许云华　付文英

[摘要] 目的 探讨护理流程管理用于开放式精神病区的效果。 方法 选择2012年8月～2013年10月在重庆三峡中心医院平湖分院早期干预科住院治疗的精神类疾病患者共140例，随机分为观察组与对照组，每组各70例。对照组给予临床常规的护理方案，观察组在常规护理方案的基础上，给予护理流程管理模式，于护理流程管理2个月后采用简明精神病量表（BPRS）及护士用精神症状住院患者评定观察量表（NOSIE）分别对两组患者精神、心理健康状况进行测评。 结果 ①采用护理流程管理2个月，两组患者的BPRS量表总得分及焦虑抑郁、思维障碍、缺乏活力等项得分均较护理流程管理前明显下降，差异均有统计学意义（P < 0.05或P < 0.01）；且观察组护理流程管理2个月总得分及焦虑抑郁、思维障碍、缺乏活力等项得分明显低于对照组，差异均有统计学意义（均P < 0.05）。②护理流程管理2个月两组患者NOSIE量表病情总估计因子、总积极因子得分均显著高于护理流程管理前，总消极因子均低于护理流程管理前，差异均有高度统计学意义（均P < 0.01）；且护理流程管理2个月观察组病情总估计因子、总积极因子得分明显高于对照组，而总消极因子得分明显低于对照组，差异均有统计学意义（均P < 0.05）。 结论 护理流程管理应用于开放式精神病区可改善患者的心理、精神状态，值得临床应用推广。

[关键词] 护理流程管理；开放式精神病区；研究

[中图分类号] R473.74 [文献标识码] A [文章编号] 1673-7210（2015）02（b）-0149-04

[Abstract] Objective To investigate the application of nursing process management in open management ward of psychiatric unit. Methods 140 cases with mental illness in Department of Early Intervention of Pinghu Branch Hospital in Chongqing Three Gorges Center Hospital from August 2012 to October 2013 were selected and randomly divided into observation group and control group with 70 cases in each group. The control group were treated with clinical routine nursing care plan， the observation group were treated with nursing process management combined with routine nursing. The brief psychiatric rating scale （BPRS） and NOSIE scale were used to evaluate the mental and physical health situation before and 2 months after the nursing process management. Results ①The total score of BPRS， the scores of anxiety-depression， disturbance of thought， lack of energy in the two groups 2 months after the nursing process management were all lower than those of before the nursing process management， the differences were all statistically significant （P < 0.05 or P < 0.01）； the total score of BPRS， the scores of anxiety-depression， disturbance of thought， lack of energy 2 months after the nursing process management in observation group were all lower than those in control group， the differences were all statistically significant （all P < 0.05）. ②The NOSIE scores of total estimated factor， total positive factor 2 months after the nursing process management in the two groups were all higher than those before the nursing process management， the total scores of negative factor 2 months after the nursing process management in the two groups were all lower than those before the nursing process management， the differences were all statistically significant （all P < 0.01）； the scores of total estimated factor， total positive factor 2 months after the nursing process management in observation group were all higher than those in control group， the total scores of negative factor 2 months after the nursing process management in the observation group were all lower than those in control group， the differences were all statistically significant （all P < 0.05）. Conclusion The nursing process management can improve the psychological and mental states of the patients in open management ward of psychiatric unit， it is worthy of clinical application and popularization.

[Key words] Nursing process management； Open management ward of psychiatric unit； Research

随着经济社会的持续发展、进步，民众对医疗、护理服务的要求也愈来愈高，传统习惯上的经验依赖式的管理模式愈发无法适应、符合现代护理理念的发展[1-2]。护理流程化管理是当代护理管理理念的新模式，是一种依赖规范化、科学化的优秀护理流程为核心，以连续增强护理业务能力、服务于患者为最终目的的管理方式[3-4]。伴随着医疗方式的逐渐改变，精神类疾病患者的服务与管理，已经从集中化、封闭式逐渐转变为开放式的模式，为精神类疾病患者创造一个与周围人交流、沟通，与外界社会不断接触的优良环境，势必极大地促进精神类疾病患者的治疗与康……