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共享决策联合患者导航护理应用于脑血管畸形介入栓塞术患者中的效果分析

Effect of shared decision-making combined with patient navigation nursing in patients undergoing endovascular embolization for cerebral vascular malformation

    摘要
  • 摘要:
    目的 探讨共享决策联合患者导航护理模式对脑血管畸形介入栓塞术患者自护技能、应对方式的影响。
    方法 选取行脑血管畸形介入栓塞术患者80例，按照随机数字表法分为对照组和干预组。对照组40例，行常规干预措施; 干预组40例，在对照组基础上行共享决策联合患者导航护理模式干预。比较干预前后2组自护技能(脑卒中患者自我管理行为量表)、应对方式医学应对问卷(MCMQ)、心理状态抑郁焦虑压力量表(DASS-21)、康复效果美国国立卫生研究院卒中量表(NHISS)、Barthel指数(BI)。
    结果 干预后, 2组自我管理行为量表中各维度评分以及总分均升高，且干预组升高幅度更大，差异有统计学意义(P < 0.05); 2组MCMQ中回避与屈服评分降低，面对评分升高，且干预组升高或降低的幅度更大，差异有统计学意义(P < 0.05); 2组DASS-21中抑郁、焦虑以及压力维度的评分均下降，且干预组下降幅度更大，差异有统计学意义(P < 0.05); 2组NHISS评分降低, BI评分升高，且干预组升高或降低的幅度更大，差异有统计学意义(P < 0.05)。
    结论 共享决策联合患者导航护理模式可提升脑血管畸形介入栓塞术患者的自主护理能力，改善其疾病应对方式，实现生理与心理的双重康复效果。

     

    Abstract:
    Objective To explore the impact of the shared decision-making combined with patient navigation nursing model on self-care skills and coping styles in patients undergoing endovascular embolization for cerebral vascular malformation.
    Methods A total of 80 patients who underwent endovascular embolization for cerebral vascular malformation were selected and divided into control group (40 cases) and intervention group (40 cases) according to the random number table method. The control group (n=40) received routine intervention measures, while the intervention group (n=40) received shared decision-making combined with patient navigation nursing model intervention in addition to the control group's measures. Self-care skills (using the Stroke Self-Management Behavior Scale), coping styles using the Medical Coping Modes Questionnaire (MCMQ), psychological status using the Depression Anxiety Stress Scale (DASS-21), and rehabilitation outcomes using the National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) were compared between the two groups before and after the intervention.
    Results After the intervention, the scores of each dimension and the total score on the Self-management Behavior Scale increased in both groups, with a greater increase in the intervention group (P < 0.05). The avoidance and resignation scores in the MCMQ decreased, while the confrontation score increased in both groups, with a greater increase or decrease in the intervention group (P < 0.05). In the DASS-21, the scores of the depression, anxiety, and stress dimensions decreased in both groups, with a greater decrease in the intervention group, and the difference was statistically significant (P < 0.05). The NHISS scores decreased, and the BI scores increased in both groups, with a greater increase or decrease in the intervention group (P < 0.05).
    Conclusion The shared decision-making combined with patient navigation nursing model can enhance the self-care ability of patients undergoing endovascular embolization for cerebral vascular malformation, improve their disease coping styles, and achieve dual rehabilitation effects on both physical and psychological aspects.

     

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