目的 探讨阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响。方法 选取社区门诊2014年4月—2016年4月收治的100例行静脉输液治疗的患儿作为研究对象,采取随机数字表法将其分成两组,每组50例。观察组患儿给予阳性强化法干预,对照组给予常规护理干预,对比两组患儿穿刺疼痛相关指标、穿刺效果、患儿静脉输液依从性及患儿家长的满意度。结果 观察组患儿疼痛面容持续时间明显短于对照组,穿刺后心率明显慢于对照组,啼哭时间>30s的患儿占比明显低于对照组(P<0.01)。观察组一次穿刺成功率、穿刺耗时>5min占比分别为94.00%、24.00%,对照组分别为74.00%、62.00%,观察组一次穿刺成功率明显高于对照组,穿刺耗时>5min占比明显低于对照组(P<0.01)。观察组患儿静脉输液依从率为90.00%,与对照组的66.00%对比有明显上升(P<0.01)。观察组患儿家长满意度为96.00%,与对照组的80.00%对比有明显上升(P<0.05)。结论 对社区门诊静脉输液患儿实施阳性强化法干预可有效减轻穿刺疼痛,提高患儿的输液依从性,患儿家长满意度高。

Objective To explore positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion. Methods Select 100 cases of children who receive intravenous infusion in community outpatients from April 2014 to April 2016 as research objectives and divide them into two groups randomly with each group of 50 cases. Provide positive reinforcement to observation group while provide routine nursing to control group. Compare two groups' puncture pain relevant indicator, puncture effect, children's intravenous infusion compliance and parents' satisfaction. Results Children in observation had less duration of pain face expression, lower heart rate after puncture and less children crying >30s than those in control group (P<0.01). Observation group's first puncture success rate, puncture time duration >5mins rate were 94.00% and 24.00% respectively while control group's data were 74.00% and 62.00%. Observation group's first success rate was significant higher than that of control group. Observation group's puncture time duration >5mins rate was significant lower than that of control group (P<0.01). Children's intravenous infusion compliance rate in observation group was 90.00% which was significant higher than control group's 66.00% (P<0.01). Parents satisfaction rate in observation groups was 96.00% which was significant higher than control group's 80.00% (P<0.05). Conclusion Implementing positive reinforcement on children in community outpatient may help to relieve puncture pain, improve children's compliance to intravenous infusion and increase parents' satisfaction.

目的 研究限制会阴切开及会阴不同切口对产妇产后出血、疼痛及性功能的影响。方法 选取我院2012年4月—2013年4月头位自然分娩产妇480例,抽签随机分为三组,每组160例,实施限制会阴切开的为限制组,实施会阴侧切的为侧切组,实施会阴正中切开的为正切组,比较三组产妇产后2 h出血量、产后住院时间、产妇会阴阴道裂伤率、产后疼痛程度和性功能满意程度。结果 产后2 h产妇出血量限制组(203.65±76.68)mL较侧切组(241.41±80.63)mL和正切组(239.15±85.19)mL少(P＜0.05);侧切组(1.64±0.87)d产后住院时间较限制组(1.37±0.64)d较长(P＜0.05);限制组会阴Ⅰ/Ⅱ°裂伤率为86.25%较侧切组1.25%和正切组6.88%较高(P＜0.05);侧切组2.50%和正切组3.13%会阴Ⅲ/Ⅳ°裂伤较限制组0%较高(P＜0.05);女性性功能指数限制组(22.69±2.65)分较侧切组(19.12±2.05)分与正切组(18.96±2.16)分较高(P＜0.05)。结论 实施限制会阴切开的产妇术后出血量少,会阴重度裂伤率低,保证了会阴完整性,产后性功能满意度高,值得临床上应用推广。

目的 探讨优质护理对大面积烧伤患者创面换药时对疼痛及不良情绪的影响。方法 收集我院大面积烧伤的患者,分为研究组和对照组。两组基础护理相同,研究组加用优质护理。对比两组护理前护理4周时焦虑评分,以及两组护理前、护理4周时创面换药时的疼痛评分。结果 ①研究组和对照组护理前焦虑评分结果比较无差异;研究组和对照组护理4周焦虑评分结果比较有差异。②研究组和对照组护理前创面换药时的疼痛评分结果比较无差异;研究组和对照组护理4周创面换药时的疼痛评分结果比较有差异。结论 本次研究认为通过优质护理能够明显提高大面积烧伤患者创面换药时的疼痛程度,对减少住院期间焦虑不良情绪有重要的意义。

