摘要
目的 探讨延续性护理对类风湿关节炎患者自我效能和自我护理能力的影响。方法 选取选取2020年4月至2021年6月我院类风湿关节炎住院患者60例为研究对象，随机分为对照组与观察组各30例。对照组予以常规护理；观察组在常规护理基础上实施延续性护理干预，于入院时、出院6月比较两组病人类风湿关节炎相关指标（红细胞沉降率、Ｃ反应蛋白、类风湿因子）变化；采用视觉模拟评分法（VAS）及医学应对方式问卷 （MCMQ）、中文版类风湿关节炎自我效能量表（Rheumatoid Arthritis Self-Efficacy Scale, RASE）、自我护理能力量表（ESCA），评价患者的自我效能及自我护理能力。结果 入院时两组患者自我效能、自我护理能力评分无差异（P＞0.05），出院后6月患者自我效能、自我护理能力评分高于入院时（P＜0.05），研究组自我效能、自我护理能力评分高于对照组（P＜0.05）。研究组和对照组病人的类风湿关节炎相关指标在干预前后无显著相关。结论 延续性护理能显著改善类风湿关节炎患者自我效能，提高患者的自我护理能力。
关键词： 类风湿关节炎；延续性护理；自我效能；自我护理能力；红细胞沉降率；Ｃ反应蛋白；类风湿因子
Abstract
Objective To explore the effect of continuous nursing on self-efficacy and self-care ability of patients with rheumatoid arthritis. Methods A total of 60 inpatients with rheumatoid arthritis in our hospital from April 2020 to June 2021 were selected as the research objects, and they were randomly divided into the control group and the observation group with 30 cases in each group. The control group received routine nursing; the observation group received continuous nursing intervention on the basis of routine nursing, and the changes of rheumatoid arthritis-related indicators (erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor) were compared between the two groups at the time of admission and 6 months after discharge. ; Using Visual Analogue Scale (VAS), Medical Coping Style Questionnaire (MCMQ), Chinese version of Rheumatoid Arthritis Self-Efficacy Scale (Rheumatoid Arthritis Self- Efficacy Scale, RASE), Self-Care Ability Scale (ESCA) to evaluate patients self-efficacy and self-care abilities. Results There was no difference in the scores of self-efficacy and self-care ability between the two groups at admission (P>0.05). The scores of self-efficacy and self-care ability of patients 6 months after discharge were higher than those at admission (P<0.05). The ability score was higher than that of the control group (P<0.05). There was no significant correlation between the rheumatoid arthritis-related indicators in the study group and the control group before and after the intervention. Conclusion Continuous nursing can significantly improve the self-efficacy and self-care ability of patients with rheumatoid arthritis.
Key words： Rheumatoid arthritis; continuous care; self-efficacy; self-care ability; erythrocyte sedimentation rate; C-reactive protein; rheumatoid factor
参考文献 References
[1] 刘建军,白洁,李晓平,郝亮亮,赵丽,胡彦君.类风湿关节炎四肢关节病变的磁共振 影像学表现[J].中国药物与临床,2016,16(10):1431-1433.
[2] Guo G, Fu T, Yin R, et al. Sleep quality in Chinese patients with rheumatoid arthritis: contributing factors and effects on health-related quality of life[J]. Health Qual Life Outcomes,2016,14(1):151.
[3] 张贤政,张玲玲,魏伟.炎症因子及脂肪因子参与类风湿关节炎并发心血管疾病的 研究进展[J].医药导报,2017,36(11):1283-1287.
[4] 张震,李维,时广宇,等.疼痛点定位视觉模拟评分法联合影像学检查对输尿管结石定位的诊断价值[J].中国医科大学学报,2012,40(11):1011-1013.
[5] Shapiro DE, Rodrigue JR, Boggs SR, et al. Cluster analysis of the medical coping modes questionnaire: evidence for coping with cancer styles?[J]. J Psychosom Res, 1994,38(2):151-159.
[6] 赵上萍,陈红.中文版类风湿关节炎自我效能量表信度与效度检验[J].护理研究,2019,33(10).
[7] Yamashita M. The exercise of self care agency scale[J]. West Nursers, 1998,20(3):370-381.
[8] 王亚亚,戴明辉,万巧琴,等.携带管路出院患者延续护理服务需求调查分析[J].中国护理管理, 2013,13(10):31-33.
[9] 孔德华.老年类风湿关节炎患者护理中的综合化服务应用分析[J].影像研究与医学应用,2017, 1(7):233-234.
[10] 黄映华,张伟勇,郭粉莲.延续性护理对类风湿关节炎病人生存质量的影[J].护理研究,2015,35:4461-4463.
[11] 张欢,张春燕,王薇.延续性护理方案在类风湿关节炎患者中的应用[J].解放军护 理杂志,2017,16:38-41.
[12] 卢秀芳,傅萍. 基于微信平台的延伸护理服务对类风湿关节炎病人的影[J].全科护理， 2017,32:3987-398.