| BackgroundCongenital heart disease(CHD)is the most common childhood congenital malformations during childhood.The vast majority of CHD requires being treated by surgery,now Interventional surgery has been more widely used as a new choice,Thanks for its benefits to children such as causing less trauma,pain,mortality,complication,and shorter hospital stay etc.,this treatment has become the first choice of treatment for some CHD.However,the children who need interventional treatment were always young,emotionally unstable,poor tolerance,unable to express feelings,and faced more postoperative complications.So the implementation of effective nursing interventions for rehabilitation of children after congenital heart surgery is essential.According with the modern medical model,"Family-Centered Care"(FCC)emphasizes human beings’ needs,rather than conventionally focusing on the disease.Its core concepts include respect,cooperation,support,information,flexibility,empowerment,strength,choice.This nursing model emphasis importance on the role of the family throughout the treatment and recovery of the disease,care about physical as well as mentalchanges and requires of children and their parents,guide and encourage parents to participate in nursing decision-making,which will help building cooperative relationship among children-family-nurse,effectively improving the quality of service.ObjectiveIn this study,we performed a "family-centered care" model for pediatric patients with CHD who underwent interventional closure,and compared the effects between two nursing models on relieving the postoperative pain,the anxiety level of the parents and assess satisfaction of parents for nursing care when they were in the hospital.The purpose is to find a more reasonable and reliable way for caring children with CHD who underwent interventional closure.MethodsThis research was conducted through investigation questionnaire.Strict case inclusion and exclusion criteria are enforced.100 children who underwent interventional treatment of CHD at some hospital from January to June in 2016 were selected as the subjects of this study.The control group adopted routine nursing mode of pediatrics,while the test group receiving FCC model which gave the parents full information during treatment,educated them on congenital heart disease,including active communication and psychological support.General information of their families and disease were collected,Assessment Scale(Face Legs Activity Cry Consolability,FLACC),State Anxiety Questionnaire(State Anxiety Inventory,SAI)and Newcastle care Satisfaction Scale(Newcastle satisfaction with using pain behavior nursing scales,NSNS)were used to evaluate postoperative pain of two groups of children,parents perioperative anxiety and satisfaction of clinical care services.SAI was collected on the day before surgery,24 hours postoperatively,and the day of discharge;FLACC was collected on the first three days in the general ward,and the day of discharge.NSNS was collected during the day leaving hospital.All data were analyzed using the SPSS 17.0 package,resultsare expressed as (?)±s (mean ± standard deviation)for quantitative variables.The data which accorded with the normality test were analyzed by t test,the other data which did not meet the normality test were analyzed by rank sum test.Enumeration data were compared using the χ~2 test.P< 0.05 was considered statistically significant.Results1.There was no significant difference in sex distribution,age,rural and urban distribution,type of congenital heart disease of the children and education level of the parents between the two groups(P > 0.05).2.The postoperative pain degree of the two groups showed a decreasing trend.The FLACC score of the intervention group was significantly lower than that of the control group on day 1 to day 3 after surgery(P < 0.05).There was no statistic difference between two groups of FLACC score on the day of leaving hospital(P > 0.05).3.Compared with the control group,the family status anxiety scale(SAI)scores of the intervention group was significantly lower than those of the control group at the preoperative day,the postoperative 24 h and the day of discharge(P < 0.05).4.The scores of nursing satisfaction of family members in intervention group were significantly higher than those of the control group.There were significant differences between the two groups(P < 0.05).Conclusions1.The "family-centered care" model can effectively relieve pain of children after interventional closure.The improvement of postoperative pain scores was closely related to the involvement of parents or other family members.2.The "family-centered care" model can effectively relieve the anxiety state of these parents in the whole perioperative period.When these parents participated in children’s disease care,their cognition to children’s disease would be improved,and anxiety state would be alleviated.3.Carrying out the "family-centered care" model can significantly improve the satisfaction of the parents to the nursing care,which is effective to promote benign interaction between the health workers and the patients. |
