基于个人和家庭自我管理理论的护理干预在经皮椎间孔镜手术患者术后康复中的应用

Application of nursing intervention based on individual and family self-management theory in postoperative rehabilitation of patients undergoing percutaneous transforaminal endoscopic surgery

目的探讨基于个人和家庭自我管理理论(IFSMT)护理干预措施对经皮椎间孔镜患者术后康复的影响。方法采用方便抽样法,选取2018年1月—2020年1月于山西省人民医院行经皮椎间孔镜手术的835例患者为研究对象,依据信封法按照近似1:1标准将患者随机分为对照组(n=417)和观察组(n=418),对照组予以常规护理干预,观察组在对照组基础上予以基于IFSMT的护理干预。比较两组患者干预前后自我管理能力、术后康复时间、腰椎功能恢复情况、疼痛评分及术后并发症发生率的差异。结果观察组患者干预后治疗管理、心理管理、生活管理、知识技能管理评分均较干预前高,且均高于对照组,差异有统计学意义(P<0.01)。观察组患者住院天数、生活自理时间、工作恢复时间均短于对照组,差异有统计学意义(P<0.01)。干预后观察组患者Oswestry功能障碍指数、疼痛评分均低于干预前,且均低于对照组,日本骨科协会评估治疗评分高于干预前,且高于对照组,差异均有统计学意义(P<0.01)。观察组患者术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论经皮椎间孔镜手术患者接受基于IFSMT的护理干预有助于患者术后康复,值得临床推广。

Objective To explore the effect of nursing interventions based on individual and family self-management theory(IFSMT)on postoperative rehabilitation of patients undergoing percutaneous transforaminal endoscopic surgery.Methods A total of 835 patients who underwent percutaneous transforaminal endoscopic surgery in Shanxi Provincial People's Hospital from January 2018 to January 2020 were selected as research objects by the convenient sampling method.According to the random envelope method,patients were divided into the control group(n=417)and the observation group(n=418)according to the approximate 1∶1 standard.The control group was given routine nursing intervention,while the observation group was given nursing intervention based on IFSMT on the basis of the control group.The differences in self-management ability,postoperative recovery time,lumbar functional recovery,pain score and postoperative complication rate before and after intervention were compared between the two groups.Results After intervention,the scores of treatment management,psychological management,life management and knowledge and skill management in the observation group were higher than those before intervention and were higher than those in the control group,and the differences were statistically significant(P<0.01).The hospitalization days,self-care time and work recovery time of observation group were shorter than those of control group,and the differences were statistically significant(P<0.01).After intervention,the Oswestry dysfunction index and pain score in the observation group were lower than those before intervention and lower than those in the control group.The treatment score evaluated by the Japanese Orthopedic Association was higher than that before intervention and higher than that of the control group,and the differences were statistically significant(P<0.01).The incidence of postoperative complications in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusions IFSMT based nursing intervention for patients undergoing percutaneous foraminal endoscopic surgery is beneficial to postoperative rehabilitation of patients,which is worthy of clinical promotion.