外科手术患者延续性护理模式需求现状调查

Investigation of current requirement of transitional care model on surgical patient

目的对外科手术患者进行延续护理的需求调查，为构建精准的外科手术患者延续性护理模式提供依据。方法采用便利抽样法选择广东省广州市某三甲医院自2016年10月25日-2017年1月25日外科住院的手术患者363例，用外科手术患者延续性护理需求调查表进行延续性护理需求调查。结果共10个病区的363例患者接受调查，不需要他人协助的占51．8％（188例）；居家照顾完全能够满足照顾需求的占54．0％（196例）；外科手术患者对复诊、疾病相关知识的需求量最大，分别占72．7％（264例）、69．1％（251例）；针对“由谁来提供延续性护理的服务”，53．7％（195例）选择多学科团队、17．4％（63例）选择专科护士；延续性护理的方式，62．5％（227例）及28．7％（104例）的患者倾向电话随访及微信短信交流；随访期限1个月的占68．3％（248例）、2个月的占28．2％（106例）。结论手术患者自理能力较好但仍有延续性护理的需求。我们应以多学科团队或专科护士为主导，采用电话回访及微信短信交流等方式，以1～2个月为期限，根据患者出院前评估结果制定延续性护理内容，为外科手术患者提供精准的征缝一件护王单．

Objective To investigate the current requirement of transitional care on surgical patients and provide evidences for the establishment of accurate transitional care on surgical patients. Methods A total of 363 cases of patients after the surgery in a grade A class three hospital in Guangzhou city of Guangdong province were selected using convenience sampling. Questionnaire of transitional care requirement in surgical patients was applied in the investigation of transitional care requirement. Results A total of 363 surgical patients from l0 wards were surveyed. 51.8% （188） of patients did not need others assistance; 54.0% （196） of patients completely met the needs with home care; the requirement of further consultation and disease related knowledge accounted for 72.7% （264） and 69.1% （251） of patients; for the ＂who provides the transitional care services＂, 53.7% （195） of patients chose the multidisciplinary team, while 17.4%（63）chose the specialist nurse; for the methods of transitional care, 62.5% （227）of patients preferred telephone follow-up, and 28.7% （104） of patients preferred WeChat and message exchange; 68.3% （248） of patients chose one month of follow- up, while 28.2% （106） of patients chose two months of follow-up. Conclusions The surgical patients have good self-care ability, but still need the transitional care. We should take multidisciplinary team and the specialist nurses as the dominant, and use telephone interview and WeChat SMS exchange for one or two months to provide accurate transitional care according to the evaluation results before the discharge.