| Objective Through the study of the perioperative compliance behavior of the patients who had diabetic retinopathy minimally invasive vitrectomy and the main factors affect it,to discussion the intervention measures to improve the compliance of patients comfort care.Subjects and Methods The patients who had diabetic retinopathy minimally invasive vitrectomy in the Second People’s Hospital of Zhengzhou City fundus group between December 2013 to December 2014 were selected for the research, and 185 cases meet the test requirements. The patients were divided into experimental group and the control group by ward. The control group, namely conventional care group, accepted the overall care, the routine care and health education of ophthalmic surgical vitrectomy.The experimental group, namely comfort care group, based on routine care, accepted comfort care, preoperative glucose control, eye medication, position, eye position nursing training, and position to maintain skills after operation.Whether there is significant difference between the two groups in compliance behavior and the treatment.Results (1)The distribution of non-compliance behavior:ln the 185 cases of patients with diabetic retinopathy,50 patients had non-compliance behavior before surgery, accounting for about 27%, of which 39 cases not complying with the blood glucose control,11 cases failing to apply eye drops.55 patients had non-compliance behavior after surgery, accounting for about 30%, of which 9 cases not complying with the blood glucose control,6 cases failing to apply eye drops and 40 cases unable to keep the position.16 cases in 96 cases of the experimental group had non-compliance behavior before surgery, accounting for about 17%,and 31 cases in 89 cases of the control group had non-compliance behavior before surgery, accounting for about 35%.(2)The reasons of non-compliance behavior:The main reason before the operation is the poor blood glucose control caused by poor control of the amount and the eating-time;The main reason during the operation is the head and neck muscle discomfort caused by the long-term supine position, the mismatch of the head position and the eye position;The main reason after the operation is the neck and lumbar muscle pain and insomnia caused by keeping a position for a long term.(3)The difference of compliance behavior in the patients with different gender, residence, age, educational level and the cost origin,was not statistically significant (P>0.05).Understanding of disease itself and the cooperation with the treatment of the patients,and the patients’family situation all had effect on the compliance behavior, and the differences were statistically significant (P<0.05).(4) The comparison of the conventional care group and the comfort care group according to the medical behavior:16 cases in 96 cases of the experimental group had non-compliance behavior before surgery, accounting for about 16.7%,while 17 cases had non-compliance behavior after surgery accounting for about 17%.31 cases in 89 cases of the control group had non-compliance behavior before surgery, accounting for about 35%,while 39 cases after surgery,accounting for about 44%.The difference between the two groups was statistically significant by Chi-square test(P<0.05).(5)The comparison of the conventional care group and the comfort care group according to the surgical curative effect:91 cases in 96 cases of the experimental group had one-time successful operation, accounting for 94.7%,while 76 cases in 89 cases of the control group,accounting for 85.3%.There was a statistically significant difference between the two groups by Chi-square test(P<0.05).(6)The comparison of the conventional care group and the comfort care group according to the postoperative complications:In the comfort care group,there were 6 cases of postoperative ocular hypertension,7 cases of postoperative cataract worse,5 case of vitreous hemorrhage once again,5 cases of retinal not reset, no case of endophthalmitis after the operation.In the conventional care group,there were 15 cases of postoperative ocular hypertension,17 cases of postoperative cataract worse, 15 cases of vitreous hemorrhage once again,2 cases of endophthalmitis; 13 cases of retinal not reset after the operation.There was a statistically significant difference in the incidence of complications between the two groups by Chi-square test(P<0.05).(7)The comparison of the conventional care group and the comfort care group according to the total hospitalization days:In the comfort care group.the hospital stay before the operation is 2±1.6 days,and 5±2.3 days after the operation,the total hospital day is 7±2.1. In the conventional care group, the hospital stay before the operation is 4±1.9 days,and 9±2.3 days after the operation,the total hospital day is 12+2.9. The difference between the two groups was statistically significant (P<0.05).(8)The comparison of the conventional care group and the comfort care group according to the patients’satisfaction:In the 96cases of the comfort care group,with 49 case very satisfied (51.1%),44 case satisfied (45.9%),3 case general satisfied (3.1%),no cases dissatisfied with nursing service,the total satisfaction is 96.9%.While in the 89 cases of the conventional care group,with 36 case very satisfied (40.5%),40 case satisfied (44.5%),8 case general satisfied (9%),5 cases dissatisfied with nursing service,the total satisfaction is 85.49%.There was a statistically significant difference between the two groups by Rank sum test(P<0.05).Conclusion.Application of comfortable nursing intervention can effectively improve the compliance behavior of patients who underwent the diabetic retinopathy minimally invasive vitrectomy surgery in peri operation period,and also can reduce surgical complications, shorter total hospital stay, improve the success rate,and improve patient satisfaction. |
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