赖海静 李津 肖厚安 苏婧 王煜 王丽娜

[摘要]目的：探討同伴教育对重度烧伤患负面情绪、依从性、生活质量的影响，为临床开展有效康复护理提供依据。方法：选取2017年3月-2019年3月在西安市第九医院烧伤科住院的66例重度烧伤患者纳入研究，然后用随机数字表法将其分为实验组（33例）和对照组（33例）。对照组实施常规护士主导的健康教育，实验组在对照组基础上给予专业培训的同伴支持教育，比较两组干预前后的焦虑自评量表（Self-rating anxiety scale，SAS）与抑郁自评量表（Self-rating depression scale，SDS）、依从性量表、生活质量量表（SF-36）评分情况。结果：两组SAS、SDS评分均较干预前降低或减弱，且干预后实验组的SAS、SDS显著低于对照组，差异具有统计学意义（P<0.05）。干预后实验组（90.91%）依从性优于对照组（66.67%），差异有统计学意义（P<0.05）。两组患者SF-36各维度评分均较干预前提高，且干预后实验组各维度评分均较对照组提高明显，差异具有统计学意义（P<0.05）。结论：同伴教育能有效减轻患者焦虑、抑郁心理，有助于削减患者的负性情绪，并改善心理状态及功能，使患者自主进行功能锻炼，提高其依从性，进一步加快功能恢复，提高患者生活质量，以便帮助患者更快适应社会、重拾自我。

[关键词]重度烧伤;同伴教育;康复效果;生活质量;焦虑;抑郁;依从性

[中图分类号]R473.6    [文献标志码]A    [文章编号]1008-6455（2021）01-0153-03

Effect of Peer Education on Rehabilitation of Patients with Severe Burn

LAI Hai-jing1，LI Jin2，XIAO Hou-an1，SU Jing1，WANG Yu1，WANG Li-na1

（1.Department of Burn and Plastic Surgery，Xi'an Ninth Hospital，Xi'an 710054，Shaanxi，China;2.Nursing Department，Medical College of Xi'an Jiaotong University，Xi'an 710061，Shaanxi，China）

Abstract： Objective  To explore the influence of peer education on negative emotions， compliance with functional exercise and quality of life in severe burn patients， so as to provide evidence for effective clinical rehabilitation nursing. Methods  66 patients with severe burns admitted to the burn department of Xi 'an ninth hospital from March 2017 to March 2019 were included in the study using convenient sampling method， and then randomly divided into the experimental group （n=33） and the control group （n=33）. The control group received routine health education led by nurses， and the experimental group was given professional training and peer support education on the basis of the control group. The scores of Self-rating anxiety scale（SAS）， Self-rating depression scale（SDS）， compliance scale and quality of life scale （SF-36） were compared between the two groups before and after intervention. Results  The SAS and SDS scores of the two groups were lower than those before the intervention， and the SAS and SDS scores of the experimental group were significantly lower than those of the control group after the intervention， the differences were statistically significant（P<0.05）. After the intervention， the compliance of the experimental group （90.91%） was better than that of the control group （66.67%， P<0.05）. The scores of each dimension of SF-36 in the two groups were higher than those before the intervention， and the scores of each dimension in the experimental group were significantly higher than those in the control group after the intervention（P<0.05）. Conclusion  The peer education can effectively relieve patients' anxiety， depression， helps cut patients' negative mood， and improve the psychological status and function， make of functional exercise on their own patients， improve its compliance， further speed up the functional recovery， improve patient quality of life， in order to help patients more quickly adapt to the society， to regain self.

Key words： severe burn; peer education; rehabilitation effect; quality of life; anxiety; depression; compliance

烧伤是一个不可预期的事件，发生的突然性给患者身心造成显著的双重损害。有关数据中心估计全世界大约每年有1 100万人遭受烧伤带来的不同程度的损害[1]。有调查显示我国与发达国家相比烧伤发生率更高[2]，随着医疗技术取得的突破性进展，重度烧伤生存率已达98.9%[3]，因此患者对生存质量有了更高的要求，烧伤医治目标已经向“功能和心理一体化康复”转移和发展，目前已成为国内外共同探讨、改善的重点和热点话题。削减患者的负性情绪，并改善心理状态及功能，使患者自主进行功能锻炼，提高其依从性，进一步加快功能恢复，提高患者生活质量，以便帮助患者更快适应社会、重拾自我。……