目的 探讨基于目标达成理论的护理干预在CO2点阵激光治疗痤疮瘢痕的应用.方法 选择2020年1月至2022年2月,痤疮瘢痕患者140例,均先行CO2点阵激光治疗,能量12.5～70 mJ,治疗3次为1个疗程,每次治疗间隔2个月.根据不同护理干预方式分成对照组和目标达成组,每组患者70例.对照组患者采用常规护理干预;目标达成组患者采用基于目标达成理论的护理干预.激光治疗前、末次激光治疗后1个月和3个月,借助皮损积分系统对患者皮损症状积分评估皮损状况.激光治疗前、末次激光治疗后3个月,使用皮肤疾病生活质量量表(dermatology life quality index,DLQI)[5]进行生存能力评估;利用自我感受负担量表(self-perceived burden,SPB)[6]对患者的自我感受进行评估;选择健康调查简表(the MOS item short from health survey,SF-36)评估患者生活质量.比较两组患者痤疮缓解时间、不良反应发生情况、生存能力、自我感受负担及不良反应.结果 治疗前,两组患者的皮损症状积分相似(P＞0.05);末次激光治疗后1个月和3个月,目标达成组皮损症状积分均低于对照组,两组比较差异具有统计学意义(均P＜0.05).治疗前,两组患者的DLQI评分相似(P＞0.05);末次激光治疗后3个月,两组患者的DLQI评分均呈现下降趋势(P＜0.05),且目标达成组患者的DLQI评分较对照组降幅更明显(P＜0.05).治疗前,两组患者的SPB评分相似(P＞0.05);末次激光治疗后3个月,两组患者的SPB评分均呈现下降趋势(P＜0.05),且目标达成组患者的SPB评分较对照组降幅更明显(P＜0.05).两组患者治疗前生活质量评分比较,差异无统计学意义(P＞0.05);末次激光治疗后3个月,目标达成组患者生活质量评分高于对照组(P＜0.05).目标达成组经干预后,患者痤疮缓解时间(3.21±4.0)个月短于对照组(5.95±4.4)个月(P＜0.05);而目标达成组不良反应发生率(5.71％)显著低于对照组的(12.9％),两组比较差异具有统计学意义(P＜0.05).结论 基于目标达成理论的护理干预通过提高治疗效率、制定个体化护理计划、预防和管理不良反应、促进术后恢复以及提供心理支持、加强信息教育和增强社会支持等方式,能够显著提高CO2点阵激光治疗痤疮瘢痕患者的生存能力并降低患者的自我感受负担.
Application of Nursing Intervention Based on Goal Attainment Theory in Treatment of Acnes Scarring with CO2 Lattice Laser
Objective To explore the application of the nursing intervention based on goal attainment theory in the treatment of acne scars with CO2 fractional laser.Methods Totally 140 patients with acne scars admitted to our hospital between Jan.2020 and Feb.2022 were selected and divided into a control group(routine nursing intervention)and agoal achievement group(nursing intervention based on goal achievement theory)by intervention methods,70 patients in each group.The healing time,viability,self-perceived burden and adverse reactions were compared between the two groups.Results Before the intervention,the symptom scores of the two groups were similar(P＞0.05).The scores of the target achievement group were lower than those of the control group 1 month and 3 months after the intervention,and the differences between the two groups were significant(P＜0.05).Before the intervention,the DLQI scores of the two groups were similar(P＞0.05).After the intervention,the DLQI scores of both groups dropped(P＜0.05),and the DLQI score was much lower in the target group than in the control group(P＜0.05).Before the intervention,the SPB scores of the two groups were similar(P＞0.05).After the intervention,the SPB scores of both groups showed a downward trend(P＜0.05),and the SPB score in the goal achievement group was significantly lower than that in the control group(P＜0.05).There was no significant difference in life quality score between the two groups before the intervention(P＞0.05).Three months after the intervention,the life quality score of the patients in the goal achievement group was higher than that in the control group(P＜0.05).After the intervention,the remission time of acnes in the study group was shorter than that in the control group(P＜0.05).The incidence(5.71％)of adverse reactions in the study group was significantly lower than that(12.86％)in the control group,and the difference between the two groups was significant(P＜0.05).Conclusions The nursing intervention based on goal attainment theory will significantly improve the survival ability of patients with acne scars treated with CO2 laser and reduce their self-perceived burden through improving treatment efficiency,formulating individualized nursing plan,preventing and managing adverse reactions,promoting postoperative recovery,providing psychological support,strengthening information education and enhancing social support.
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