本文選題：病毒性腦炎　切入點：后遺癥　出處：《貴州醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:基于家長在重癥病毒性腦炎后遺癥兒童延續(xù)性護理需求的調(diào)查基礎(chǔ)上,建立了重癥病毒性腦炎后遺癥兒童的延續(xù)性護理模式,并驗證該模式的有效性。方法:類實驗研究,非同期對照。2015年7月—10月通過自行設計的問卷,采用方便抽樣的方法,抽取貴州醫(yī)科大學附屬醫(yī)院、貴州省人民醫(yī)院、貴州省兒童醫(yī)院即將出院的重癥病毒性腦炎后遺癥患兒家長126例,探討其延續(xù)性護理的需求。2015年10月—12月采取德爾菲法對貴州省6所醫(yī)院和1所護理院校22名專家開展兩輪函詢,根據(jù)函詢結(jié)果,最終確立重癥病毒性腦炎后遺癥兒童的延續(xù)性護理模式。將2015年7月—12月于貴州醫(yī)科大學附屬醫(yī)院就診的重癥病毒性腦炎后遺癥患兒及家長44例設為對照組,并實施常規(guī)出院護理。將2016年1月—6月于貴州醫(yī)科大學附屬醫(yī)院就診的重癥病毒性腦炎后遺癥患兒及家長設為實驗組,并開展延續(xù)性護理模式。實驗組在出院時、離院1個月、離院3個月分別用兒童生存質(zhì)量普適性核心量表進行患兒的生存質(zhì)量本身的評估對比,對照組在出院時、離院1個月、離院3個月分別用兒童生存質(zhì)量普適性核心量表進行患兒的生存質(zhì)量本身的評估對比,再將兩組患兒不同時期生存質(zhì)量評分進行效果評價對比,并且實驗組分別于出院時、離院3個月進行SVE后遺癥兒童家長照護知識問卷評分。采用獨立樣本t檢驗、?2檢驗和Mann-Whitney U秩和檢驗、配對樣本t檢驗、重復測量方差分析進行數(shù)據(jù)分析,使用SPSS 22.0軟件進行統(tǒng)計分析。結(jié)果:(1)通過對126例即將出院的患兒家長進行調(diào)查,94%家長希望獲得出院延續(xù)性護理,在21項延續(xù)性護理內(nèi)容需求中,結(jié)果顯示家長對延續(xù)性護理內(nèi)容需求有:100.00%家長對精神心理咨詢有強烈需求、約96.04%家長對運動功能障礙等并發(fā)癥指導有需求,此外,患兒家長還對社會支持、日常活動、知識指導、照顧能力方面存在一定需求。家長對延續(xù)性護理需求方式占前3位的分別是電話短信占88.12%、門診復診占83.17%、網(wǎng)絡交流占76.24%,其中家庭訪視需求最低。(2)通過兩輪函詢后,專家積極系數(shù)為100%,權(quán)威系數(shù)(Cr)為0.87,各級指標的協(xié)調(diào)系數(shù)(W)依次為0.324、0.516,且所有的統(tǒng)計檢驗水準α=0.05。最后確定的延續(xù)性護理模式包含4個一級指標和25個二級指標,一級指標條目的評分均數(shù)±標準差為3.93±0.86~4.87±0.35;變異系數(shù)(CV)為0.07~0.20;滿分比為46.67%~86.67%,選擇率為73.33%~100.00%。二級指標條目的評分均數(shù)±標準差為4.21±0.87~4.94±0.27;變異系數(shù)(CV)為0.07~0.22;滿分比為40.00%~93.33%,選擇率為73.33%~100.00%。(3)實施延續(xù)性護理模式方案,兩組患兒及家庭基線資料在出院時差異無統(tǒng)計學意義(P0.05),5~7歲和8~12歲實驗組與對照組患兒出院時生存質(zhì)量各維度評分差異無統(tǒng)計學意義(P0.05);5~7歲和8~12歲兩組患兒出院時、離院1個月、離院3個月患兒生存質(zhì)量各維度評分逐漸增加,差異有統(tǒng)計學意義(P0.05),且實驗組增長幅度高于對照組(P0.05)。實驗組患兒出院時、離院3個月后家庭照護知識得分差異有統(tǒng)計學意義(P0.05)。結(jié)論:(1)延續(xù)性護理需求的調(diào)查是建立延續(xù)性護理模式的基礎(chǔ)。(2)延續(xù)性護理模式的形成的方案具有創(chuàng)新性、針對性,可以為兒科護理提供依據(jù)和參考。(3)生存質(zhì)量的評價反映了重癥病毒性腦炎后遺癥患兒通過延續(xù)性護理模式的實施效果,并且增強了家長對疾病知識的掌握程度,在臨床工作中值得推廣。
[Abstract]:Objective: Based on the survey of parents based continuous care needs in patients with severe viral encephalitis sequela in children, a continuing nursing mode of severe sequelae of viral encephalitis in children, and verify the validity of the model. Methods: experimental study,.2015 in July October by the self-designed questionnaire of non control over the same period, with convenient sampling method, Guizhou People's Hospital Affiliated Hospital of Guizhou Medical University, extraction, 126 cases of severe viral encephalitis sequelae in children with parents of children's Hospital of Guizhou province to the hospital, to explore the continuity of care needs.2015 in October December by Delphy Fa carried out two rounds consultation in 6 hospitals in Guizhou Province and 1 nursing colleges in 22 experts, according to the letter the final establishment of continuity of care in children with severe viral encephalitis sequela. July 2015 - December in the Affiliated Hospital of Guizhou Medical University Treatment of severe sequelae of viral encephalitis of children and parents in 44 cases as control group, and routine nursing. In January 2016 to June in Guizhou Medical University Affiliated Hospital with severe sequelae of viral encephalitis of children and parents for the experimental group, and carry out continuous nursing mode. In the experimental group when discharged from hospital, 1 a month away from the hospital, 3 months respectively suitable core scale comparative assessment of quality of