严重急性唿吸道综合征( Severe Acute Respiratory Syn2drome ， SARS ，即非典型肺炎)中重癥患者因其病情进展迅速 ，无特效治疗且死亡率高 ，而极易出现心理障碍 ，以至于影响严重急性唿吸道综合征。因此 ，有针对性的心理调适是消除患者心理障碍的有效治疗手段。
1 SARS重癥患者心理障碍的影响因素
(1) SARS传染性强 ，无特效治疗方法;
(2)疾病使患者发热、 憋气 ，缺氧 ，这些痛苦使患者情绪低沉;
(3)容易传染给家人、 亲属、 同事、 朋友、 邻居等 ，令患者有负疚感;
(4)入院后单独处在陌生的环境中 ，不能得到亲人精神上的支持、 安慰和生活上的照料、 护理 ，使患者感到孤独无助;
(5)看到病区中医护人员的严格防护措施和整套严谨的操作步骤 ，而引起恐慌;
(6)邻近患者的死亡或者相关消息的传播 ，更加重患者的恐惧心理;
(7)严密的防护措施带来的护士实施操作的难度
(3 层手套使护士操作时灵敏度下降 ，防护眼镜内形成的水蒸汽使护士看不清楚) ，使患者在忍受病痛时增加了不适感。
2 SARS重癥患者心理障碍的表现
SARS可引起患者紧张、 焦虑、 焦躁、 恐惧的表现:
(1)随着病程的进展 ，患者的心理压力增大 ，处于应急状态 ，易出现失眠 ，烦躁不安 ，情绪不稳等癥状。
(2)部分患者(尤医务人员患者)对疾病有所了解 ，心理负担更大 ，担心即使痊愈 ，也会留有后遗癥(如发生肺间质纤维化) ，体质从此下降 ，由此造成精神的高度紧张。
(3)由于不了解病程的发展规律 ，患者往往对治疗失去信心 ，出现不配合治疗 ，情绪低落 ，有濒死感。
3 应对方法
(1)像对待亲人一样地对待患者:由于患者无法见到亲人 ，内心已经感到焦虑 ，因此需要病区医护人员在严格遵守防护措施的前提下 ，让患者得到没有恐惧、 没有嫌弃的护理 ，感受到胜似亲人的温暖和关爱。既然严格执行了严密的防护措施 ，护士就需要克服莫名的恐惧心理 ，像护理普通患者一样地护理 SARS患者;对待医务人员患者 ，更要经常不断地鼓励他们 ，让他们感到所有的同事都是他们强有力的支撑 ，一定会让他们康复出院。
(2)增加沟通和交流:要把对患者的心理护理融合到日常护理当中 ，护士在每次巡视中 ，都要主动询问患者 “您感觉好些吗 ?” “有什麽新问题需要解答吗 ?” “有什么难处需要帮助吗 ?” 尽可能地帮助他与外界联系。
并在每一次的操作中都要耐心、 细致 ，一边解释 ，一边进行 ，尽量减轻患者的痛苦。加强心理护理 ，让患者感到虽然不幸患病 ，但并没有被社会抛弃;虽然暂时不能和亲友同事见面 ，但自己的需求仍然能得到满足。当病情一时不见缓解时 ，应向患者解释病程发展的规律;当病情出现好转时 ，及时把信息反馈给患者本人。心理上的细致照顾 ，能有效增强患者康復的信心 ，加快康復进程。
(3)加强有关疾病知识的宣教:在对患者实施治疗、 护理的同时 ，讲解有关 SARS 的知识 ，让患者了解 SARS并不是无法战胜的 ，帮患者认清心理障碍对疾病治疗及康复的不利影响 ，及时消除不积极的心理状态。
(4)提高护理操作技能:护士必须在短时间内适应全新的工作环境 ，要在戴着 3 层防护手套及模煳的护目镜情况下 ，做到 “一针见血” ，这是相当高的专业要求 ，也是 “战时” 锻炼强手的极好机会。同时还要培训护士加强对应用无创唿吸机患者的观察和监护 ，只有这样 ，才能真正减轻患者对治疗的紧张和恐惧。
译文：
Of severe acute respiratory syndrome (Severe Acute Respiratory Syn2drome, SARS, or atypical pneumonia) in patients with severe disease because of its rapid progress, no specific treatment and the mortality rate is high and prone to psychological disorder, so that the impact of severe acute respiratory Comprehensive sign. Thus, targeted patients with psychological adjustment is to remove the psychological barriers to effective treatment.
