Study On The Nursing Intervention Effect Based On Risk Factors Analysis For Children With Severe Measles

ObjectiveTo retrospectively analyze the clinical data of children with measles,we explore the risk factors of the progression from mild to severe for children with measles.According to the risk factors and several experts'opinions,a nursing intervention is preliminarily established.It includes the prevention of risk factors,early identification and intervention.We conducted the nursing intervention and evaluated the nursing intervention effects.Methods1.The clinical data of 230 children measles were analyzed by retrospective study.The ANOVO and Logistic regressions were used to explore the risk factors of children severe measles,in order to find the methods of preventing and identifying the risk factors.Then it could provide references for establishing a new nursing intervention.2.According to the above risk factors,previous literature,and rich experts experience in the children with measles,the nursing intervention for children with measles was put forward initially.Using the Delphi method,a nursing intervention was established based on risk factors analysis for children severe measles.3.According to the random number table method,90 children with measles were randomly divided into the experimental group and the control group.Before being discharged,the control group was given routine care,and the experimental group was nursing intervention on the basis of routine care.The effect of this nursing intervention was evaluated by comparing the incidence rate of severe measles,time of fever,eruption time,length of hospitalization,hospitalization cost and satisfaction of hospitalization between the two groups.Results1.The main risk factors for severe measles in children is hypokalemia(OR=5.697,P=0.004,95%CI:1.761-18.435),the decrease of CD4~+/CD8~+(OR=3.473,P=0.007,95%CI:1.395-8.645)?hypernatremia(OR=2.815,P=0.035,95%CI:1.075-7.371),recent history of respiratory infection(OR=2.649,P=0.031,95%CI:1.090-6.437),hypohemoglobin(OR=2.333,P=0.042,95%CI:1.031-5.282)?2.The nursing intervention was established for children with measles after two rounds of experts'inquiry.It included three first-level indicators and 17 second-level indicators.The first-level indicators included prevention and reduction of the risk factors,early identification and improvement of the correction effect for children with measles.The weights values were 0.514,0.278,0.208respectively.In addition,the risk assessment scale was established including four aspects and 17 observational indicators.3.A total of 90 children with measles were included in strict accordance with the inclusion and exclusion criteria,including 45 children in the control group and 45children in the experimental group.The study showed that the incidence rate of children with severe measles in the experimental group was significantly lower than that in the control group(?~2=4.712,P=0.030).The differences in fever,rash,hospitalization time and hospitalization cost between the two groups were statistically significant(t=10.179,P<0.001;t=4.961,P<0.001;t=2.724,P=0.007;t=2.822,P=0.002).And the hospital satisfaction in the experimental group was significantly higher than the control group(?~2=4.444,P=0.035).Conclusion1.Decreased CD4~+/CD8~+,hypokalemia,the recent history of respiratory tract infection,hypernatremia and hypohemoglobin are important risk factors for severe measles in children,which can be used as a reference for nurses to identify and prevent severe measles in the early stage.2.According to the above risk factors,a nursing intervention is established finally.It includes the prevention of risk factors,early identification and intervention.The authority and representativeness of the experts in this research are good,and the opinions on various indicators are consistent.It demonstrates that the scientific,credible and feasible.3.The nursing intervention based on the risk factors of children with severe measles could effectively alleviate the disease,reduce the probability of progression,shorten the time of fever,eruption time and the length of hospital time,lower hospital costs,improve the satisfaction of hospitalization.It can be used as a reference to improve the quality of care for children with measles,delay the disease progression and reduce the occurrence of severe diseases.