基于IMB模型的干预模式在食管癌手术患者中的应用效果观察

Observation on the Application Effect of IMB-Based Intervention Model in Patients Undergoing Esophageal Cancer Surgery

目的 研究基于信息-动机-行为技巧(information-motivation-behavioral, IMB)模型的干预模式在食管癌手术患者中的应用效果。方法 选择2020年11月—2022年10月在福建医科大学附属第二医院接受手术治疗的食管癌患者82例,随机分为对照组40例和研究组42例。对照组采用常规护理干预,研究组在常规护理基础上采用基于IMB模型的干预模式。比较两组术后康复情况、营养状况、负性心理、应对方式及并发症。结果与对照组相比,研究组首次排气、进食、肠鸣音恢复、下床活动及住院时间均更短,差异有统计学意义(P<0.05)。两组术后7d时前白蛋白(prealbumin,PA)、白蛋白(albumin,ALB)、转铁蛋白(transferrin,TRF)、血红蛋白(hemoglobin, Hb)、总蛋白(total protein, TP)、红细胞(red blood cell, RBC)、球蛋白、维生素D水平均升高,研究组高于对照组,差异有统计学意义(P<0.05)。两组干预后心理评估量表(self-ratomganxietyseale, SAS;selfrating depression scale,SDS)、回避、屈服评分均降低,且研究组比对照组降低更为显著,差异有统计学意义(P<0.05);而两组面对评分均升高,且研究组比对照组升高更为显著,差异有统计学意义(P<0.05)。观察组并发症发生率为7.14%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论 基于IMB模型的干预模式可有效改善食管癌手术患者营养状况,缩短术后康复时间,缓解负性心理,改善应对方式,减少并发症。

Objective To study the application effect of information-motivation-behavior skills(informationmotivation-behavioral,IMB)based intervention model in patients undergoing esophageal cancer surgery.Methods Eighty-two patients with esophageal cancer who underwent surgical treatment in our hospital from November 2020 to October 2022 were retrospectively analyzed.They were divided into two groups according to the random number table method.The control group(40 cases)received routine intervention,and the research group(42 cases)received the IMB-based intervention model on the basis of routine intervention.The postoperative rehabilitation,nutritional status,negative psychology,coping style and complications were compared between the two groups.Results Compared with the control group,the first exhaust time,eating time,bowel sounds recovery,ambulation time and hospitalization time in the study group were significantly shorter(P<0.05).Seven days after operation,the levels of prealbumin(PA),albumin(ALB),transferrin(TRF),hemoglobin(HB),total protein(TP),red blood cell(RBC),globulin and vitamin D in both groups increased significantly,especially in the study group(P<0.05).After the intervention,the scores of SAS,SDS,avoidance and yield in the two groups were significantly decreased,and the study group had lower SAS,SDS,avoidance and yield scores than control group.The facing scores were significantly increased after intervention,and the study group had higher facing score than control group(P<0.05).The incidence of complications in the observation group was 7.14%,which was significantly lower than the 25.00%of the control group(P<0.05).Conclusion The intervention model based on IMB model can effectively improve the nutritional status of patients undergoing esophageal cancer surgery,shorten the postoperative rehabilitation time,relieve negative psychology,improve coping style and reduce complications.