Continuous Care On Psoriasis Based On The Theory Of Goal Attainment Effect Study Of Patient Intervention

Objectives: To understand the current nursing status and continuing care needs of patients with psoriasis in a dermatological hospital,and to analyze the current problems of psoriasis patients.According to the results of the current survey,the patient demand-oriented,interactive compliance theory is the theoretical framework.Patients with psoriasis undergo continuation nursing intervention to explore the continuation of nursing based on the theory of compliance to improve the self-health management ability of patients with psoriasis,enhance medication compliance,improve patients' psychological status and quality of life,increase medical satisfaction and reduce the rate of re-admission.effect.Provide scientific,effective and standardized clinical basis for the continuous nursing practice of patients with psoriasis,and provide a strong guarantee for improving the quality management and nursing service level of psoriasis in dermatological hospitals.Methods: Firstly,the current situation of psoriasis patients in our dermatology clinics and wards,as well as dermatology nurses in our hospital,was investigated to understand the current problems of psoriasis care,and the related needs and satisfaction of patients with psoriasis.Degree,dermatology specialist nurses' structure and their cognition of continuation care provide a practical basis for the implementation of psoriasis continuation nursing intervention;secondly,the establishment of continuation nursing group,the development of continuation nursing intervention program,based on the theory of interactive compliance.The entire continuation nursing intervention process is divided into five stages of “assessment-diagnosis-planning-execution-evaluation” to establish and maintain a dynamic and continuous nursing method for hospitalization in our hospital from March 2018-June 2018.The 136 patients with psoriasis provided a 6-month continuation of nursing interventions;the final is a systematic and standardized training for dermatology nurses to master the specific interventions based on the continuation of the theory of compliance,using the continuation of care models Nursing intervention for patients with psoriasis in dermatology hospital,statistical analysis of the intervention model before use,1 month After 3 months and 6 months,the self-health management ability,medication compliance,quality of life,patient satisfaction,and readmission rate of patients with psoriasis were evaluated to improve the self-health management ability of patients with psoriasis.Increase the compliance of medication,improve the patient's psychological status and quality of life,and improve the patient's satisfaction with medical treatment.Results:(1)Current status survey results: Epidemiological survey of psoriasis:(1)From a worldwide perspective,the incidence of psoriasis is 0.1 to 3%,and about 125 million people suffer from psoriasis.The patient has at least 150,000.The prevalence rate in Europe and the United States is 1% to 2%,while the incidence rate in China is 0.47%.However,about 6.5 million people are sick in China and increase year by year.(2)In the past 25 years,the psoriasis specialist clinic in our hospital The number of visits is about120,000,and the number of psoriasis patients is high.Survey of current status of continuing care needs for patients with psoriasis: average age of psoriasis patients(39.79±11.52)years old,(1)Demand situation: 84.1% of patients believe that continuous care is needed,10.7% of patients do not care about continuing care,5.2% think that continuous care is unnecessary;(2)continuation of nursing content needs:96.2% of patients indicated that they needed to be rehabilitated,98.2% said they needed skin care guidance,85.8% said they needed oral and topical medications and precautions,and 82.3% said they needed daily activities and rest guidance,97.8 % of patients indicated that they needed dietary guidance,96.9% of patients indicated that they needed exercise and lifestyle guidance,78.3% said they needed emotional support and psychological guidance,97.0% said they needed guidance of Chinese medicine bath,and 77.2% said Outpatient referral guidance is required,and 97.3% of patients indicate that individualized health education is required.Pediatric nurses continue to care service cognition survey:(1)average age(26.75 ±5.73)years old,including 16 specialists,accounting for 55.2%,13 undergraduates,accounting for 44.8%;5 employees,accounting for 17.2%,title There are 14 people who are nurses,accounting for 48.3%,9 of whom are called