循环管理联合层级护理管理对胃肠外科患者术后并发症及自我效能的影响

Effect of cyclic management combined with hierarchical nursing management on postoperative complications and self-efficacy of patients undergoing gastrointestinal surgery

目的探讨循环管理联合层级护理管理对胃肠外科患者术后并发症及自我效能的影响。方法选取2017年11月—2020年2月医院胃肠外科患者104例为研究对象,依据建档顺序分为观察组与对照组,各52例。对照组采取常规护理管理,观察组在对照组基础上采取循环管理联合层级护理管理。观察两组患者干预前后自我效能感评分、并发症发生率、术后康复情况、不良医疗事件发生率、负性情绪、护理工作满意度。结果干预后,两组患者一般自我效能感量表评分较干预前升高,且观察组高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组下床活动时间、肛门排气时间、引流时间、住院时间均短于对照组(P<0.05);观察组医疗纠纷、护患纠纷、风险事件发生率均低于对照组(P<0.05);干预后观察组焦虑自评量表、抑郁自评量表评分低于对照组(P<0.05);观察组护理工作满意度高于对照组(P<0.05)。结论对胃肠外科患者实施循环管理联合层级护理管理,可有效改善其自我效能感,减少并发症及不良医疗事件发生概率,有效缓解患者的不良情绪,对患者的后期康复具有良好的促进作用且护理满意度高。

Objective To explore the effect of cyclic management combined with hierarchical nursing management on postoperative complications and self-efficacy of patients undergoing gastrointestinal surgery.Methods To select 104 patients with gastrointestinal surgery in the hospital from November 2017 to February2020 was as the study objects,and they were divided into an observation group and a control group,52 cases in each group,according to the order of filing.The control group adopted routine nursing management,and the observation group adopted cyclic management combined with hierarchical nursing management on the basis of the control group.The self-efficacy score,incidence of complications,postoperative recovery,incidences of adverse medical events,negative emotions,and satisfaction with nursing work were observed between the two groups of patients before and after intervention.Results After the intervention,the general self-efficacy scale scores of the two groups of patients were higher than before the intervention,and the observation group was higher than the control group(P<0.05);the observation group had a lower incidence of complications than the control group(P<0.05);the observation group had shorter time of getting out of bed,time of anal exhaust,drainage time and hospitalization than the control group(P<0.05);the observation group had lower rates of medical disputes,nurse-patient disputes,and risk events than the control group(P<0.05).After the intervention,the scores of selfrating depression scale and self-rating depression in the observation group were lower than those in the control group(P<0.05),and the nursing satisfaction in the observation group was higher than the control group(P<0.05).Conclusion The implementation of cyclic management combined with hierarchical nursing management for gastrointestinal surgery patients can effectively improve their self-efficacy,reduce the probability of complications and adverse medical events,effectively alleviate the patients’bad mood,have a good role in promoting the patient s later recovery,and patients’nursing satisfaction was high.