life for children itself with ordinary children's living quality, the control group at the time of discharge from the hospital, 1 months, 3 months respectively from the hospital of core scale comparative assessment of quality of life of children with itself with ordinary quality the survival of children, the quality of life in different periods in two groups were evaluated and compared the effect, and the experimental group were discharged from the hospital, 3 months for parents of children with sequelae of SVE care knowledge questionnaire score. Using independent sample t test Experiment 2? Mann-Whitney test and U rank sum test, paired samples t test, analysis of variance of repeated measurement data analysis, using SPSS 22 software for statistical analysis. Results: (1) according to a survey of parents of children with 126 cases to be discharged, 94% parents hope to obtain discharge continuity of care, in 21 continuity nursing needs, results showed that the parents of the continuing nursing care content needs: 100% parents have a strong demand for psychological counseling, about 96.04% parents have needs, to guide the movement dysfunction and other complications in addition, parents of social support, daily activities, knowledge guidance, there needs care ability. The parents of the continuation of demand nursing mode of the top 3 were telephone messages accounted for 88.12%, accounted for 83.17% of outpatient visits, network exchange accounted for 76.24%, the family visit demand the lowest. (2) through two rounds of expert consultation, expert product A coefficient of 100%, authority coefficient (Cr) was 0.87, the coordination coefficient of each index (W) were 0.324,0.516, including continuity of care and statistical test level a =0.05. all the final 4 indexes and 25 two level indicators, level indicators to score standard deviation 3.93 + 0.86~4.87 + 0.35; the coefficient of variation (CV) for 0.07~0.20; out than to 46.67%~86.67%, select the rate of 73.33%~100.00%. two level index to score standard deviation was 4.21 + 0.87~4.94 + 0.27; the coefficient of variation (CV) for 0.07~0.22; out of more than 40% ~93.33%, the selectivity of 73.33%~100.00%. (3) implementation continuous nursing mode, two groups of children and families in the baseline data of discharge and no significant difference (P0.05), 5~7 and 8~12 years old experimental group and the control group were all dimensions of quality of life score no significant difference (P0.05); 5~7 and 8~12 At the age of two groups of patients discharged from hospital, 1 months, 3 months away from the hospital in all dimensions of quality of life score gradually increased, the difference was statistically significant (P0.05), and the growth rate of experimental group was higher than the control group (P0.05). In the experimental group when discharged from the hospital after 3 months of family care knowledge scores there was statistical significance (P0.05). Conclusion: (1) survey of extended care needs is the basis of continuous nursing mode. (2) continuous nursing mode scheme for the formation of innovative, targeted, can provide the basis and reference for pediatric nursing. (3) the quality of life evaluation reflects children the sequelae of severe viral encephalitis by the effect of continuous nursing mode, and enhance the parents' mastery of the knowledge of disease, worthy of promotion in clinical work.

