基于IMB的围术期护理对肠造口患者自我护理能力的影响

Effect of perioperative nursing based on IMB on self-care ability of patients with enterostomy

目的探讨基于信息-动机-行为技巧模型(IMB)的围手术期护理对肠造口患者自我护理能力及并发症的影响。方法选取2021年7月至2022年6月南昌大学第二附属医院胃肠外科收治的124例肠造口患者作为研究对象,按照随机数字表法分为对照组(n=62)和观察组(n=62)。对照组采用常规的围手术期护理措施,观察组在常规护理上实施基于IMB的围手术期护理,比较两组肠造口患者干预前及出院1、3个月时的造口患者自我护理能力与造口并发症的发生率。结果自我护理意愿、自我护理知识和自我护理技能评分的组间、时间、交互作用比较,差异有统计学意义(P<0.05)。两组出院后1、3个月的自我护理意愿、自我护理技能评分均高于本组干预前,且两组出院后3个月的自我护理意愿、自我护理技能评分均高于本组出院后1个月时,差异有统计学意义(P<0.05);对照组出院后3个月的自我护理知识评分高于本组干预前、出院后1个月时,观察组出院后1、3个月的自我护理知识评分高于本组干预前,观察组出院后3个月的自我护理知识评分高于本组出院后1个月时,差异有统计学意义(P<0.05)。观察组出院后1、3个月的自我护理意愿、自我护理知识和自我护理技能评分均高于对照组,差异有统计学意义(P<0.05)。两组患者干预前的并发症总发生率比较,差异无统计学意义(P>0.05)。观察组患者出院后1、3个月的并发症总发生率均低于对照组,差异有统计学意义(P<0.05)。结论基于IMB模式的围手术期护理有利于提高肠造口患者自我护理能力,降低肠造口并发症发生率。

Objective To explore the effect of perioperative nursing based on information-motivation-behavioral skill model(IMB)on self-care ability and complications in patients with enterostomy.Methods A total of 124 patients with enterostomy admitted to the Department of Gastrointestinal Surgery,the Second Affiliated Hospital of Nanchang University from July 2021 to June 2022 were selected as the research objects.According to the random number table method,they were divided into the control group(n=62)and the observation group(n=62).Patients in the control group received routine perioperative nursing,while patients in the observation group received IMB-based perioperative nursing on the basis of routine nursing.The self-care ability of patients with enterostomy and the incidence of complications of enterostomy were compared between the two groups before intervention,1 and 3 months after discharge.Results There were statistically significant differences in the scores of self-care willingness,self-care knowledge and self-care skills between groups,time and interaction(P<0.05).The self-care willingness and self-care skill scores of the two groups 1 and 3 months after discharge were higher than those before intervention,and the self-care willingness and self-care skill scores of the two groups 3 months after discharge were higher than those 1 month after discharge,and the differences were statistically significant(P<0.05).The self-care knowledge score of the control group 3 months after discharge was higher than that before the intervention and 1 month after discharge,the self-care knowledge scores of the observation group 1 and 3 months after discharge were higher than that before the intervention,and the self-care knowledge score of the observation group 3 months after discharge was higher than that 1 month after discharge,and the differences were statistically significant(P<0.05).The scores of self-care willingness,self-care knowledge and self-care skills in the observation group were higher than those in the control group at 1 and 3 months after discharge,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups before intervention(P>0.05).The total incidences of complications in the observation group were lower than those in the control group at 1 and 3 months after discharge,and the differences were statistically significant(P<0.05).Conclusion Perioperative nursing based on IMB model is helpful to improve the self-care ability of patients with enterostomy and reduce the incidence of complications of enterostomy.