基于即时适配干预理论的智慧护理方案在介入手术患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.20.001

摘要/Abstract

摘要：

目的基于即时适配干预理论构建介入手术室等待区智慧护理方案，评估该方案对改善介入手术患者术前等待体验的效果。方法采取时间序列法，选取2024年4月和8月四川省成都市某三级甲等医院介入手术室等待区的患者作为研究对象，分为试验组（共纳入766例）和对照组（共纳入864例）。试验组采用基于即时适配干预理论的介入手术室等待区智慧护理方案，对照组采用常规护理措施，比较两组在知觉等待时间、实际等待时间、焦虑程度以及满意度方面的差异。结果试验组脱落13例，对照组脱落11例，最终试验组纳入753例，对照组纳入853例，试验组实际等待时间为50.03（23.92，76.38）min，对照组为65.62（35.77，104.32）min，两组比较差异有统计学意义（P<0.001）；试验组知觉等待时间为48.00（20.00，70.00）min,对照组为73.00（38.00，105.00）min，两组比较差异有统计学意义（P<0.001）；试验组等待期间焦虑评分低于对照组，试验组满意度高于对照组，差异均有统计学意义（P<0.05）。结论基于即时适配干预理论的介入手术室等待区智慧护理方案可以有效地缩短患者术前实际等待时间和知觉等待时间，优化患者的术前等待体验。

关键词: 即时适配干预, 实际等待时间, 知觉等待时间, 满意度, 围手术期护理

Abstract:

Objective This study develops and evaluates a just-in-time adaptive intervention（JITAI）-based smart nursing protocol for interventional radiology preoperative waiting areas，assessing its impact on patient experience Methods A time-series design was employed. Patients in the waiting area of an interventional operating room at a tertiary hospital in Chengdu，Sichuan Province，were studied during April and August 2024. Participants were divided into an intervention group（n=766） and a control group（n=864）. The intervention group received the newly developed management protocol，while the control group received conventional nursing care. Differences between the groups were compared regarding perceived waiting time，actual waiting time，preoperative anxiety levels，and satisfaction rates. Results Totally 13 participants were lost to follow-up in the intervention group and 11 in the control group，resulting in final analyzed cohorts of 753 and 853 patients，respectively. The median actual waiting time was significantly shorter in the intervention group with 50.03（23.92，76.38）min，compared to the control group with 65.62（35.77，104.32）min. A significant difference was observed between the 2 groups（P<0.001）. Similarly，the median perceived waiting time was significantly lower in the intervention group with 48.00（20.00，70.00） min than 73.00（38.00，105.00） min in the control group. A significant difference was observed between the 2 groups（P<0.001）. The anxiety score during the waiting period was lower in the experimental group than it in the control group，and the experimental group showed a significantly higher satisfaction level compared to the control group，with both differences being statistically significant（P<0.05）. Conclusion The intelligent nursing program，developed based on the JITAI theory，effectively reduces both the actual and perceived preoperative waiting time for patients in the interventional operating room，optimizing their preoperative waiting experience.

Key words: Just-in-Time Adaptive Intervention, Actual Waiting Time, Perceived Waiting Time, Satisfaction, Perioperative Nursing

代玉, 罗月, 杨会琼, 李伟. 基于即时适配干预理论的智慧护理方案在介入手术患者中的应用研究[J]. 中华护理杂志, 2025, 60(20): 2437-2443.

DAI Yu, LUO Yue, YANG Huiqiong, LI Wei. Study on the application of an intelligent just-in-time adaptive nursing intervention in interventional surgery patients[J]. Chinese Journal of Nursing, 2025, 60(20): 2437-2443.

图/表 5

表1 介入手术室等待区智慧护理方案

Table 1 Intelligent nursing program for interventional surgery waiting areas

图1 介入手术室等待区管理流程

Figure 1 Management workflow for interventional surgery waiting areas

表2 两组一般资料的比较

Table 2 Comparison of general date between the 2 groups

表3 两组等待时间的比较[min，M（P25，P75）]

Table 3 Comparison of waiting times for 2 groups of patients[min，M（P25，P75）]

表4 两组焦虑评分和满意度的比较[分，M（P25，P75）]

Table 4 Comparison of anxiety scores and satisfaction between 2 groups of patients[score，M（P25，P75）]

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