Stanford a型主动脉夹层术后谵妄分层护理干预方案的构建与应用:准实验试验。

IF 2.1 3区 医学 Q2 ANESTHESIOLOGY
Xueping Li, Miaomiao Zheng, Ailin Lin, Chaohong Chen, Yuanbo Wu, Huai Zhang, Zhiqin Yin
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引用次数: 0

摘要

背景:术后谵妄是a型主动脉夹层术后患者常见且重要的后果;然而,目前尚无有效的术后护理方案。目的:本研究的目的是制定和评估分层护理干预方案对斯坦福a型主动脉夹层手术患者术后谵妄的实际实施。方法:采用文献回顾、小组讨论、专家邮件询问德尔菲法等方法,对术后谵妄患者进行分层护理干预。采用准实验设计,以中国温州某三级医院普通病房的患者为研究对象。于2022年9月至12月选取43例患者作为对照组,给予标准治疗。干预组于2023年1 - 6月招募37例患者,接受常规护理和干预方案。比较两组的干预效果。结果:干预组谵妄和住院时间明显短于对照组(P < 0.05)。结论:在病房环境下实施该护理干预可缩短患者术后谵妄和住院时间,提高患者对护理的满意度,改善患者预后和生活质量。这种干预也将为今后谵妄术后的临床管理提供重要的资源。试验注册:国家卫生安全信息平台医学研究注册信息系统已为本研究注册,注册号为MR-33-22-022978。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Construction and application of a stratified nursing intervention program for postoperative delirium after Stanford type A aortic dissection: a quasi-experimental trial.

Background: Postoperative delirium is a common and significant consequence in patients with type A aortic dissection following surgery; however, there is currently no effective postoperative care plan.

Objective: The purpose of this study is to develop and evaluate the practical implementation of a stratified nursing intervention program for postoperative delirium in patients undergoing surgery for Stanford type A aortic dissection.

Methods: A stratified nursing intervention program for postoperative delirium was created using a literature review, group discussions, and the Delphi method via expert mail inquiry. A quasi-experimental design was used, with patients admitted to the general ward of a tertiary hospital in Wenzhou, China, functioning as subjects. From September to December 2022, 43 patients were included in the control group and given standard treatment. From January to June 2023, 37 patients were recruited in the intervention group, receiving both routine care and the intervention plan. The intervention's effects were compared in the two groups.

Results: The intervention group had considerably shorter delirium and hospital stays than the control group (P < 0.05), as well as higher patient satisfaction levels. There were no inadvertent extubations in the intervention group. When the incidence and beginning time of delirium in the general ward were compared, there were no significant differences between the two groups (P > 0.05).

Conclusion: Implementing this nurse intervention in the ward context can shorten postoperative delirium and hospital stays, increase patient satisfaction with care, and improve patient prognosis and quality of life. This intervention will also serve as a great resource for future clinical management of postoperative delirium.

Trial registration: The National Health Security Information Platform's Medical Research Registration Information System has registered this study under the registration number MR-33-22-022978.

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