IKAP模式在外伤后皮肤大面积缺损皮瓣修复患者中的应用

Application of IKAP Model in Patients with Large Area Skin Defect after Trauma

目的:探究信息-知识-信念-行为(Information-knowledge-attitude-practice,IKAP)护理模式对创伤后皮肤大面积缺损患者术后创面愈合、自我效能、健康行为及心理状态的影响。方法:选取2019年2月-2023年2月笔者医院收治的91例皮肤大面积缺损皮瓣修复患者,按随机数字表法分为IKAP组(46例)和对照组(45例)。对照组采用常规护理干预,IKAP组采用IKAP护理模式干预。比较两组患者术后相关指标、自我效能[一般自我效能感量表(General perceived self-efficacy scale,GSES)]、健康行为[健康促进生活方式量表(Health-promoting lifestyle profile-Ⅱ,HPLP-Ⅱ)]、社会心理反应[症状自评量表(Symptom checklist 90,SCL-90)]及并发症发生情况。结果:两组患者皮瓣成活率、皮肤愈合时间比较差异无统计学意义(P>0.05),IKAP组住院时间短于对照组(P<0.05)。干预后,IKAP组GSES和HPLP-Ⅱ评分均高于对照组(P<0.05),IKAP组SCL-90中抑郁、焦虑、恐怖、敌对、偏执、躯体化评分均低于对照组(P<0.05)。干预期间,IKAP组感染、血肿、压疮等并发症发生率低于对照组(P<0.05)。结论:针对创伤后皮肤大面积缺损患者术后护理,IKAP模式干预可以有效缩短住院时间,提升患者自我效能和健康行为,改善心理健康状况,降低并发症发生。

Objective To explore the effect of the information,knowledge,attitude,and practice(IKAP)nursing model on postoperative repair effect and social and psychological responses in patients with large-area skin defects after trauma.Methods A total of 91 patients who underwent repair of large-area skin defects in the author's hospital from February 2019 to February 2023 were selected,and randomly divided into the IKAP group(n=46)and the control group(n=45).The control group received routine nursing intervention,while the IKAP group received IKAP model of nursing intervention.Postoperative repair effect,self-efficacy,activities of daily living,social and psychological responses,and complications were compared between the two groups.Results There was no statistically significant difference in the survival rate of skin flap or skin healing time between the two groups(P>0.05).Hospital stay of the IKAP group was shorter than that of the control group(P<0.05).After intervention,the GSES and HPLP-Ⅱscores in the IKAP group were higher than those in the control group(P<0.05),and the scores of depression,anxiety,terror,hostility,paranoia and somatization in SCL-90 in the IKAP group were lower than those in the control group(P<0.05).The incidence rates of complications such as infection,hematoma and pressure sores in the IKAP group during intervention were lower than those in the control group(P<0.05).Conclusion For postoperative care of patients with large-area skin defects after trauma,IKAP model of intervention can effectively shorten hospital stay,improve self-efficacy and healthy behaviors,alleviate negative psychological emotions,and reduce complications.