量表(MMSE)、简式Fugl-Meyer运动功能评分法(FMA)评分较高,脑卒中神经功能缺损评分表(CNS)评分较低,差异具有统计学意义(P<0.05);研究组治疗有效率为80.95%(68/84),高于对照组治疗有效率95.24%(80/84),差异具有统计学意义(Z=2.595,P=0.010)。结论综合护理干预能够有效缓解脑卒中后失眠伴焦虑患者的焦虑情绪,提高睡眠质量,改善认知功能、神经功能及运动功能,提高患者生活质量,护理效果确切。
Objective To investigate the effect of comprehensive nursing intervention on insomnia and anxiety in patients with post-stroke stroke. Methods A total of 168 cases of post-stroke insomnia with anxiety admitted to Taizhou Hospital from December 2013 to July 2016 were randomly divided into two groups according to random number table. Eighty-four patients in the control group were given routine nursing care. The study group consisted of 84 patients in the control group Comprehensive nursing interventions include psychological care, rehabilitation training, dietary care, bedtime care and drug care. After intervention, the psychological status, sleep quality, cognitive function, neurological function and motor function of the two groups were observed and compared. Clinical efficacy was also compared. Results Compared with the control group, the HAMA, HAMD, SDS and SDS scores of the study group were lower than those of the control group. After the intervention, the scores of the Hamilton anxiety scale (HAMA), depression scale (HAMD), Zung’s anxiety self-rating scale PSQI score, total sleep time, high sleep efficiency, MMSE and FMA (simple FMA) were significantly higher in wakefulness, sleep latency and Pittsburgh Sleep Quality Index (PSQI) (P <0.05). The effective rate of the study group was 80.95% (68/84), which was higher than that of the control group Efficiency 95.24% (80/84), the difference was statistically significant (Z = 2.595, P = 0.010). Conclusion Comprehensive nursing intervention can effectively relieve the anxiety in patients with insomnia and anxiety after stroke, improve the quality of sleep, improve cognitive function, nerve function and motor function, and improve the quality of life of patients with definite effect of nursing.