| Objectives To observe the intervention effect on constipation of comprehensive evaluation and personalized nursing mode based on CGA in elderly patients with cerebral hemorrhage.Methods Elderly patients with cerebral hemorrhage and constipation admitted to the department of Neurology and Neurosurgery in Tangshan Kailuan General Hospital from December 2019 to May 2020 were selected as the study subjects.Using random number grouping method,100 elderly cerebral hemorrhage patients were divided into experimental group and control group with 50 cases each.Control group: carry out constipation routine diversified nursing,give diet education,health guidance and psychological care,and follow the doctor’s advice when necessary.Experimental group: nursing assessment was conducted using the comprehensive assessment system related to constipation based on CGA in electronic medical records,and individualized nursing interventions were implemented for the existing and potential factors of constipation that were found in the assessment.After two weeks of intervention,the physiological function of the patients was evaluated according to the constipation symptoms and efficacy evaluation scale,standards for diagnosis and curative effect of Chinese medical symptom,and the incidence of constipation-related adverse events.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the psychological state of patients.Quality of life index(QL-index)was used to evaluate the quality of life of patients.SPSS22.0 was used for statistical processing and analysis,The normal distribution numerical data were expressed as x ±s,t test and ANOVA were performed;Rank sum test was performed for non-normal distribution numerical data;The chi-square test was used for rate index and constituent ratio data regardless of grade;Rank sum test of ordered classification variables was used for graded constituent ratio data.Results 1 Evaluation of physiological function related to constipation: 1)Comparison of constipation symptoms and curative effect: There was no statistically significant difference between the two groups in the total score and scores of all dimensions of constipation symptoms before intervention(P>0.05);After 1 week of intervention,the total score of constipation symptoms and scores of defecate difficulty,fecal traits and abdominal distension in experimental group were lower than those in control group,with statistically significant differences(P<0.01);After 2 weeks of intervention,the total score of constipation symptoms and scores of defecate difficulty,fecal traits,frequency of defecation and abdominal distension in experimental group were lower than those in control group,with statistically significant differences(P<0.01);Repeated measures of ANOVA for the total scores of constipation symptoms before intervention,after 1 week of intervention,and after 2 weeks of intervention showed that time,intergroup and interaction effect were statistically significant(P<0.01).2)Comparison of the effective rate of constipation relief: The effective rate in experimental group was higher than that in control group,with statistically significant difference(P<0.01).3)Comparison of other physiological functions: After 2 weeks of intervention,the incidences of abdominal pain,abdominal distension,intracranial re-bleeding and electrolyte disturbance in experimental group were lower than those in control group,with statistically significant differences(P<0.05);the nutritional status of experimental group was better than that of control group,with statistically significant difference(P<0.01).2 Evaluation of psychological state:Before intervention,there was no statistically significant difference between the two groups in scores of HAMA and HAMD(P>0.05);After 2 weeks of intervention,scores of HAMA and HAMD in experimental group were lower than those in control group,with statistically significant differences(P<0.05).3 Evaluation of the quality of life: Before intervention,there was no statistically significant difference between the two groups in the total score and scores of all dimensions of QL-index(P>0.05);After 2 weeks of intervention,the total score and scores of all dimensions of QL-index in experimental group were higher than those in control group,with statistically significant differences(P<0.05).Conclusions Through the application of comprehensive assessment based on CGA in elderly patients with cerebral hemorrhage and constipation,to formulate and implement individualized nursing intervention program in view of the individual factors that lead to constipation problem,can effectively relieve constipation in elderly patients with cerebral hemorrhage,reduce adverse events associated with constipation,improve nutritional status and reduce adverse emotions such as anxiety,depression,improve the quality of life.Figure1;Table22;Reference192... |
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