日间鼻科手术患者围术期出院准备度干预的效果观察

Observation on the effect of perioperative discharge readiness intervention programs for patients undergoing daytime nasal surgery

目的探讨日间鼻科手术患者围术期出院准备度干预的效果。方法选取2023年7月至2024年1月首都医科大学附属北京同仁医院接受日间鼻窦开放术的患者76例。采用随机数字表法将患者随机分为对照组及观察组,每组38例,对照组给予常规护理,观察组在常规护理的基础上实施以互联网为载体的智能平台和场景模拟的宣教、优化日间流程的关键环节,给予从院前-院中-院后全过程的信息支持等出院准备度干预措施。比较两组患者出院准备度、围术期焦虑评分、术后恢复质量(quality of recovery,QoR)及护理满意度。结果76例患者中,男43例、女33例,年龄21~65岁,平均(44.0±10.0)岁。观察组出院准备度评分中自身状况[(56.0±8.0)分比(49.8±10.0)分]、疾病认识[(65.6±14.0)分比(54.7±18.8)分]、出院后应对能力[(26.3±6.0)分比(22.9±4.7)分]及总分[(184.1±27.9)分比(167.5±29.6)分]均高于对照组;术前状态焦虑评分[(41.7±5.1)分比(46.2±4.6)分]和特质焦虑评分[(39.5±4.2)分比(45.3±3.4)分]、术后状态焦虑评分[(36.4±4.5)分比(41.3±3.8)分]及特质焦虑评分[(32.3±4.9)分比(41.8±4.1)分]均低于对照组;术后1 d的QoR[(116.9±4.7)分比(94.0±4.1)分]、术后7 d的QoR[(121.1±3.9)分比(103.1±4.4)分]及护理满意度[(94.2±1.6)分比(86.7±2.5)分]均高于对照组,差异均有统计学意义(P<0.05)。结论出院准备度干预能有效降低日间鼻科手术患者围术期焦虑,提升术后QoR及护理满意度。

Objective To explore the the effect of perioperative discharge readiness intervention for patients undergoing daytime nasal surgery.Methods A total of 76 patients who underwent daytime endoscopic sinus surgery in Beijing Tongren Hospital,Capital Medical University from July 2023 to January 2024 were selected,and were randomly divided into control group and observation group,with 38 cases in each group.The control group was given routine care,while the observation group was given the education of intelligent platform and scene simulation based on the internet,optimized key links of daytime process,and information support from pre-hospital,in-hospital and after-hospital,and other discharge readiness intervention measures on the basis of routine nursing.The discharge readiness,perioperative anxiety scores,postoperative quality of recovery(QoR)and nursing satisfaction were compared between the two groups.Results Among the 76 patients,there were 43 males and 33 females,ranged from 21 to 65 years,with an average age of(44.0±10.0)years.Compared with the control group,the self-condition[(56.0±8.0)score vs.(49.8±10.0)score],disease awareness[(65.6±14.0)score vs(.54.7±18.8)score],coping ability after discharge[(26.3±6.0)score vs.(22.9±4.7)score]and total score[(184.1±27.9)score vs.(167.5±29.6)score]were higher,and the scores of preoperative state anxiety[(41.7±5.1)score vs.(46.2±4.6)score]and trait anxiety[(39.5±4.2)score vs.(45.3±3.4)score],postoperative state anxiety[(36.4±4.5)score vs.(41.3±3.8)score]and trait anxiety[(32.3±4.9)score vs.(41.8±4.1)score]were lower,while the QoR were higher at 1 d[(116.9±4.7)score vs.(94.0±4.1)score]and 7 d[(121.1±3.9)score vs.(103.1±4.4)score]after operation,and nursing satisfaction[(94.2±1.6)score vs(.86.7±2.5)score]were higher in the observation group,and the differences were statistically significant(all P<0.05).Conclusions Discharge readiness intervention can effectively reduce patients'perioperative anxiety and improve QoR and nursing satisfaction who undergo daytime nasal surgery.