个案管理的延伸护理在甲状腺结节患者微波消融术后的应用观察

Observation on the Application of Case Management Extended Nursing in Patients with Thyroid Nodules after Mi⁃crowave Ablation

目的:探讨个案管理的延伸护理服务在甲状腺结节患者超声引导下微波消融术后的应用价值。方法:选择2019年11月—2020年10月郑州大学第一附属医院收治的112例甲状腺结节患者作为研究对象,采用随机数表法分为对照组和研究组,每组各56例。对照组患者实施常规护理,研究组患者在常规护理基础上实施个案管理的延伸护理服务。比较两组患者的遵医行为,护理满意度及干预前,干预1个月、3个月后的自我护理能力(ESCA),健康行为(HPLP-II)。结果:研究组患者总遵医率为94.64%,高于对照组患者的80.36%,差异有统计学意义(χ^(2)=5.225,P<0.05);研究组患者干预1个月、3个月后ESCA、HPLP-II评分高于对照组患者,差异有统计学意义(t=6.479、6.593、3.443、5.933,P<0.05);研究组患者干预后服务质量量表(SERVQUAL)各维度评分较对照组患者高,差异有统计学意义(t=4.289、8.348、7.561、7.949、4.977,P<0.05)。结论:个案管理的延伸护理服务可改善甲状腺结节患者超声引导下微波消融术后遵医行为,协助患者进行自我监督,巩固健康行为,且护理满意度较高。

Objective:To explore the application value of extended nursing service of case management in patients with thyroid nodules after ultrasound-guided microwave ablation.Methods:A total of 112 patients with thyroid nodules admitted to the hospi⁃tal from November 2019 to October 2020 were selected as the research objects,and divided into control group and research group by random number table method,with 56 cases in each group.The patients in the control group were given routine nursing care,and the patients in the study group were given extended nursing services of case management on the basis of the patients in the control group.The medical compliance behavior,nursing satisfaction,self-care ability(ESCA)and health behavior(HPLP-II)be⁃fore the intervention,1 month and 3 months after the intervention were compared between the two groups.Results:The total com⁃pliance rate of patients in the study group was 94.64%,which was higher than 80.36%in the control group,and the difference was statistically significant(χ^(2)=5.225,P<0.05).The ESCA and HPLP-II scores of the patients in the study group were higher than those in the control group after 1 month and 3 months of intervention,and the differences were statistically significant(t=6.479,6.593,3.443,5.933,P<0.05).The service quality scale(SERVQUAL)scores of the patients in the study group were higher than those in the control group,and the difference was statistically significant(t=4.289,8.348,7.561,7.949,4.977,P<0.05).Conclu⁃sion:The extended nursing service of case management can improve the compliance behavior of patients with thyroid nodules after ultrasound-guided microwave ablation,assist patients in self-supervision,and consolidate healthy behaviors.And its nursing satis⁃faction is high.