| BackgroundStudies have shown that patients’medical care needs are ranked by treatment,disease monitoring,psychological care,and life care.Visible psychological nursing is in addition to the disease itself the most needed nursing content.With more and more attention being paid to psychological nursing in clinical application,the nursing mode is becoming more and more perfect,and is developing towards scientific,humanized and individualized direction.But the implementation process is prone to such as:blind,lack of evidence,the effect is not obvious,dispensable and a series of problems,resulting in the psychological nursing effect is not significant.Hierarchical psychological nursing is a supplement to hierarchical nursing combined with the national conditions of our country.According to the degree of patients’psychological problems,hierarchical nursing is carried out,and targeted measures are implemented for patients of different levels,so as to improve the effect of psychological nursing and achieve ideal results in clinical application.ObjectiveTo understand the psychological status and influencing factors of patients undergoing facial nerve microvascular decompression,establish the standard and measure of graded psychological nursing and observe the effect of clinical intervention,for the classification of psychological nursing standards to provide evidence-based basis.Methods1.To investigate the preoperative and postoperative psychological status and influencing factors of patients undergoing facial nerve microvascular decompression,so as to provide a basis for the establishment of graded psychological nursing standards and measures.The study subjects were 119 patients with facial spasm who underwent"facial nerve microvascular decompression"from January to December2018 in the department of neurosurgery of a third-grade first-class hospital in zhengzhou.Data were collected through questionnaires,including:basic patient information questionnaire,self-assessment of mental health questionnaire(SRQ-20),Pittsburgh sleep quality index scale(PSQI),Cohen grading,postoperative efficacy,appetite,pain,etc.2.According to patients’srq-20 level and related factors affecting patients’psychology,combined with clinical practice,the grading standards of psychological nursing and nursing measures at all levels for patients undergoing neurovascular microvascular decompression were formulated,which were repeatedly revised and improved according to expert review opinions and clinical experience.3.The effect of graded psychological nursing of patients with facial nerve microvascular decompression.The study subjects were 80 patients who met the above diagnostic criteria and voluntarily joined the study from January to August 2019.They were randomly divided into the control group(n=40)and the intervention group(n=40).Patients in the control group were given original psychological nursing in the department,while patients in the intervention group were given graded psychological nursing on the basis of original psychological nursing.Results were evaluated using srq-20,Pittsburgh sleep quality,appetite,pain,postoperative complications,vital signs,and patient satisfaction.SPSS 24 was used for statistical analysis,including descriptive analysis,t test,andχ~2 test.Results1.The overall mental health status of MVD patients before and after surgery was poor and varied in severity.Cohen grade,duration of illness,postoperative pain and other factors may affect patients’mental health.2.Independent sample t test andχ~2 test were used to analyze the data of patients in the two groups at the time of admission,and the difference was not statistically significant(P>0.05).The patients in the intervention group were graded according to the psychological classification standard,and the patients in the control group were given conventional psychological nursing intervention.Comparison of data after intervention:SRQ-20 score in the intervention group was significantly lower than that in the control group(P<0.05).The PSQI score of the intervention group was significantly lower than that of the control group(P<0.05).The appetite of the intervention group was significantly lower than that of the control group(P<0.05).The postoperative pain score of the intervention group was significantly lower than that of the control group(P<0.05).The differences in postoperative heart rate,systolic blood pressure and diastolic blood pressure between the two groups were not statistically significant(P>0.05).Complications in the intervention group were significantly lower than those in the control group,and discharge satisfaction rate in the intervention group was significantly higher than that in the control group(P<0.05).ConclusionThe severity of preoperative and postoperative mental health status of MVD patients varied,and the influencing factors included:Cohen grading,duration of illness,postoperative pain,etc.Graded psychological nursing can improve the mental health level of MVD patients,improve sleep quality and appetite,relieve postoperative pain,reduce the incidence of complications and improve treatment satisfaction. |
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