ADOPT模式护理干预对全喉切除患者气道自我护理能力的影响研究

Influence of ADOPT mode nursing intervention on airway self-care ability in patients after total laryngectomy

目的探讨态度-诊断-开放思维-制订计划-问题解决(ADOPT)模式护理干预对全喉切除患者气道自我护理能力的影响。方法选取2021年3—8月在湖北省肿瘤医院实施全喉切除术的患者50例,按照随机数字表法分为对照组和观察组各25例,对照组实施常规护理,观察组实施ADOPT模式护理干预。于术后第1天、出院时和出院后3个月运用自我护理能力测定量表及自制气道自我护理知识问卷评估2组患者气道自我护理能力,于术后3个月评价2组气道相关并发症的发生情况。结果出院时和出院后3个月观察组气道自我护理知识总分为(83.80±5.06)、(89.40±4.86)分,高于对照组的(68.75±5.57)、(72.50±6.76)分,差异有统计学意义(t=-9.91、-10.09,均P<0.05)。出院时和出院后3个月观察组自我护理能力总分为(126.88±9.77)、(133.60±8.10)分,明显高于对照组的(113.29±17.06)、(119.13±15.30)分,差异有统计学意义(t=-3.42、-4.12,均P<0.05)。出院后3个月对照组气道并发症发生率为41.67%(10/24),观察组为12.00%(3/25),差异有统计学意义(χ^(2)=5.53,P<0.05)。结论ADOPT模式护理干预能显著提高全喉切除患者气道自我护理能力,减少气道并发症的发生,有利于患者身心康复。

Objective To explore the effect of ADOPT mode nursing intervention on airway selfcare ability in patients with total laryngectomy.Methods 50 patients who received total laryngectomy were randomly divided into control group(25 cases)and observation group(25 cases).The control group received routine nursing,while the observation group received ADOPT mode nursing intervention on the basis of routine nursing.The Exercise of Self-Care Agency Scale and self-made airway self-care knowledge questionnaire were used to evaluate the airway self-care ability and the incidence of airway related complications was also evaluated.Results On discharge and 3 months after discharge,total scores about self-care knowledge of airway were 83.80±5.06 and 89.40±4.86 in the experimental group,which were significantly higher than those in the control group(68.75±5.57,72.50±6.76),the differences were statistically significant(t=-9.91,-10.09,both P<0.05).On discharge and 3 months after discharge,total scores in ESCA were 126.88±9.77 and 133.60±8.10 in the experimental group,which were significantly higher than those in the control group(113.29±17.06 and 119.13±15.30).The differences were significant(t=-3.42,-4.12,both P<0.05).The incidence of airway complications was 41.67%(10/24)in the control group and 12.00%(3/25)in the observation group,which was statistically significant(X^(2)=5.53,P<0.05).Conclusions ADOPT mode nursing intervention can significantly improve the airway selfcare ability of patients with total laryngectomy,reduce the incidence of airway complications,and is beneficial to patients'physical and mental recovery。