基于ERAS理念的HAPA模型健康教育在肝切除术中的应用效果

Effect of HAPA model health education based on ERAS concept for liver resection

目的探讨基于加速康复外科(ERAS)理念的健康行动过程取向(HAPA)模型健康教育在肝切除术中的应用效果。方法选取2020年1月至2022年6月在湖北省荆州市第一人民医院行肝切除术的患者90例,按照随机数字表法,分为干预组和对照组,每组45例。对照组给予常规健康教育,干预组给予基于ERAS理念的HAPA模型健康教育,比较两组患者术后身体体征恢复情况、自我效能感、健康行为、自我管理能力差异。结果干预组患者首次活动时间为(23.87±4.32)min、首次进食时间为(9.87±2.67)h、首次通气时间为(45.28±4.32)min、引流管拔管时间为(22.45±4.25)h、住院时间为(10.53±2.85)d,均短于对照组,差异均有统计学意义(P<0.05);干预后,干预组患者自我效能感量表、健康促进生活方式量表Ⅱ、成年人健康自我管理能力测评量表评分均高于对照组,且干预前后各指标差值比较,差异均有统计学意义(P<0.05)。结论肝切除术患者采用基于ERAS理念的HAPA模型健康教育干预,能够提高术后身体体征恢复效率,改善患者自我效能感、健康行为及自我管理能力。

Objective To explore the effectiveness of health and health action process orientation(HAPA)model health education based on the concept of accelerated rehabilitation surgery(ERAS)in liver resection.Methods A total of 90 patients undergoing liver resection from January 2020,to June 2022 were divided into intervention group and control group according to random number table method,with 45 cases in each group.The control group received routine health education,and the intervention group was given health education in the HAPA model based on the ERAS concept to compare the recovery of postoperative physical signs,self-efficacy,health behaviors,and self-management ability between the two groups.Results In the intervention group,the first active time of the patients was(23.87±4.32)min,first time of feeding was(9.87±2.67)h,time of first ventilation was(45.28±4.32)min,time of drain extubation was(22.45±4.25)h,time of hospital⁃ization was(10.53±2.85)d,which were all lower than those in the control group,and the differences were all statistically significant(P<0.05).After the intervention,patients’self-efficacy scale,health promotion lifestyle scale,and adult health self-management ability assess⁃ment scale in the intervention group were all higher than those in the control group,and the difference between the indicators before and after the intervention was statistically significant(P<0.05).Conclusions The health education intervention of HAPA model based on ERAS con⁃cept in liver resection patients can improve the recovery of postoperative physical signs and improve patients’self-efficacy,health behavior and self-management ability.