【學位授予單位】：貴州醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.72

【參考文獻】

相關(guān)期刊論文 前10條

1 李宇紅;陸月岑;黃瑤;阮洪;吳正一;;運用Delphi法構(gòu)建口腔門診護士工作范疇[J];上海口腔醫(yī)學;2016年05期

2 顏麗;劉嬌;楊嵐;;延續(xù)性護理對膽道閉鎖術(shù)后患兒的護理效果分析[J];繼續(xù)醫(yī)學教育;2016年06期

3 王穎;單偉超;閆宏偉;李青;辛小林;單偉穎;;我國開展延續(xù)期護理存在的問題及建議[J];護士進修雜志;2016年12期

4 汪燕妮;薛紅麗;陳倩;;家庭親密度和適應性對學齡前兒童行為問題的影響[J];中國當代兒科雜志;2016年05期

5 蒙婷婷;李亞玲;;早產(chǎn)兒父母延續(xù)性護理需求狀況調(diào)查與分析[J];川北醫(yī)學院學報;2016年02期

6 李尉萌;張繼華;尚清;;早期康復介入對重癥病毒性腦炎患兒運動功能、智力的影響[J];臨床醫(yī)藥文獻電子雜志;2016年12期

7 丁金花;苗歌;曾小燕;宋敏;吳克念;;過敏性紫癜患兒出院后延續(xù)護理需求的質(zhì)性研究[J];護士進修雜志;2016年08期

8 楊輝;唐珊;;山西省腦卒中病人出院后延續(xù)性護理模式探索研究[J];護理研究;2016年09期

9 唐穎;孫曉燕;溫賢秀;陳德志;;延續(xù)護理信息平臺的構(gòu)建及應用[J];中國護理管理;2016年03期

10 李丹鳳;鄧烈夏;陳筱玲;;腰椎間盤突出癥患者延續(xù)性護理需求調(diào)查與對策[J];齊魯護理雜志;2016年04期

相關(guān)碩士學位論文 前6條

1 韋誠誠;重型β-地中海貧血患兒造血干細胞移植術(shù)后生存質(zhì)量及其影響因素的研究分析[D];廣西醫(yī)科大學;2015年

2 魯玉姣;先天性肛門直腸畸形兒童生存質(zhì)量及影響因素研究[D];南華大學;2015年

3 李君麗;以家庭為中心的護理對原發(fā)性腎病綜合征兒童生活質(zhì)量影響的研究[D];廣西醫(yī)科大學;2013年

4 陳燕;北京地區(qū)慢性心力衰竭患者延續(xù)性照護模式的初步探索[D];北京協(xié)和醫(yī)學院;2013年

5 羅西貝;白血病住院患兒的生存質(zhì)量及其影響因素研究[D];華中科技大學;2011年

6 黃衛(wèi)東;長春市社區(qū)護理需求與對策[D];吉林大學;2007年

，

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