supervisors,accounting for 31.1%,1 of whom are called deputy directors,accounting for 3.4%;5 of them are less than 3 years old.,accounting for 17.2%,16 people in 3-5 years,accounting for 55.2%,8 people over 5years,accounting for 27.6%;(2)Details of continuing care including proficiency in professional knowledge: continuing main content and purpose of care,skin diseases Mechanism principle,various external medicines and methods of use,psoriasis treatment and nursing technology;dermatology professional knowledge development training;master professional skills: external application wet compress,packaging,sealing technology,dermatological management of severe skin diseases,ultraviolet light therapy Operation methods,skin barrier repair nursing techniques,communication skills,humanities knowledge,other(psychological counseling,religious beliefs,etc.);with professionals: standardized training for continuing care workers,the establishment of a continuing care team;hope policy support: Issue relevant policies and regulations,and establish a continuous care quality monitoring organization.(2)Based on the theory of compliance,the development of nursing plan: based on the analysis and summary of the preliminary needs survey results,the final determination of continuing care interventions at four different levels are physiological level,psychological level,behavioral lifestyle and social environment.According to the existing nursing problems at all levels,the goal of nursing intervention is proposed,and the personalized continuing nursing intervention content is further developed.(3)Intervention effect study based on the continuation of the nursing program:Comparison of medication adherence between the two groups: after the intervention,the proportion of high compliance in the routine group was 22.7%,and the proportion of the intervention group was 41.2%;the proportion of compliance in the routine group was24.2%,and that in the intervention group was 36.0%;The sex ratio was 53.1%,and the intervention group was 22.8%.Comparison of self-health management ability between the two groups: the scores of the routine group and the scores of cognitive ability,psychological status,behavioral lifestyle,social environment and treatment compliance were(3.37±2.60)and(3.24±0.85)after the intervention.(3.40±0.86),(3.42±0.82),(3.45±0.89),(3.34±0.85),and the intervention group were(4.25±2.00),(4.22±0.83),(4.28±0.83),(4.20).±0.84),(4.28±0.77),(4.25±0.78).Comparison of quality of life between the two groups: the scores of the routine group after the intervention in the total score and symptom performance,daily life,leisure and entertainment,personal relationship,treatment,etc.were(5.35±1.53),(0.68±0.47),(0.52± 0.54),(0.55±0.53),(0.48±0.50),(0.60±0.49),and the intervention group were(3.89±1.26),(0.44±0.50),(0.11±0.31),(0.08±0.27),(0.39±0.49),(0.16±0.37).Comparison of readmissions between the two groups: the expected readmission rate was 23.5% for the entire group and 13.2%for the intervention group.Comparison of medical satisfaction between the two groups:the scores of the regular group in health education,nursing guidance content,professional technical level,service attitude,and humanistic care were(3.02±1.11),(2.98±1.06),(3.27±0.94),respectively.(3.01±1.06),(3.13±1.28),intervention group(4.06±0.83),(4.09±0.77),(4.03±0.78),(3.98±0.69),(3.95±0.68),between groups Differences in intervention time and intervention methods were statistically significant.Conclusion: Psoriasis,as a chronic inflammatory skin disease,is easy to relapse,has a long course of disease,and the condition is repeatedly delayed and unhealed,which seriously affects the physical and mental health of patients.Because of traditional nursing models are difficult to provide patients in a timely and efficient manner.Good out-of-hospital services,therefore,there is an urgent need for an individualized continuation care model to meet the nursing needs of patients with psoriasis and improve their quality of life.the continuation care model based on the theory of compliance,highlighting the initiative of nurses to patients The demand-oriented,through the cooperation of nurses and patients,to participate in and solve the nursing care problems,to achieve the goal of care.Thereby,the self-health management ability of patients with psoriasis can be enhanced,thereby improving the quality of life and reducing and preventing the recurrence of psoriasis.It is of great significance in increasing patient satisfaction,reducing the rate of re-admission,improving the value of nurses,and improving the quality of nursing services,truly reflecting the practical value of continuing care.