ADOPT护理模式在机器人辅助腹腔镜下根治性膀胱切除术中的应用效果

ADOPT nursing care model in robot-assisted laparoscopic radical cystectomy

目的:探究以解决问题为导向的态度-定义-开放思维-计划-实施护理模式在机器人辅助腹腔镜下根治性膀胱切除术(RALRC)中的应用效果。方法:采用回顾性研究方式,选取2022年4月-2023年6月于鼓楼医院泌尿外科ADOPT解决问题护理模式下行RALRC手术患者66例为观察组,选取2020年1月-2022年3月入院并在本院行常规护理管理模式下RALRC手术患者60例为对照组。比较两组患者引流管放置时间、胃管拔除时间、排气时间、住院天数、住院总费用、术后疼痛评分、自我护理能力实施量表(ESCA)评分的差异。结果:观察组引流管放置时间、胃管拔除时间、排气时间、住院天数较对照组更短、住院总费用较对照组更少,自我护理能力更好,术后24 h、术后2 d、3 d、5 d疼痛视觉模拟(VAS)评分更低(P<0.05)。结论:以解决问题为导向的ADOPT护理模式可提高RALRC患者康复效率,改善患者自我护理能力。

Objective:To explore the effect of the ADOPT(Attitude,Definition,Open mind,Planning,Try it out)problem solving model in robot-assisted laparoscopic radical cystectomy(RALRC).Methods:A retrospective study was conducted.A total of 66 patients who underwent RALRC with ADOPT nursing intervention in the Department of Urology,Nanjing Drum Tower Hospital from April 2022 to June 2023 were selected as the observation group,and 60 patients who were performed RALRC from January 2020 to March 2022 under the conventional nursing intervention were selected as the control group.The differences in drainage tube indwelling time,removal time of gastric tube,total hospitalization cost,postoperative pain score,incidence of adverse reactions,and Self-care Ability Implementation Scale(ESCA)scores were compared between the two groups.Results:The drainage tube indwelling time,removal time of gastric tube,exhaust time and length of hospital stay in the observation group were shorter than those in the control group,and the total hospitalization cost was less than that in the control group.The self-care ability of patients in the observation group was better and the visual analogue scale(VAS)scores were lower at 24 h,2 d,3 d and 5 d after surgery(P<0.05).Conclusion:ADOPT nursing intervention can improve the self-care ability and rehabilitation efficiency of patients under RALRC.