目的 探讨延续性护理干预对癌痛患者服药依从性及疼痛治疗效果的影响。方法 选取105例住院治疗的中度至重度癌痛患者,均需服用阿片类药物止痛治疗,单日出院的患者(48例)设为对照组,双日出院的患者(57例)设为干预组。对照组在出院前由责任护士给予常规的用药指导;实验组则在此基础上,于出院后提供延续性护理干预,对患者每周进行电话回访1次,每个出院患者至少回访4次,比较两组患者出院4周后服药依从性及疼痛治疗效果的差异。结果 实验组服药依从性、疼痛治疗效果高于对照组(P＜0.05)。结论 延续性护理干预能提高出院癌痛患者服药依从性及疼痛治疗效果,改善患者的生存质量。

Objective To investigate the impact of continuing nursing on the medication compliance and effect of pain treatment in patients with cancer pain. Methods 105 cases of hospitalized patients with medium to severe cancer pain were selected,need to take opioid analgesic therapy,they were divided into the control group who were single-day discharged(n=48)and intervention group who were double-day discharged(n=57),when discharged,the control group was received conventional health education of medication by the specialized nurses;on this basis,the experimental group was received continuing nursing after discharge,the patients had a return visit by telephone once a week,each patient were visited 4 times at least. After 4 weeks,the medication compliance and effect of pain treatment in the two groups were compared. Results In the experimental group,the medication compliance of patients and effect of pain treatment were significantly higher than those of the control group(P＜0.05). Conclusion The continuing nursing intervention can significantly improve the medication compliance and effect of pain treatment for discharged patients with cancer pain,and improve the quality of life.

       目的   探讨叙事护理在老年疼痛患者中的应用效果。方法   根据随机数字表法将84例于2020年12月—2023年12月中国人民解放军南部战区总医院收治的患有恶性肿瘤的老年疼痛患者分为接受常规干预的对照组（n=42）和接受叙事护理的观察组（n=42），比较两组疼痛情况、负性情绪、睡眠状况及自我效能。结果   观察组在干预2、4、6、8周后疼痛数字分级评分分别为（5.02±1.07）（4.26±0.76）（3.58±0.65）（2.92±0.41）分，均低于对照组（t分别为2.126、2.419、3.232、2.545，P均＜0.05）；干预2个月后，观察组焦虑、抑郁自评量表评分、匹兹堡睡眠质量指数分别为（41.27±2.28）（42.47±3.19）（5.13±1.46）分，均低于对照组（t分别为11.795、9.669、3.579，P均＜0.05），一般自我效能量表评分为（21.72±4.13）分，高于对照组（t=5.834，P＜0.05）。结论   叙事护理可有效控制老年癌性疼痛患者的疼痛，显著改善负性情绪和睡眠状况，有利于自我效能的提升。

       Objective  To explore the application effect of narrative nursing in elderly patients with pain．Methods  From December 2020 to December 2023，84 elderly patients with malignant tumor in the General Hospital of the Southern Theater Command of the People’s Liberation Army of China were randomly divided into control group（n=42）receiving  routine intervention and observation group（n=42）receiving narrative nursing．Results The pain digital grading scores of the observation group at 2 weeks，4 weeks，6 weeks and 8 weeks after intervention were（5.02±1.07），（4.26±0.76），（3.58±0.65）and（2.92±0.41），which were lower than the control group（t=2.126，2.419，3.232，2.545，all P＜0.05）．After 2 months of intervention，the scores of Self-Rating Anxiety Scale，Self-Rating Depression Scale and Pittsburgh Sleep Quality Index in the observation group were（41.27±2.28），（42.47±3.19）and（5.13±1.46），which were lower than the control group（t=11.795，9.669，3.579，P＜0.05）．The score of general self-efficacy scale was（21.72±4.13），which was higher than the control group（t=5.834，P＜0.05）．Conclusions  Narrative nursing can effectively control the pain of elderly patients with cancer pain，significantly improve negative emotions and sleep status，and is conducive to the improvement of self-efficacy．