IMB模型干预对膀胱癌根治术患者应激水平及心理适应状况的影响

Effect of IMB model intervention on stress level and psychological adaptation of patients undergoing radical cystectomy for bladder cancer

目的 研究信息-动机-行为技巧(IMB)模型干预对膀胱癌根治术患者的干预效果。方法 124例行根治术治疗的膀胱癌患者为研究对象,随机分为进行常规干预的常规组(62例)和同时进行IMB模型干预的IMB组(62例),两组均干预至患者出院。统计两组术后恢复情况、并发症发生情况、护理满意度、应激指标水平、心理社会适应情况及希望水平、病耻感、疼痛情况。结果 IMB组术后恢复情况优于常规组(P<0.05)。两组干预后血清去甲肾上腺素(NE)、可的松(Cor)、肾上腺素(E)水平与干预前比较,均升高,但IMB组低于常规组(P<0.05)。两组干预完成后心理社会适应各项评分、希望水平评分与干预前比较均升高,IMB组高于常规组(P<0.05);两组病耻感及疼痛评分与干预前比较降低,IMB组低于常规组(P<0.05)。干预期间,IMB组总并发症发生率低于常规组(P<0.05);干预完成后,IMB组总满意率高于常规组(P<0.05)。结论 采用IMB模型干预对膀胱癌根治术患者进行干预,可降低患者机体应激指标水平,改善其心理社会适应情况,提高希望水平及护理满意度,降低病耻感、疼痛程度及并发症的发生,促进患者术后恢复,具有较好的干预效果。

Objective To investigate the effect of information-motivation-behavioral skills(IMB)model intervention on patients undergoing radical bladder cancer surgery.Methods A total of 124 patients with bladder cancer who underwent radical surgery were randomly divided into a routine intervention group(62 cases)and an IMB model intervention group(62 cases),both of which were treated with IMB model intervention until the patients were discharged.The routine intervention group received routine intervention,and the IMB group received IMB model intervention on the basis of the routine intervention group.Both groups received intervention until the patients were discharged from hospital.The postoperative recovery,complications,nursing satisfaction,stress index,psychosocial adaptation and hope level,stigma and pain of the two groups were analyzed.Results The postoperative recovery of IMB group was better than that of routine intervention group(P<0.05).Compared with before intervention,the serum levels of norepinephrine(NE),cortisol(Cor)and epinephrine(E)in both groups were increased after intervention,but the IMB group was lower than the routine intervention group(P<0.05).After the intervention,compared with before the intervention,scores of attitude,anxiety/depression,sense of belonging,self-control and self-efficacy,self-esteem and self-acceptance scores,level of hope of the two groups increased,and the IMB group was higher than the routine intervention group(P<0.05).The scores of shame and pain of the two groups decreased,and the IMB group was higher than the routine intervention group(P<0.05).During the intervention period,the total complication rate of the IMB group was lower than that of the routine intervention group(P<0.05).After the intervention,the total satisfaction rate of the IMB group was higher than that of the routine intervention group(P<0.05).Conclusion The intervention of IMB model in patients undergoing radical surgery for bladder cancer could reduce the level of physical stress index,improve their psychosocial adaptation,raise the level of hope and nursing satisfaction,reduce stigma,pain degree and complications,and promote postoperative recovery of patients,with good intervention effect.