基于计划行为理论的多模式照护策略对腹股沟疝患者术后恢复的价值

Effect of multimodal care on postoperative recovery of patients with inguinal hernia:Based on theory of planned behavior

目的探讨基于计划行为理论的多模式照护策略对腹股沟疝患者术后恢复的影响。方法选取2022年2月至2023年5月收治的腹股沟疝患者94例,采用简单随机法将患者分为对照组与观察组,每组47例。对照组进行常规护理,观察组采取基于计划行为理论的多模式照护策略,比较2组患者术后在不同护理策略下的疼痛持续时间、胃肠功能恢复时间、术后下床时间差异;记录2组患者在术前、术后1 d、术后5 d的心理状态[医院焦虑抑郁量表(HADS)];记录2组患者在术前、术后1 d、术后5 d的睡眠质量[匹兹堡睡眠质量指数(PSQI)]、自我效能感[自我效能感量表(GSES)]评分变化;对比2组患者术后1 d的Kolcaba舒适状况量表(GCQ)评分差异;于术后1 d评价2组患者依从率及并发症发生情况差异。结果观察组的疼痛持续时间、首次肛门排气时间、首次进食时间均短于对照组同年龄段患者(P<0.05),2组中青年患者以上指标均显著短于同组老年患者(P<0.05)。术后1 d、5 d,2组患者HADS评分、PSQI评分显著降低,且观察组该项评分显著低于对照组(P<0.05);2组患者GSES评分均高于术前(P<0.05),且观察组显著高于对照组(P<0.05)。术后1 d,观察组GCQ评分均显著高于对照组(P<0.05),2组患者总依从率差异显著(P<0.05),且观察组中青年总依从率高于对照组同年龄患者(P<0.05),2组老年患者并发症发生率之间差异显著(P<0.05)。结论基于计划行为理论的多模式照护策略有利于加快腹股沟疝患者术后恢复,患者依从率较高,且能提高其自我效能感,改善心理状态、睡眠质量及舒适度,具有较高临床应用价值。

Objective To explore the effect of multimodal care based on theory of planned behavior on postoperative recovery of patients with inguinal hernia(IH).Methods Totally 94 IH patients treated in our hospital from February 2022 to May 2023 were randomly assigned to control group(n=47)and observation group(n=47),in which they received conventional care and multimodal care based on theory of planned behavior,respectively.The differences in postoperative pain duration,gastrointestinal function recovery time,out of bed time between the two nursing strategies were compared.Hospital Anxiety and Depression Scale(HADS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,General Self-Efficacy Scale(GSES)scores preoperatively and at 1 day and 5 days postoperatively,Kolcaba General Comfort Questionnaire(GCQ),compliance rate and incidence of complications at 1 day postoperatively were recorded.Results When stratified by the age,the pain duration,time to first anal exhaust and first intake of patients in observation group were significantly shorter relative to their counterparts in control group(P<0.05),which were significantly shorter among the younger patients,but not among the older patients in the both groups(P<0.05).At 1 day and 5 days postoperatively,significantly lower HADS and PSQI scores,and significantly higher GSES scores were detected in both groups(all P<0.05),the improvements were significantly pronounced in the observation group(all P<0.05).At 1 day postoperatively,GCQ scores in the observation group was significantly higher than that in the control group(P<0.05).There was a significant difference in the total compliance rate between groups(P<0.05),according to age,a significantly higher compliance rate was founded in the younger patients in the observation group compared to those in the control group(P<0.05).The incidence of complications in the older patients were obvious difference between groups(P<0.05).Conclusion Multimodal care based on theory of planned behavior is beneficial to promote postoperative recovery of IH patients,which can improve compliance rate,self-efficacy,psychological state,sleep quality and comfort,and with high clinical application.