思维导图教学法结合核查清单在甲状腺切除术后护理中的应用

Effect of mind mapping combined with nursing checklist on postoperative care for patients after thyroidectomy

目的观察症状引导的思维导图教学法结合核查清单在甲状腺切除术后患者护理中的应用效果。方法采用连续收集样本方法,选取福建省某三级甲等专科医院甲状腺乳腺外科(以下简称甲乳外科)2021年6月-2023年10月诊断为甲状腺肿瘤(及甲状旁腺肿瘤)并行甲状腺切除术的368例患者作为研究对象,按照就诊时间顺序分为对照组和观察组,其中2021年6月-2022年6月184例患者为对照组,2022年7月-2023年10月184例患者为观察组,对照组给予甲状腺切除术后护理常规护理,观察组在对照组的基础上应用思维导图教学法结合核查清单进行护理,观察两组患者术后并发症发生率、术后护理不良事件发生率以及患者对护理满意度。结果观察组术后并发症中的体位综合征发生率为2.72%(5/184),低于对照组的9.78%(18/184),两组比较,差异有统计学意义(P<0.001),而观察组手术切口出血发生率和低钙血症发生率与对照比较[1.63%(3/184)VS 3.80(7/184)]、[1.09%(2/184)VS 3.26(6/184)],差异无统计学差异(均P>0.05);观察组护理不良事件中的抽血时间不准确发生率、给药时间不准确发生率均低于对照组[0%(0/184)VS 7.38%(17/184)]、[0%(0/184)VS 7.38%(17/184)],两组比较,差异具有统计学意义(均P<0.001);而观察组非计划性拔管发生率与对照组比较[0%(0/184)VS 1.63%(3/184)],差异无统计学意义(P>0.05)。结论思维导图教学法结合护理核查清单应用于甲状腺切除术患者的护理,可降低甲状腺切除术后患者并发症及护理不良事件发生率,提高患者对护理满意度,值得借鉴。

Objective To observe the effect of symptom-guided mind mapping combined with nursing checklist on the postoperative care for the patients who had thyroidectomy.Methods A continuous sampling method was adopted to select 120 patients with thyroid tumour at a specialised general hospital in Fujian Province from June 2021 to October 2023.The patients were equally divided into a control group and an observation group based on the visit date.Between June 2021 and June 2022,patients in the control group received routine nursing care,between July 2022 and October 2023,patients in the observation group were managed with the mind mapping combined with a nursing checklist.The two groups were compared in terms of the incidence of postoperative complication,the rate of adverse nursing events and patient satisfaction with nursing care.Results The observation group presented a significantly lower incidence of postoperative postural syndrome compared to the control group[2.72%(5/184)vs.9.78%(18/184),P<0.001],without significant difference in the incidence of incision bleeding and hypocalcaemia[1.63%(3/184)vs.3.80(7/184),P>0.05]and[1.09%(2/184)vs.3.26(6/184),P>0.05],respectively.Additionally,the observation group exhibited significantly lower incidences of inaccurate blood drawing time and inaccurate drug administration time compared to the control group[0%(0/184)vs.7.38%(17/184),P<0.001]and[0%(0/184)vs.7.38%(17/184),P<0.001],respectively,without significant difference in the incidence of unplanned extubation compared with the control group[0%(0/184)vs.1.63%(3/184),P>0.05].Conclusion The mind mapping combined with a nursing checklist in the care of the patients after thyroidectomy is effective in terms of reduction of the rates of postoperative complications and adverse nursing events,and the improvement of patient satisfaction with the nursing care.