基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用

Application of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation

目的探讨基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带胆管出院患者中的干预效果。方法采用目的抽样法。选取2019年1月至12月在广州医科大学附属第一医院行B超引导下经皮肝Ⅰ期胆道造瘘取石手术且带胆管出院患者86例,根据患者入院时间先后分为对照组和试验组,各43例。对照组男14例、女29例,年龄(53.50±12.35)岁;试验组男16例、女27例,年龄(52.50±11.26)岁。对照组给予常规健康教育,试验组采用基于授权理论的健康教育路径干预。采用自我护理能力测定量表、胆管自我管理行为调查表、患者满意度问卷测评两组患者自我护理能力、胆管自我管理行为、满意度及出院1个月内留置胆管相关并发症发生情况。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ^(2)检验。结果干预后,试验组患者的自我护理能力总分为(124.74±4.09)分,明显高于对照组的(110.81±4.45)分,试验组患者的胆管自我管理水平、满意度评分分别为(5.28±0.91)、(95.80±2.37)分,高于对照组的(4.09±1.27)、(91.70±4.15)分,差异均有统计学意义(均P<0.05)。试验组患者出现胆管堵塞、非计划性拔管、胆道感染并发症的总发生率为9.3%(4/43),低于对照组的25.58%(11/43),差异有统计学意义(P<0.05)。结论在经皮肝Ⅰ期胆道造瘘取石术后带胆管出院患者中实施基于授权理论的健康教育路径,可降低胆管相关并发症的发生率,改善自我管理行为,提高就诊满意度。

Objective To explore the application effect of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation(PTOBF).Methods The purpose sampling method was adopted.A total of 86 patients discharged with biliary drainage tube after PTOBF in The First Affiliated Hospital of Guangzhou Medical University from January to December 2019 were selected and were divided into an experimental group and a control group according to the time of admission,with 43 cases in each group.In the control group,there were 14 males and 29 females,with an age of(53.50±12.35)years old;there were 16 males and 27 females in the experimental group,with an age of(52.50±11.26)years old.The control group received routine health education,and the experimental group received health education pathway based on empowerment theory.The self-care ability,biliary drainage tube self-management behavior,satisfaction,and indwelling biliary drainage tube related complications within 1 month in the two groups were evaluated by Self-Care Ability Measurement Scale,Biliary Drainage Tube Self-Management Behavior Questionnaire,and Patient Satisfaction Questionnaire.The independent sample t test was used for comparison of the measurement data between groups,andχ^(2) test was used for comparison of the count data between groups.Results After the intervention,the score of self-care ability in the experimental group was(124.74±4.09),which was significantly higher than(110.81±4.45)in the control group;the scores of biliary drainage tube self-management behavior and satisfaction of the experimental group were(5.28±0.91)and(95.80±2.37),which were higher than(4.09±1.27)and(91.70±4.15)in the control group,with statistically significant differences(all P<0.05).The total incidence of biliary drainage tube blockage,unplanned extubation,infection of biliary tract in the observation group was 9.3%(4/43),which was lower than 25.58%(11/43)in the control group,with a statistically significant difference(P<0.05).Conclusions Health education pathway based on empowerment theory can reduce the incidence of biliary drainage tube related complications in patients discharged with biliary drainage tube after PTOBF,improve the patients'self-management behavior,and improve their satisfaction.