The Effectiveness Research Of Grading Psychological Nursing Care In The Patients With Moderate Or Severe Burn Injury

Objective:1To analyze the psychological status and its relative factors in the adult patientswith moderate or severe burn injuries;2To verify the effectiveness of grading psychological nursing care.Methods:1Sixty patients with moderate or severe burn injuries were recruited from ourburn center from May to December2012and were randomly divided into two groups:the control group(n＝31) and the intervention group(n＝29).2Questionnaires, including the self-designed questionnaire, Hospital Anxietyand Depression Scale(HAD), Medical Coping Modes Questionnaire(MCMQ) andSocial Support Rating Scale(SSRS), were performed within72hours after admission.The anxiety and depression status of the burn patients and its relative factors wereanalyzed.3Single routine nursing was applied to the control group, and the gradingpsychological nursing care.was applied to the intervention group.4HAD was collected again on the18th day after admission. Through thecomparison and analysis，the effectiveness of grading psychological nursing care wasverified.5Statistic analyses were accomplished using the SPSS16.0software to performthe chi-square, two independent samples t-test, Wilcoxon Matched-PairsSigned-Ranks Test to examine differences between the two groups. The linearregression analysis was used to determine the relationships between HAD and age,gender, education, marital status, medical expense resource, total burn surface area(TBSA), severity of burn injury, total annual income of family, MCMQ, and SSRS.All statistic analysis were performed by two-tailed test (inspection standard, α＝0.05). P＜0.05is considered statistically significant.Results:1Before intervention, all parameters such as age, gender, level of education, occupation, marital status, medical expense resource, TBSA, severity of burn injury,total annual income of family, the total score, the anxiety and depressionsub-scale score of HAD,"confronce","avoidance" and "resignation" sub-scale scorein MCMQ, SSRS total score and its three dimensions: an objective support,subjective support and utilization of support, showed no significant difference(P>0.05)between the two groups.2If defined scores not less than9in anxiety or depression as a positive, theincident of anxiety was51.67%and the incident of depression was45.23%.3Multiple linear regression analysis indicated that the TBSA, the score ofresignation, the total annual income of family and SSRS total score weresignificantly related to scores of anxiety and depression in the adult patients.4The decline in the total score, the anxiety and depression sub-scale scoreof HAD in the intervention group was greater than that in the control group (P <0.05).And the difference between two groups showed significant difference (P <0.05).5The changes of psychological nursing level required in the control group hadno significant difference, while the changes showed significant difference in theexperimental group between before and after intervention (P <0.05).Conclusion:1There exist severe psychological problems in the adult patients with moderateor severe burn injuries at early stage.2Social supports to the patients from poor family with severe burn injury shouldbe enhanced, which is helpful to promote physical and mental rehabilitation processin those patients.3The grading psychological nursing care is effective in adult patients withmoderate or severe burn injury by decreasing the HAD score and the psychologicalnursing level.