Clinical Applications of Navigation Nursing Model in the Desensitization Treatment of Children with Allergic Asthma
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摘要:
目的 探讨护理主导模式下导航护士对过敏性哮喘患儿的效果观察。 方法 选取2021年3月至2022年3月上海市儿童医院呼吸科收治的110例过敏性哮喘患儿作为研究对象。随机数字表法分为对照组与观察组,每组各55例。对照组采用常规护理,观察组在此基础上采用改进的过敏性哮喘导航护理(allergic asthma navigational nursing,AANN)模式精准护理。比较2组临床疗效、肺活量(FVC)、峰值呼气流速(PEF)、一秒用力呼气容积/FVC(FEV1/FVC)、血清总免疫球蛋白 E(IgE)、嗜酸性粒细胞(EOS)水平、哮喘控制测试(ACT)评分和工作满意度。 结果 治疗4周后,观察组疗效高于对照组(P < 0.05);2组患儿FCV、FEV1/FVC、PEF较治疗前升高,且观察组高于对照组(P < 0.05);2组患儿IgE、EOS水平较治疗前降低,且观察组患儿IgE、EOS水平低于对照组(P < 0.05);2组患儿ACT评分较治疗前升高,且观察组ACT评分高于对照组(P < 0.05)。观察组各项护理内容及总满意度评分均高于对照组(P < 0.05)。 结论 导航护理模式能够提高过敏性哮喘患儿治疗效果,促进患儿早日康复,提高家长满意度,提升医疗服务品质,值得推广。 Abstract:Objective To investigate the effect of navigation nurses on children with allergic asthma under the nursing-led model. Methods A total of 110 children with the allergic asthma who were admitted to the Respiratory Department of Shanghai Children’s Hospital from March 1, 2021 to March 1, 2022 were selected as the research subjects and randomly divided into the control-group and the observation-group with 55 cases in each group. The control-group was treated with routine nursing care, and the observation-group was treated with improved Allergic Asthma Navigational Nursing (AANN) model on this basis. The clinical efficacy, vital capacity (FVC), peak expiratory flow rate (PEF), forced expiratory volume per second (FEV1/FVC), serum total immunoglobulin E (IgE), eosinophil (EOS) level, Asthma Control Test (ACT) score and job satisfaction were compared between the two groups. Results After 4 weeks of the treatment, the effect on the observation-group was higher than that on the control-group (P < 0.05); FCV, FEV1/FVC and PEF in the two groups were higher than those before the treatment, and those in the observation-group were higher than those in the control-group (P < 0.05); The levels of IgE and EOS in the two groups were lower than those before the treatment, and those in the observation-group were lower than those in the control-group (P < 0.05); The ACT score of the two groups was higher than that before the treatment, and the ACT score of the observation-group was higher than that of the control-group (P < 0.05). All nursing contents and total satisfaction scores in the observation-group were higher than those in the control-group (P < 0.05). Conclusion The navigation nursing mode can improve the treatment effect on children with allergic asthma, promote their early recovery, improve parents’ satisfaction, and improve the quality of medical services, which is worth promoting. -
Key words:
- Navigation nursing /
- Allergic asthma in children /
- Navigation nurse /
- Application effect
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表 1 2组患儿一般资料比较[(
$\bar x \pm s $ )/n(%)]Table 1. Comparison of general information between two groups of children [(
$\bar x \pm s $ )/n(%)]一般资料 对照组 观察组 χ2/t P 性别(男/女) 43(78.18)/12(21.82) 39(70.91)/16(29.09) 0.766 0.381 年龄(岁) 10.22 ± 2.28 9.44 ± 2.72 1.777 0.082 体质量指数(kg/m2) 18.66 ± 2.97 18.40 ± 2.71 0.755 0.455 病程(a) 2.39 ± 0.32 2.43 ± 0.35 0.449 0.656 表 2 治疗后2组患儿疗效比较[n(%)]
Table 2. Comparison of therapeutic effects between two groups of children after treatment [n(%)]
