意识强化模式下的延伸护理服务在术后 留置导尿患者中的应用效果

Effect of extended nursing service under enhanced consciousness mode on patients with indwelling catheterization after urological surgery

目的研究泌尿外科术后留置导尿患者实施意识强化模式下的延伸护理服务的效果。方法本研究为前瞻性研究。选取2019年5月至2022年4月河南科技大学第一附属医院泌尿外科术后留置导尿患者400例,按就诊顺序分为对照组(200例)、观察组(200例),两组院内护理措施相同。对照组男128例、女72例,年龄(40.76±5.72)岁,予以常规延伸护理;观察组男119例、女81例,年龄(41.12±5.94)岁,予以意识强化模式下的延伸护理服务。比较两组遵医行为、情绪状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自我护理能力[自我护理能力测定量表(ESCA)]、按时拔管率及并发症发生率。采用独立样本t检验、χ^(2)检验。结果观察组患者的总遵医率高于对照组[92.00%(184/200)比85.50%(171/200)],差异有统计学意义(χ^(2)=4.232,P=0.040);术后1个月内,观察组按时拔管率高于对照组[93.00%(186/200)比86.50%(173/200)],差异有统计学意义(χ^(2)=4.593,P=0.032);干预1个月后,观察组SAS、SDS评均低于对照组[(36.84±3.79)分比(45.46±4.25)分、(32.42±4.75)分比(40.59±5.06)分],ESCA评分高于对照组[(112.43±6.14)分比(103.72±5.98)分],两组比较差异均有统计学意义(t=21.408、16.648、14.372,均P<0.001);观察组尿路感染、肉眼血尿、腰腹疼痛及膀胱刺痛发生率均低于对照组[6.50%(13/200)比12.50%(25/200)、12.50%(25/200)比20.50%(41/200)、11.00%(22/200)比21.00%(42/200)、18.00%(36/200)比28.00%(56/200)],差异均有统计学意义(χ^(2)=4.187、4.645、7.441、5.647,均P<0.05)。结论意识强化模式下的延伸护理服务有助于提高泌尿外科术后留置导尿患者自护能力及遵医行为,调节患者情绪状态,还可有效预防并发症,提高患者的按时拔管率。

Objective To study the effect of extended nursing service under the mode of enhanced consciousness in patients with indwelling catheterization after urological surgery.Methods It was a prospective study.From May 2019 to April 2022,400 patients with indwelling catheterization after urological surgery in The First Affiliated Hospital of Henan University of Science and Technology were selected and were divided into a control group(200 patients)and an observation group(200 patients)according to the order of treatment.The hospital nursing measures in the two groups were the same.The composition ratio of men and women in the control group was 128/72,with an age of(40.76±5.72)years old,and routine extended nursing was given.The composition ratio of men and women in the observation group was 119/81,with an age of(41.12±5.94)years old,and extended nursing service under the mode of enhanced consciousness was given.The compliance behavior,emotional state[Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)],self-care ability[Exercise of Self-care Agency Scale(ESCA)],on-time extubation rate,and complication rate were compared between the two groups.Independent sample t test andχ^(2) test were used.Results The total compliance rate of the observation group was higher than that of the control group[92.00%(184/200)vs.85.50%(171/200)],with a statistically significant difference(χ^(2)=4.232,P=0.040).The rate of on-time extubation in the observation group was higher than that in the control group[93.00%(186/200)vs.86.50%(173/200)],with a statistically significant difference(χ^(2)=4.593,P=0.032).After 1 month of intervention,the SAS and SDS scores of the observation group were lower than those of the control group[(36.84±3.79)points vs.(45.46±4.25)points,(32.42±4.75)points vs.(40.59±5.06)points],and the ESCA score was higher than that of the control group[(112.43±6.14)points vs.(103.72±5.98)points],with statistically significant differences between the two groups(t=21.408,16.648,and 14.372;all P<0.001).The incidences of urinary tract infection,gross hematuria,lumboabdominal pain,and bladder stinging in the observation group were lower than those in the control group[6.50%(13/200)vs.12.50%(25/200),12.50%(25/200)vs.20.50%(41/200),11.00%(22/200)vs.21.00%(42/200),18.00%(36/200)vs.28.00%(56/200)],with statistically significant differences(χ^(2)=4.187,4.645,7.441,and 5.647;all P<0.05).Conclusion The extended nursing service under the enhanced consciousness mode is helpful to improve the self-care ability and compliance behavior in patients with indwelling catheterization after urological surgery,regulate their emotional state,effectively prevent the complications,and improve the rate of on-time extubation.