引领式健康教育路径对胆结石患者术后心理状态及自我效能的影响

Effectiveness of leading health education pathway on postoperative psychological state and self-efficacy in patients with gallstones

目的 探究引领式健康教育路径对胆结石患者术后心理状态及自我效能的影响。方法 选取2018年7月—2020年11月在本院接受治疗的胆结石手术患者124例作为研究对象,采用掷币法随机分为观察组(n=61)和对照组(n=63)。其中观察组患者采用引领式健康教育路径干预,对照组患者采用常规护理。护理前后,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评测2组患者心理状态的变化情况。术后第1、3、5天,采用一般自我效能感量表(GSES)评测其自我效能水平。此外,记录2组患者恢复情况相关参数,观察并记录2组患者术后不良事件的发生情况以及术后1年内的复发率。结果护理前,2组患者的SAS、SDS评分比较,差异均无统计学意义(P>0.05);护理后,2组患者的SAS、SDS评分均较护理前有所降低(P<0.05),且观察组评分低于对照组(P<0.05)。术后,2组患者的GSES评分均随着时间的推移越来越高(P<0.05),且术后第3、5天,观察组患者的GSES评分均高于同时期的对照组(P<0.05)。观察组患者的首次排气时间、术后恢复正常活动时间以及住院时间均短于对照组,且差异均有统计学意义(P<0.05)。此外,观察组患者不良事件发生率为3.28%,小于对照组的14.29%(P<0.05);观察组患者术后1年的胆结石复发率为1.64%,小于对照组的11.11%(P<0.05)。结论 引领式健康教育路径能够显著改善胆结石患者术后的心理状态,提高其自我效能水平,帮助患者更快恢复,并能降低不良事件的发生率,值得临床推广。

Objective This study aimed to investigate the effectiveness of leading health education on postoperative psychological state and self-efficacy in patients with gallstones.Methods A total of 124 patients with gallstones who received treatment in Zhumadian Central Hospital from July 2018 to November 2020 were selected as the study participants and randomly assigned to the observation group(n=61) and the control group(n=63) by the coin toss method.Among them,patients in the observation group received the leading health education pathway intervention,and patients in the control group received routine care.The self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were employed to evaluate the changes in psychological state in the two groups before and after care.On postoperative days 1,3,and 5,their self-efficacy levels were evaluated using the General Self-Efficacy Scale(GSES).In addition,the relevant parameters of recovery were recorded,and the occurrence of postoperative adverse events and the recurrence rate within 1 year after surgery were observed and recorded in the two groups.Results Before care,there was no significant difference in SAS and SDS scores between the two groups(P>0.05);after care,SAS and SDS scores in the two groups were significantly lower than those before intervention(P<0.05),with the scores in the observation group significantly lower than those in the control group(P<0.05).After the operation,the GSES scores of patients in both groups increased over time(P<0.05),and on the 3rd and 5th days after the operation,the GSES scores of patients in the observation group were significantly higher than those of the control group at the same time(P<0.05).The time to first flatus,postoperative ambulation time,and length of hospital stay of patients in the observation group were significantly shorter than those in the control group(P<0.05).In addition,the incidence rate of adverse events in the observation group was 3.28 %,which was significantly smaller than that in the control group(14.29%,P<0.05);the recurrence rate of gallstones 1 year after operation in the observation group was1.64%,which was significantly smaller than that in the control group(11.11 %,P<0.05).Conclusion Leading health education can markedly improve the psychological state of patients with gallstones after surgery,increase their self-efficacy,help them recover faster,and reduce the incidence of adverse events.These benefits hold promise for a wider application of this procedure clinically.