组别 病例数 显效 有效 无效 对照组 55 14(25.45) 22(40.00) 19(34.55) 观察组 55 33(60.00)* 16(29.09) 6(10.91)* 与对照组比较,*P < 0.05。 表 3 2组患儿护理前后肺功能指标比较(
$\bar x \pm s $ )Table 3. Comparison of lung function indicators between two groups of children before and after nursing care (
$\bar x \pm s $ )组别 FCV FEV1/FVC PEF 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 2.19 ± 0.39 2.36 ± 0.41# 99.78 ± 7.56 104.54 ± 7.49# 3.90 ± 1.23 4.40 ± 1.30# 观察组 2.17 ± 0.66 2.87 ± 0.85#* 98.63 ± 8.81 108.59 ± 9.16#* 3.88 ± 1.26 5.03 ± 1.35#* 与治疗前比较,#P < 0.05;与对照组比较,*P < 0.05。 表 4 2组患儿治疗前后IgE、EOS水平比较(
$\bar x \pm s $ )Table 4. Comparison of IgE and EOS levels between two groups of children before and after treatment (
$\bar x \pm s $ )组别 IgE(μg/L) EOS(×109/L) 治疗前 治疗后 治疗前 治疗后 对照组 199.85 ± 25.83 138.85 ± 21.75# 0.50 ± 0.07 0.39 ± 0.06# 观察组 209.51 ± 25.76 113.57 ± 11.13#* 0.52 ± 0.08 0.31 ± 0.04#* 与治疗前比较,#P < 0.05;与对照组比较,*P < 0.05。 表 5 2组患儿ACT评分比较[(
$\bar x \pm s $ ),分]Table 5. Comparison of ACT scores between two groups of pediatric patients [(
$\bar x \pm s $ ),points]组别 n 治疗前 治疗后 对照组 55 16.70 ± 2.18 21.34 ± 2.56# 观察组 55 16.77 ± 2.21 23.02 ± 2.32#* 与治疗前比较,#P < 0.05;与对照组比较,*P < 0.05。 表 6 2组患儿家长对护理工作满意度比较[(
$\bar x \pm s $ ),分]Table 6. Comparison of parental satisfaction with nursing work between two groups of pediatric patients [(
$\bar x \pm s $ ),points]组别 护理态度 护理技巧 护理安全 护理水平 总满意度 对照组 3.49 ± 0.66 4.02 ± 0.65 4.16 ± 0.66 4.05 ± 0.68 15.73 ± 2.03 观察组 4.73 ± 0.49* 4.65 ± 0.52* 4.91 ± 0.29* 4.95 ± 0.23* 19.24 ± 0.94* 与对照组比较,*P < 0.05。 -
[1] 陆璐,王进雅,姜艳荷. 安脱达尘螨疫苗治疗儿童过敏性哮喘的疗效及安全性评价[J]. 儿科药学杂志,2020,26(2):10-14. [2] 皇惠杰,侯晓玲,任亦欣,等. 儿童支气管哮喘和过敏性鼻炎稳定控制的相关因素研究[J]. 中华全科医师杂志,2022,21(7):668-674. [3] 李燕宁. 李燕宁教授从痰瘀同源论治儿童哮喘慢性持续期经验总结[J]. 中国医药导报,2020,17(27):147-150. [4] 钟君,陈晓莉,曹雯雯,等. 大肠癌病人导航服务模式的构建[J]. 护理研究,2022,36(15):2688-2692. [5] 杨艳英,杨静,勾冯茜. 导航护士在加速康复外科中的作用: 以腹腔镜肝切除围手术期为例[J]. 中国卫生质量管理,2020,27(2):19-22. [6] 鲍一笑,陈爱欢,符州. 儿童支气管哮喘诊断与防治指南(2016年版)[J]. 中华儿科杂志,2016,54(3):167-181. [7] 中华儿科杂志编辑委员会,中华医学会儿科学分会. 儿童过敏性疾病诊断及治疗专家共识[J]. 中华儿科杂志,2019,57(3):164-171. doi: 10.3760/cma.j.issn.0578-1310.2019.03.002 [8] 沈鸣雁,冯志仙,陈翔,等. 互联网医院导航护理岗位的设立及实践探索[J]. 中国护理管理,2022,22(3):425-429. [9] 黄五乐,张华,陈海丹. 百令胶囊联合奥马珠单抗治疗儿童过敏性哮喘临床疗效及对呼吸道重塑的影响[J]. 中华中医药学刊,2022,40(4):238-241. [10] 杨玲,廖道明,梁慧. 儿童呼吸和哮喘控制测试改良中文版在基层医院哮喘管理的应用研究[J]. 中国妇幼保健,2020,35(14):2544-2548. [11] 李五妹. 如何提高患者对护理质量满意度[J]. 中国中医药现代远程教育,2011,9(12):64-65. [12] 蒋宵宵,俞红丽,徐凤,等. 医院-社区联动管理模式对PICC带管出院患者知信行的影响研究[J]. 中国医药导刊,2021,23(9):710-714. [13] Akar-Ghibril N,Casale T,Custovic A,et al. Allergic endotypes and phenotypes of asthma[J]. J Allergy Clin Immunol Pract,2020,8(2):429-440. doi: 10.1016/j.jaip.2019.11.008 [14] 王一,王琦,孟翔鹤,等. 基于中医体质学原理探析肺部菌群对过敏性哮喘的调控作用[J]. 北京中医药大学学报,2022,45(4):387-392. [15] 刘春涛. 过敏性哮喘防治的重要性与特殊性[J]. 中华内科杂志,2019,58(9):628-629. [16] 高倩男,饶兴愉,朱惠芳. NK细胞在介导儿童过敏性哮喘中的作用和研究进展[J]. 赣南医学院学报,2020,40(2):183-187. [17] 苏琼英,李媚珍,潘美珠. 目视导航护理模式在子宫肌瘤行腹腔镜手术患者中的应用研究[J]. 护理实践与研究,2020,17(18):92-94. [18] 寇艳,马科,王春芬. 全程护理干预在支气管哮喘儿童雾化吸入治疗中的应用分析[J]. 贵州医药,2019,43(7):1166-1167. [19] 纪和雨,沈力,王淼,于广军. 基于上海市某儿童医院过敏性疾病患儿照顾者对多学科诊疗的认知和需求的调查与分析[J]. 中国医院,2020,24(1):32-34. [20] 陈佳,杨光云. 认知行为团体心理护理干预在脱敏治疗过敏性哮喘患者中的效果评价[J]. 成都医学院学报,2022,17(2):214-217. [21] 严华杰,张海清,董蔚,等. 上海南翔地区575例气道过敏性疾病患者变应原特异性IgE检测分析[J]. 贵州医药,2021,45(3):460-462. [22] 李佳. 绿色通道流程信息化对重症哮喘合并呼吸衰竭病人抢救室滞留时间及家属护理工作满意度的影响[J]. 全科护理,2021,19(5):633-635.