基于预见性理论的优质护理对肠梗阻患者术后感染的预防效果研究

Preventive effects of high quality nursing based on predictive theory on postoperative infection of patients with intestinal obstruction

目的探讨基于预见性理论的优质护理对肠梗阻患者术后感染的预防效果研究。方法选取收治的手术治疗的肠梗阻患者100例,随机分为优质护理组和常规组,每组50例,常规组给予入院宣教、心理护理等常规护理,优质护理组在常规护理基础上给予基于预见性理论的优质护理干预,采用自制《肠梗阻患者术后预防感染知识问卷》评估预防感染知识掌握情况,采用自制《肠梗阻患者遵医行为问卷》评估遵医行为依从性,采用焦虑自评表(SAS)评估焦虑状态,采用logistic回归性分析法分析肠梗阻患者术后感染独立影响因素,分析2组患者预防术后感染知识掌握程度、遵医行为依从性、干预前后及干预后3、6、10 d的焦虑状态、术后3、7、14、21 d切口感染情况。结果优质护理组患者术后感染预防知识掌握率高于常规组,差异有统计学意义(P<0.05);优质护理组患者遵医行为依从率高于常规组,差异有统计学意义(P<0.05);优质护理组患者护理干预前SAS评分与常规组差异无统计学意义(P>0.05),而优质护理组干预后3 d、6 d、10 d的SAS评分明显低于常规组,差异有统计学意义(P<0.05);优质护理组患者术后切口总感染率低于常规组,差异有统计学意义(P<0.05);Logistic回归性分析法结果显示,预防感染知识掌握程度、焦虑状态及遵医行为依从性是患者术后感染的独立危险因素(P<0.05)。结论对肠梗阻术后患者实施基于预见性理论的优质护理能有效提高患者的遵医行为依从性和预防感染知识掌握程度,同时改善患者不良情绪,有利于降低患者术后感染率及其独立影响因素的不良影响,值得临床进一步推广应用。

Objective To investigate the preventive effects of high quality nursing bases on predictive theory on postoperative infection of patients with intestinal obstruction. Methods A total of 120 patients with intestinal obstruction who were treated in our hospital from June 2014 to May 2016 were randomly divided into high quality nursing group and routine nursing group, with 50 patients in each group. The patients in routine nursing group were treated by propaganda and education on admission and mental nursing, however, the patients in high quality nursing group, on the basis of routine nursing group, were treated by high quality nursing based on predictive theory. The postoperative infection prevention knowledge levels of patients were assessed by self-made 〈（ Questionnaire about postoperative infection prevention knowledge of intestinal obstruction）〉, and patient＇ s behavior compliance according to medical order was evaluated by self-made 〈〈 Questionnaire about behavior compliance according to medical order〉〉, moreover, patient＇ s anxiety state was assessed according to anxiety scale （SAS）. Moreover the independent influencing＇factors of postoperative infection of patients with intestinal obstruction were statistically analyzed. Besides the postoperative infection prevention knowledge levels of patients, behavior compliance according to medical order, anxiety state of patients before intervention and on 3d,6d, 10d after intervention, and postoperative incision infection condition on 3d,7d, 14d,21d after surgery were analyzed by means of Logistic regression analysis. Results The postoperative infection prevention knowledge levels in high quality nursing group were significantly higher than those in routine nursing group （ P 〈 0.05 ）. The behavior compliance rate according to medical order in high quality nursing group was obviously higher than that in routine nursing group （P 〈 0.05 ）. There were no significant differences in SAS scores before nursing intervention between two groups （P 〉 0.05 ）, however, the SAS scores on 3d, 6d, 10d after nursing intervention in high qualitynursing group were significantly lower than those in routine nursing group （P 〈 0.05）. Moreover the postoperative incision infection rate in high quality nursing group was obviously lower than that in routine nursing group （ P 〈 0.05 ）. The Logistic regression analysis results showed that postoperative infection prevention knowledge levels of patients, anxiety state and behavior compliance according to medical order of patients were independent influencing factors of postoperative infection of patients with intestinal obstruction （ P 〈 0.05 ）. Conclusion The high quality nursing based on predictive theory can effectively improve the behavior compliance according to medical order and postoperative infection prevention knowledge grasping degree of patients with intestinal obstruction, moreover, which can improve the patients＇ bad emotions and is benefit to decrease postoperative infection rate and adverse impact of independent influencing factor, therefor, which is worth using widely in clinical practice.