Objective: to study children with nephrotic syndrome during the period of hospitalization， it showed several psychological problems and the effective psychological nursing intervention measures.Methods: the medical staff at the same time of treatment of psychological problems of children were targeted effective psychological nursing.Results: nursing care can keep a good state of mind, children receive hospital treatment with satisfactory results.Conclusion: the scientific nursing can make the children with nephrotic syndrome to overcome the fear, pessimism, inferiority, psychological problems such as adjusting the mentality, building confidence, and understanding the necessity of drug treatment and the side effects of drugs and diet knowledge, achieving the goal of treatment to adherence rehabilitation.
1、Clinical data: in our hospital from 2000 to 2006, clinical data collection of hospitalized children with nephrotic syndrome showed that were 38 cases of 6 ~ 12 years old in 46 cases of school-age children, during their hospitalization, they were different psychological problems, such as anxiety, fear, depressed, afraid of loneliness, inferiority and other psychological problems.Scientific and effective psychological nursing can improve children with psychological barriers to actively cooperate with medical staff in the best state.
Children with nephrotic syndrome in addition to the necessary medication and dietary control, scientific nursing is a indispensable and important link.Because these children can't live like a normal child during hospitalization and learning, in a strange environment, they contact with patients and medical workers everyday, treatment of pain and the change of the body in the process make them gradually become indifferent, loneliness, fear, inferiority complex.For these children, medical staff should strengthen the psychological nursing, make them know that the disease is not terrible, as long as active treatment, the body will soon recover, they can study and live like other normal children, they should have positive state of mind to accept treatment in order to improve curative effect and shorten course of treatment.
(1)Scared and pessimistic psychology
This group of children with nephrotic syndrome are mostly school-age children, they are in active age, due to illness, they have been admitted to the hospital this special environment, especially they must see strange medical workers in a white coat and painful strange patients, some timid children are afraid of an injection and taking medicine, they are nervous when they see medical workers, they worry about the disease to become severe, even they can die, they can become edgy, timid, gloomy, unhappy and lose the past vitality, children with this kind of undesirable mood will affect the treatment and rehabilitation of the disease.So health care workers must be like a loving mother to care and comfort them, tell them this disease is not terrible, as long as cooperate with treatment they can be cured so that they are gradually familiar with and accustomed to the new environment.For timid children, medical workers can give them some recovery of patients to improve treatment and eliminate the fear. For some of the abnormal test results and possible adverse consequences, medical workers should pay attention to avoid children when they explain for their patients, workers should take the necessary protective measures. Parents and health care workers should cooperate with each other, take care of children together, make them feel the people around you who are concerned about them, and they no longer feel fear and pessimism to build confidence, courage to overcome diseases and accept active treatment.Understanding the cause of children psychological factors of fear, you can use scientific and effective preventive measures and the corresponding nursing countermeasures in order to reduce children's fear of disease.
(2) The change of dietary habits
Children can produce strong interest in lots of food, a healthy child don't have to be strictly controlled, but for children with nephrotic syndrome, diet plays an important role in the treatment, the incorrect diet can aggravate the illness.Patients have high edema in the early period, a large number of protein is eliminated out from urine, the body appear the deficiency of protein , so children should be supplied from the diet and control the intake of salt at the same time, so children should be given a high-protein diet and low salt diet, such as meat, eggs, fish, bean products, but the salt is not more than 2 g in daily life. Some children are difficult to accept the diet especially only children at home. In this case, first of all,medical worker should explain to children and parents, explain the dangers of excessive salt diet, if children continue to a large number of edible salt diet, it can affect the treatment of diseases, the condition is difficult to improve,edema of children disappear and they can gradually eat some salty food, at the same time workers should encourage children to eat a high-protein diet, let the children know that protein is essential nutrients,it is very important for the body.Parents try every means to regulate food color, flavor and variety, the diet should be suitable for the taste of the children as far as possible, improve the patient's appetite and make treatment to proceed smoothly.
(3) Psychological inferiority and loneliness
Hormone is a commonly used drugs in the treatment of nephrotic syndrome, hormone need to be taken for a long time, but long-term use will produce a series of significant side effects, such as centrality obesity, full moon surface and buffalo hump, due to the shape has changed and the ridicule of their peers, especially some who love beauty will be away from the crowd, children can produce psychological inferiority, and loneliness, depression, any improper language is likely to be an undesirable psychology to have negative influence on children, children are reluctant to accept hormone therapy, however, hormone therapy is a long-term process, if drug is terminated, treatment will be reversed, it make the illness repeated.Medical staff meet any strong inferiority mentality of children with nephrotic syndrome, they should enthusiastically help take care of them, they should explicitly tell children the importance of hormone therapy and long-term drug treatment effect at the same time, in the process, it can also appear some side effects. With the improvement of condition, after drug withdrawal, hormone effects caused by the adverse symptoms will gradually eliminate, it can eliminate from psychological to remove the patient's psychological inferiority complex, and loneliness, children can establish the confidence of conquering disease,they need to have a positive attitude to complete the treatment plan.
2.4 Worry about affecting study
Because this group of children for school-age children, more long-term hospitalization repeatedly, they can't have normal study, parents are very worried about their grades, parents are afraid of influencing the future academic and career development, it can increase the child's psychological burden, children can become depression, silent, anxiety, irritability and temper, they want to go out of the hospital.In order to avoid and reduce the children’s anxiety, medical staff must be good at observing analysis, grasp the children’s psychological change and requirements, they should have timely communications with children and guidance with careful nursing care affecting their emotions, in the condition of permission, medical workers can organize children to learn together with parents, they also can invite the teacher and students to go to the hospital for sick children with homework, so that we can meet the needs of children with learning, reassure children hospitalized, remove the trouble back at home.
(5) Recovery psychological guidance
The children’s symptoms disappeared basically in the period, some children and parents think thoroughly cure disease, children can heartily play and eat food, children no longer pay attention to the surrounding environment, spiritual is completely relaxed, even children forget to take the maintaining quantity of hormone.However, children with symptoms disappeared basically, but due to long-term use of hormone drugs, decreased body resistance decrease due to long-term use of hormone drugs, it is easy to cause respiratory tract infection, infection and stoping using hormone can make the disease progression or recurrence.So medical personnel must be prepared to explain the relevant matters needing attention, including diet, hormone reduction principle, parents and children should understand the general disinfection method and health knowledge, children should pay attention to rest, they can have proper activity, pay attention to the weather changes, increase or decrease clothes in time, prevent colds.
Children who produce different psychological problems should have implementing targeted psychological care, that all children can overcome psychological problems and psychological barriers, actively cooperate with treatment, develop good eating habits of life, optimistic upward psychological, shorten the treatment course so as to achieve the desired effect.
Psychological care for children with psychosomatic disorders diseases can take the corresponding protective measures in the process of psychological reaction, it can give full play to the patient's subjective dynamic role, it has important value of medical treatment, prevention and health care, the patient's disease rehabilitation is one of the best results for medical staff psychological nursing work.The nursing staff use their own words and deeds to influence and change the patient's mental state, let the children be in the best state of mind with active treatment in order to improve the effect of treatment of disease, it can make a quick return to good health of body and mind, children and healthy children can have same life and learning.