基于行为分阶段转变理论的护理干预在四肢大面积烧伤后瘢痕整形患者中的应用

Application of Nursing Intervention Based on Transtheoretical Model of Behavior Change in Patients with Scar Plastic Surgery after Extensive Burns of Limbs

目的:探究基于行为分阶段转变理论的护理干预在四肢大面积烧伤后瘢痕整形患者中的应用效果。方法:选取2019年5月-2022年5月于笔者医院行瘢痕整形修复的四肢大面积烧伤后瘢痕患者作为研究对象,根据基于行为分阶段转变理论护理干预在笔者医院实施时间,将2019年5月-2020年12月收治的46例患者纳入对照组,给予常规干预;2021年1月-2022年5月收治的44例患者纳入观察组,给予基于行为分阶段转变理论的护理干预。比较干预前和干预3个月后两组患者恐动症信念[恐动症信念评分量表(Kinesiophobia causes scale,KCS)]、恐惧回避信念[恐惧-回避信念问卷(Fear-avoidance beliefs questionnaire,FABQ)]、健康行为[健康行为能力自评量表(Self-rated abilities for health practices scale,SRAHP)]、创面愈合情况[创面愈合时间、温哥华瘢痕量表(Vancouver scar scale,VSS)、瘢痕美容评估与评级量表(Scar cosmesis assessment and rating,SCAR)]、生活质量[烧伤专用健康量表(Burn specific health scale,BSHS-A)]。结果:干预3个月后,两组KCS、FABQ、VSS、SCAR评分均较干预前降低,且观察组低于对照组(均P<0.05);观察组创面愈合时间短于对照组(P<0.05);两组SRAHP、BSHS-A评分较干预前升高,且观察组高于对照组(均P<0.05)。结论:基于行为分阶段转变理论的护理干预可减弱四肢大面积烧伤后瘢痕整形术患者恐动和恐惧回避信念,促进患者健康行为及创面愈合,提高患者生活质量。

Objective To explore the application of nursing intervention based on the transtheoretical model of behavior change during plastic surgery for scars after extensive limb burns.Methods Patients with scars after extensive limb burns undergoing plastic surgery in the hospital from May 2019 to May 2022 were selected as the study subjects.According to the implementation time of nursing intervention based on the transtheoretical model of behavior change in the author's hospital,46 patients admitted from May 2019 to December 2020 were included in control group and given routine intervention,and the other 44 patients admitted between January 2021 and May 2022 were enrolled as observation group and given nursing intervention based on the transtheoretical model of behavior change.Before intervention and after 3 months of intervention,the kinetophobia belief[Kinesiophobia causes scale(KCS)],fear avoidance belief[Fear-avoidance beliefs questionnaire(FABQ)],health behaviors[Self-rated abilities for health practices scale(SRAHP)],wound healing[wound healing time,Vancouver scar scale(VSS),Scar cosmesis assessment and rating(SCAR)]and quality of life[Burn specific health scale(BSHS-A)]were compared between the two groups.Results After 3 months of intervention,the scores of KCS,FABQ,VSS and SCAR in both groups were reduced compared with those before intervention,and the scores in observation group were lower than those in control group(all P<0.05).The wound healing time in observation group was shorter than that in control group(P<0.05).The scores of SRAHP and BSHS-A were reduced compared to before treatment,and the above scores in observation group were higher than those in control group(all P<0.05).Conclusion Nursing intervention based on the transtheoretical model of behavior change can relieve the kinetophobia and fear avoidance belief,promote the health behaviors and wound healing,and enhance the quality of life of patients with scars after extensive limb burns undergoing plastic surgery.