史晓文 季学丽

[摘要]目的：探討系统性护理联合正念减压对急诊烧伤患者的应用价值，及其对患者伤残接受度、社交回避及苦恼的影响。方法：选取2017年7月-2019年10月笔者医院收治的急诊烧伤患者240例。采用随机数字法，将患者分为观察组和对照组，各120例。对照组选用常规烧伤护理方法进行干预，观察组选用系统性护理联合正念减压法进行干预。干预前后均采用焦虑自评量表（Self-rating anxiety scale，SAS）、抑郁自评量表（Self-rating depression scale，SDS）、生活自理能力量表（Activity of daily living scale，ADL）、伤残接受度量表（Acceptance of disability scale，AODS）和社交回避及苦恼量表（Social avoidance and distress scale，SADS）对两组患者进行比较。结果：干预前，两组SAS、SDS、ADL、AODS、社交回避及苦恼评分比较，差异均无统计学意义（P>0.05）。干预后，观察组SAS、SDS、社交回避及苦恼评分均低于干预前，且均低于对照组，差异有统计学意义（P<0.05）;两组ADL及AODS评分均高于干预前，且观察组高于对照组，差异有统计学意义（P<0.05）。结论：系统性护理联合正念减压干预可改善急诊烧伤患者焦虑、抑郁状况，提高身体自理能力，同时降低患者社交回避倾向及苦恼感受。

[关键词]急诊烧伤;系统性护理;正念减压;伤残接受度;社交回避;苦恼

[中图分类号]R473    [文献标志码]B    [文章编号]1008-6455（2020）12-0173-04

Application of Systemic Nursing Combined with Mindfulness-based Stress Reduction in Emergency Burn Patients and its Influence on Patients' Self Acceptance

SHI Xiao-wen，JI Xue-li

（Emergency Medical Center of Jiangsu Provincial People's Hospital，Nanjing 210029，Jiangsu，China）

Abstract： Objective  To explore the application value of systemic nursing combined with mindfulness-based stress reduction in emergency burn patients， and the effect on disability acceptance， social avoidance and distress. Methods  Total of 240 patients with emergency burn admitted to our hospital from July 2017 to October 2019 were selected. They were divided into the control group （n=120） and the observation group （n=120） by random number method. The control group was interfered by conventional management methods， and the observation group was interfered by systemic nursing and mindfulness-based stress reduction. Compared the self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， self-care ability scale （ADL）， disability acceptance scale （AODS） and social avoidance and distress scale （SADS） before and after the intervention. Results  Before intervention， there were no significant difference in the SAS， SDS， ADL， AODS and social avoidance and distress scores between the two groups （P>0.05）. After the intervention， SAS， SDS， social avoidance and distress scores of the observation group were lower than those before the intervention， and were lower than those of the control group， the differences were statistically significant （P<0.05）. The ADL and AODS scores of the two groups were higher than those before the intervention， and the observation group were higher than those of the control group （P<0.05）. Conclusion  Systemic nursing combined with mindfulness decompression intervention can improve the anxiety and depression of patients with acute burns， increase physical recovery， and reduce the patients' social avoidance tendency and distress.

Key words： emergency burns; systemic care; mindfulness decompression; disability acceptance; social avoidance; distress

近年来，由于我国工业和交通的迅速发展，家用电器的高频使用，事故急诊烧伤数量逐年上涨。烧伤具有高发生率、多并发症和高致残率等特点[1-2]。烧伤后创面感染、应激反应等，可诱发患者机体免疫、循环以及内分泌等各系统的生理功能障碍。烧伤还会导致患者出现明显的焦虑、抑郁和抵触社交活动等，其生活质量明显下降[3-4]。系统性护理是一种从生理、心理、功能锻炼和环境等多维度对患者进行护理干预的综合性护理方法，可大幅度提高康复治疗依从性，进而提高患者的治疗效果[5-6]。正念减压疗法是一种以通过教导患者进行正念呼吸、身体扫描和正念瑜伽来培育身心正念力量而发展起来的心理疗法，该方法可有效帮助患者解决长期焦虑、抑郁等状态[7-8]。本研……