摘要
目的 探究多元文化护理模式对西藏地区发育性髋关节发育患儿的应用效果。方法 选取从2017年9月01日-2019年10月31日中纳入标准的上海交通大学医学院附属儿童医院186例Salter骨盆截骨内固定术患儿，采用随机数字表方法分常规规（n=95）和干预组（n=91）。常规组为外科围手术期护理，干预组为多元文化护理模式（包括微信小程序支持、游戏课堂及家庭陪伴教育等）干预。比较两组患儿术后并发症情况（压力性损伤、切口感染、便秘）、家属临床满意度评价，与此同时，采用Zung焦虑自评量表来评定家属的焦虑程度。结果 在并发症发生率分析中，干预组比常规组压力性损伤、便秘的发生率低，差异均（p＜0.05，p＜0.001）有统计学意义；在满意度调查分析中，干预组的西藏地区患儿父母的满意度均高于常规组，均能达到“非常满意”的状态，均优于常规组（p＜0.015），差异分析有统计学意义（p＜0.05）；分别在入院时、入院1周、入院2周中对家属进行焦虑程度分析，入院一周的SAS调查分析，82%常规组焦虑指数仍徘徊在中度状态，而干预组的焦虑指数明显下降，均达到轻度焦虑，而入院两周后的测评，干预组均明显降至50分以下，为无焦虑状况，均优于常规组（p＜0.05）。结论 实施多元文化护理模式能很好的针对不同地域患儿的疾病诊疗，弥补常规护理路径的不足，改善和缓解地域差异间医护患的相关障碍，更贴切、更专业地为藏区患儿提供高效、优质、安全的护理服务。
关键词： 多元文化护理；西藏地区；发育性髋关节发育不良；患儿
Abstract
Objective To explore the effect of multicultural nursing model on children with developmental hip joint development in Tibet. Methods 186 children with Salter pelvic osteotomy and internal fixation who were included in the standard from September 1, 2017 to October 31, 2019 in the children's Hospital Affiliated to the Medical College of Shanghai Jiaotong University were selected. The random number table method was used to divide them into routine (n=95) and intervention group (n=91). The routine group was perioperative nursing, and the intervention group was multicultural nursing model (including wechat applet support, game class and family companion education). The postoperative complications (stress injury, incision infection, constipation) and the clinical satisfaction evaluation of family members were compared between the two groups. At the same time, the Zung self rating Anxiety Scale was used to evaluate the anxiety level of family members. Results in the analysis of the incidence of complications, the incidence of stress injury and constipation in the intervention group was lower than that in the routine group, and the difference was statistically significant (P < 0.05, P < 0.001); In the survey and analysis of satisfaction, the satisfaction of parents of children in Tibet in the intervention group was higher than that in the routine group, and they could reach the state of "very satisfied", which was better than that in the routine group (P < 0.015), and the difference analysis was statistically significant (P < 0.05); The anxiety level of the family members was analyzed at the time of admission, one week after admission, and two weeks after admission. According to the SAS investigation and analysis of one week after admission, the anxiety index of 82% of the routine group was still in the moderate state, while the anxiety index of the intervention group decreased significantly, reaching mild anxiety. However, the evaluation two weeks after admission, the intervention group was significantly reduced to less than 50 points, which was no anxiety state, which was better than that of the routine group (P < 0.05). Conclusion the implementation of multicultural nursing model can well target the disease diagnosis and treatment of children in different regions, make up for the deficiencies of conventional nursing paths, improve and alleviate the related obstacles between doctors and patients in regional differences, and provide efficient, high-quality and safe nursing services for children in Tibetan areas more appropriately and professionally.
Key words： multicultural nursing; Tibet region; Developmental dysplasia of hip joint; Children
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