目的 调查结直肠病变行内镜黏膜下剥离术患者心理应激水平，分析其相关影响因素，探讨其护理策略。 方法 选取无锡市第二人民医院在2019年7月至2022年8月期间消化内镜中心接收的98例结直肠病变采取内镜黏膜下剥离术治疗患者作为观察对象。依据心理应激程度的不同将其分为每组49例的心理应激障碍组和正常组，并对其进行单因素分析、Logistic多因素分析。 结果 两组年龄、性别、麻醉方式、手术时长、病变范围、病变位置、止血夹使用数量、文化水平、糖尿病史、病程、白细胞计数(WBC)、婚姻状况等差异不具有统计学意义(P>0。05)；视觉模拟量表(VAS)、疾病认知度、社会支持评定量表(SSRS)等具有统计学意义(P<0。05)；Logistic回归分析结果显示，疾病认知<75分、VAS≥4分、SSRS<33分等均为结直肠病变内镜黏膜下剥离术患者心理应激障碍的危险因素(P<0。05)。 结论 结直肠病变采取内镜黏膜下剥离手术治疗患者心理应激障碍影响因素众多，其中疾病认知差、疼痛、社会支持等为主要影响因素，应对其开展疾病知识健康宣教、疼痛管理及同伴支持等护理干预，以此促进患者早期康复。 Objective To investigate the psychological stress level of patients with colorectal lesions undergoing endoscopic submucosal dissection， analyze its related influencing factors， and discuss the nursing strategy。 Methods A total of 98 patients with colorectal lesions received by the hospital from July 2019 to August 2022 who underwent endoscopic submucosal dissection were selected as the observation objects。According to the different degree of psychological stress， they were divided into psychological stress disorder group and normal group， 49 cases in each group， and carry on single factor analysis， Logistic multi-factor analysis。 Results There were no statistically significant differences between the two groups in age， gender， anesthesia method， operation duration， lesion scope， lesion location， number of hemostatic clips used， educational level， history of diabetes， course of disease， White Blood Cell Count (WBC) and marital status(P>0。05)。 Visual Analogue Scale (VAS)， disease awareness scale and Social Support Rating Scale (SSRS) were statistically significant(P<0。05)。 Logistic regression analysis showed that， disease recognition <75 points， VAS≥4 points and SSRS<33 points were risk factors for psychological stress disorder in patients undergoing endoscopic submucosal dissection for colorectal lesions(P<0。05)。 Conclusions There are many influencing factors for psychological stress disorder in patients with colorectal lesions treated by endoscopic submucosal dissection， among which poor disease cognition， pain and social support are the main influencing factors。Nursing interventions such as health education， pain management and peer support should be carried out to promote early recovery of patients。
The factors and nursing strategies of psychological stress level in patients undergoing endoscopic submucosal dissection for colorectal lesions
Objective To investigate the psychological stress level of patients with colorectal lesions undergoing endoscopic submucosal dissection, analyze its related influencing factors, and discuss the nursing strategy. Methods A total of 98 patients with colorectal lesions received by the hospital from July 2019 to August 2022 who underwent endoscopic submucosal dissection were selected as the observation objects.According to the different degree of psychological stress, they were divided into psychological stress disorder group and normal group, 49 cases in each group, and carry on single factor analysis, Logistic multi-factor analysis. Results There were no statistically significant differences between the two groups in age, gender, anesthesia method, operation duration, lesion scope, lesion location, number of hemostatic clips used, educational level, history of diabetes, course of disease, White Blood Cell Count (WBC) and marital status(P>0.05). Visual Analogue Scale (VAS), disease awareness scale and Social Support Rating Scale (SSRS) were statistically significant(P<0.05). Logistic regression analysis showed that, disease recognition <75 points, VAS≥4 points and SSRS<33 points were risk factors for psychological stress disorder in patients undergoing endoscopic submucosal dissection for colorectal lesions(P<0.05). Conclusions There are many influencing factors for psychological stress disorder in patients with colorectal lesions treated by endoscopic submucosal dissection, among which poor disease cognition, pain and social support are the main influencing factors.Nursing interventions such as health education, pain management and peer support should be carried out to promote early recovery of patients.
Endoscopic submucosal dissectionColorectal lesionsPsychological stress levelHealth educationPain careSocial support
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