| Background:Postoperative Delirium（POD）refers to the symptoms of patients undergoing surgery after general or local anesthesia,which are mainly manifested as disturbance of consciousness level,decreased attention and confusion of thinking.Studies have shown that the incidence of postoperative delirium in ICU abroad is 11%-51%,and that in China is 10%-60%。Postoperative delirium has a high incidence and is harmful to patients.At present,there is no special drug to prevent delirium in clinic,so it is of great importance to explore an effective and feasible non-drug treatment for delirium.Based on conventional nursing combined with cognitive function training mode and conventional nursing combined with home visiting and accompanying mode,this study conducted a study on postoperative ICU patients.Richmond Agitation-Sedation Scale RASS),The Confusion Assessment Method for The Intensive Care Unit（CAM-ICU）to assess delirium,To investigate the effects of different nursing intervention modes on postoperative delirium incidence,delirium duration and hospitalization satisfaction of PATIENTS in ICU.Objective:To explore the incidence,duration and application effect of delirium in ICU patients with different nursing intervention programs,so as to further improve the overall nursing quality of ICU patients after surgery.Methods:In this study,eligible patients admitted to the ICU of Shiyan Renmin Hospital from January to December were divided into 3 groups: 73 patients in 1 district were treated as control group,and 79 patients in 2 district were treated as intervention group 1,75 patients in zone 3 were assigned to Intervention Group 2.The control group was the routine nursing model group,the Intervention Group 1 was the routine nursing model combined with cognitive function training intervention group,and the Intervention Group 2 was the routine nursing model combined with home visiting and accompanying nursing intervention group.The patients’ delirium was evaluated with RASS and ICU scale when they were admitted to ICU,24 hours after ICU,48 hours after ICU,and out of ICU.Results:1.Baseline data comparison: When entering the group,there were no significant differences among the three groups in age,sex,occupation,education level,marital status,mode of medical payment,surgical site,smoking,drinking,staying in ICU,suffering from basic diseases and using psychotropic drugs（P > 0.05）.2.Comparison of RASS scores among the three groups at different time points:There was no significant difference in RASS scores among the three groups when they were admitted to ICU（P > 0.05）;RASS scores of patients in the three groups 24 hours after admission to ICU,48 hours after admission,and after leaving ICU showed statistically significant differences between intervention group 1 and intervention group 2 and control group（P < 0.05）.There was no significant difference between intervention group 1 and intervention group 2（P > 0.05）.3.Comparison of delirium incidence in three groups at different time points:when patients were admitted to ICU,the delirium incidence in control group,intervention group 1 and intervention group 2 was 8.22%,6.33% and 9.33%,respectively,with no statistical significance（P > 0.05）;24 hours after admission to ICU,the incidence of delirium in control group,intervention group 1 and intervention group 2 was 16.44%,5.06% and 5.33%,respectively;The incidence of delirium in control group,intervention group 1 and intervention group 2 were 12.33%,3.80% and1.33% respectively 48 hours after admission to ICU;The incidence of delirium was6.85% in control group,1.27% in intervention group 1,and 0% in intervention group2 when patients left ICU.24 hours after admission to ICU,the incidence of delirium in intervention group 1 and intervention group 2 was significantly different from that in control group（P < 0.05）.The incidence of delirium in the intervention group 2 was significantly different from that in the control group at 48 hours after admission to ICU and at exit of ICU（P < 0.05）.There was no significant difference in delirium incidence between intervention group 1 and intervention group 2 at four time points（P > 0.05）.4.Comparison of delirium duration among the three groups: the average duration of delirium in control group,intervention group 1 and intervention group 2 during admission to ICU was 3.24±0.13 days,1.91±0.06 days and 1.49±0.06 days,respectively.The duration of delirium in the two intervention groups was significantly shorter than that in the control group,with statistical significance（P < 0.05）.The delirium duration of intervention group 2 and intervention group 1 was significantly different（P < 0.05）.5.Comparison of satisfaction of patients and their families in the three groups:the average satisfaction score of patients in the control group was 81.96±0.82 points,and the average satisfaction score of patients’ families was 82.78±2.16 points;The average satisfaction score of patients in intervention group 1 was 91.99±0.79,and the average satisfaction score of patients’ family members was 92.14±0.80.The average satisfaction score in intervention group 2 was 95.16±0.82.The average score of family satisfaction was 96.48±2.23.There were statistically significant differences in the satisfaction of patients and their family members between intervention group 1and intervention group 2 and control group（P < 0.05）.There were statistically significant differences in the satisfaction of patients and their families between intervention group 2 and intervention group 1（P < 0.05）.Conclusion:1.The intervention model of family visiting care can effectively reduce the incidence of postoperative delirium in ICU patients.2.Cognitive function training intervention model and family visit and care intervention model can effectively reduce postoperative delirium duration in ICU patients.Moreover,the intervention mode of family visit and care is better than that of cognitive function training.3.Cognitive function training intervention model and family visit and care intervention model can effectively improve the satisfaction of patients and their families.Moreover,the intervention mode of family visit and care is better than that of cognitive function training. |
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