1 SARS patients with severe psychological factors affecting
(1) SARS contagious, no specific treatment methods;
(2) disease so that patients with fever, suffocation and oxygen in patients with these painful emotions so deep;
(3) easily transmitted to family members, relatives, colleagues, friends, neighbors, etc., so that patients have a guilty conscience;
(4) admission to hospital in an unfamiliar environment alone can not get their loved ones spiritual support, comfort and life care, nursing care, so that patients feel lonely helplessness;
(5) to see medical ward in the strict protective measures and strict set of steps, which leads to panic;
(6) in patients near death or the dissemination of relevant news, and more emphasis on fear of patients;
(7) stricter protective measures to bring about the implementation of the operation more difficult for nurses
(3-layer glove so that the nursing operation, sensitivity decreases, protective glasses of water vapor formed inside to enable nurses to see clearly), so that patients endure pain, increase the discomfort.
2 SARS patients with severe manifestations of psychological disorders
Patients with SARS can cause stress, anxiety, irritability, fear of performance:
(1) As the disease advances, the patient's psychological pressure, in a state of emergency, easy to insomnia, irritability, mood swings and other symptoms.
(2) of the patients (particularly in patients with medical staff) an understanding of the disease, psychological burden on larger, worried that even if cured, will sequelae (such as the occurrence of pulmonary interstitial fibrosis), decreased physical fitness from the resulting mental high tension.
(3) The laws of development do not understand the course of the disease, patients often lose confidence in treatment, there is not with treatment, depression, there is a sense of dying.
3 to address the challenges
(1) treat their loved ones to treat the same patient: Because patients are unable to see their loved ones, hearts have been anxious, requiring ward staff in strict compliance with protective measures under the premise to enable patients to be without fear, without dislike of care, feelings of to like owning family warmth and love. Since the strict implementation of the strict protective measures, nurses need to overcome the fear of nameless, such as nursing care for patients as normal in patients with SARS patients; to treat patients with medical personnel, but should always continue to encourage them, let them feel that all my colleagues is that they have strong support, will make them discharged.
(2) to increase communication and exchange: the psychological care of patients should integrated into the daily care of them, nurses at each visit, the patient must take the initiative to ask 'do you feel better?' 'What new issues need answered?' 'What are the difficulties need help?' as much as possible to help him with the outside world.
And in every operation must be patient, meticulous, he explains that, while carried out to minimize patient suffering. Strengthen psychological care, to enable patients to feel that although the illness, but not abandoned by society; although not yet, colleagues and relatives to meet their own needs, but can still be met. When the disease not seen 1:00 to ease when the patient should explain the course of the development of the law; when conditions turn for the better, the time the information back to the patients themselves. Psychological meticulous care, can effectively enhance the rehabilitation of patients with confidence, speed up the recovery process.
(3) to strengthen the knowledge of the disease in the church: in the implementation of patient treatment, care at the same time, talk on the knowledge of SARS, so that patients know what SARS is not impossible to overcome, and to help patients understand the psychological barriers to medical treatment and rehabilitation of the adverse effects of timely elimination of non-positive state of mind.
(4) Improving Nursing Skills: Nurses must be in a short time to adapt to new working environment, to wear 3-layer protective gloves and goggles ambiguous circumstances, be 'sharply', which is very high professional requirements is also the 'war' an excellent opportunity to exercise strong opponents. While also training for nurses to enhance the application of non-invasive ventilator patient observation and monitoring, the only way to really relieve the tension in patients with the treatment and fear.
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严重急性唿吸道综合征心理障碍的护理|行业论文中英文模版|学术论文校正润色服务
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