知识行为模型循证实践模式结合聚焦心理护理模式在结肠镜检查前肠道准备中的应用

Application of Knowledge to Action Model Evidence-Based Practice Model Combined with Focused Psychological Nursing Model in Bowel Preparation Before Colonoscopy

目的分析知识行为模型(KTA)循证实践模式结合聚焦心理护理模式在结肠镜检查前肠道准备中的应用。方法选取2019年1月至2020年1月河南中医药大学第一附属医院收治的98例接受结肠镜检查的受试者作为研究对象,按随机数表法分为研究组与对照组,各49例。对照组接受常规护理联合心理护理干预,研究组在对照组基础上接受KTA循证实践模式结合聚焦心理护理模式干预。观察入院时与结肠镜检查前,两组受试者心理状态[状态-特质焦虑问卷(STAI)]、结肠镜检查认知水平,对比两组受试者应对方式[医学应对方式问卷(MCMQ)]、肠道准备质量[Boston肠道准备量表(BBPS)]及检查时舒适度[患者舒适度量化表(NAPCOMS)]。结果结肠镜检查前,两组受试者《大肠癌高危人群结肠镜检查知信行调查问卷》评分均较入院时升高,且研究组高于同期对照组(P<0.05);结肠镜检查前,两组受试者S-AI及T-AI评分均较入院时降低,且研究组低于同期对照组(P<0.05);结肠镜检查前,研究组受试者面对评分、3段结肠BBPS高于对照组(P<0.05),研究组患者回避、屈服及NAPCOMS评分均低于对照组(P<0.05)。结论KTA循证实践模式结合聚焦心理护理模式干预可有效减轻结肠镜检查受试者心理负担,提升相关知识水平及肠道准备质量,增加其舒适度。

Objective To analyze the application of knowledge to action model(KTA)evidence-based practice model combined with focused psychological nursing model in bowel preparation before colonoscopy.Methods A total of 98 patients who underwent colonoscopy admitted to the First Affiliated Hospital of Henan University of CM from January 2019 to January 2020 were selected as subjects,and they were divided into study group and control group according to the random number table method,with 49 cases in each group.Control group received routine nursing combined with psychological nursing intervention,and study group received KTA evidence-based practice model combined with focused psychological nursing model intervention on the basis of control group.The psychological states[state-trait anxiety inventory(STAI)]and cognitive level of colonoscopy were observed in the two groups at admission and before colonoscopy,and the coping styles[medical coping modes questionnaire(MCMQ)],bowel preparation quality[Boston bowel preparation scale(BBPS)]and comfort during examination[nurse assessed patient comfort scale(NAPCOMS)]were compared between the two groups.Results Before colonoscopy,the scores of Knowledge-Attitude-Practice Questionnaire on Colonoscopy for High-risk Populations of Colorectal Cancer of the two groups were higher than those at admission,and the scores in study group were higher than those in control group at the same time point(P<0.05).Before colonoscopy,the scores of S-AI and T-AI of the two groups were lower than those at admission,and the scores in study group were lower than those in control group at the same time point(P<0.05).Before colonoscopy,the scores of facing style and BBPS of three-segment colon in study group were higher than those in control group,while the scores of avoidance,yielding and NAPCOMS in study group were lower than those in control group(P<0.05).Conclusion KTA evidence-based practice model combined with focused psychological nursing model intervention can effectively reduce the psychological burden,improve the relevant knowledge level and quality of bowel preparation,and increase the comfort of patients.