基于授权理论护理措施在胆道结石留置T管患者中的应用

doi:10.3761/j.issn.0254-1769.2022.12.009

摘要/Abstract

摘要：

目的探讨基于授权理论的护理措施在胆道结石留置T管患者中的应用效果。方法采用前瞻性随机对照设计,采用方便抽样法选取2019年6月—2021年8月安徽省某三级甲等医院手术留置T管的胆道结石患者104例,随机分为试验组和对照组,每组各52例。试验组接受常规护理和基于授权理论的护理措施;对照组接受常规护理。出院当天采用出院准备度量表和自我护理行为依从性量表评价两组出院准备度和自我护理行为依从性,入院当天、出院当天、出院1个月使用医院焦虑抑郁量表评价两组的焦虑和抑郁情绪,比较两组T管留置时间及并发症发生率等指标。结果试验组47例和对照组48例完成该研究。干预后,试验组出院准备度和T管自我护理行为依从性得分高于对照组,T管并发症发生率低于对照组,差异具有统计学意义（P<0.05）,但两组T管留置时间、术后3个月再入院率等差异无统计学意义（均P>0.05）。出院当天和出院1个月试验组的焦虑和抑郁评分低于对照组,差异具有统计学意义（P<0.05）;随着术后时间延长各组焦虑和抑郁评分逐渐下降,两组存在时间和组间交互作用（P<0.05）。结论基于授权理论护理措施能提高胆道结石留置T管患者的自我护理行为依从性和出院准备度,减少T管留置期间并发症,改善患者的负性情绪。

关键词: 授权理论, 胆道结石, T管护理, 护理

Abstract:

Objective To explore the effect of the empowerment intervention on patients with biliary calculi carrying T tube. Methods From June 2019 to August 2021,102 biliary calculi patients undergoing surgery carrying T tube in our hospital were randomly assigned to a control group or an experiment group,with 52 cases in each group. Traditional nursing was for the control group,while the empowerment nursing intervention was implemented in the experiment group. Readiness for hospital discharge scale（RHDS） was used to evaluate the discharge readiness of the 2 groups at discharge. The 2 groups were compared in terms of rehabilitation indicators such as self-care ability,intubation time of T-tube and postoperative complications. Anxiety and depression of all patients were assessed by the hospital anxiety and depression scale（HADS） at 3 times of admission,discharge and 1 month after discharge. Results This study was completed among 48 patients in control group and 47 patients in experiment group. The scores for RHDS and self-care ability in the experiment group were higher than those in the control group（P<0.05）,while T-tube complications were lower in the experimental group（P<0.05）. The scores of anxiety and depression in the control group were higher than those in the experimental group at discharge and 1 month after discharge（P<0.05）. There was no significant difference in intubation time of T-tube,hospitalization cost,postoperative hospitalization days and readmission rate within 3 months after operation between 2 groups. With the prolongation of postoperative time,anxiety and depression scores in each group decreased gradually,and there were time interaction and intergroup interaction between 2 groups（P<0.05）. Conclusion The empowerment strategy is effective for improving the readiness for hospital discharge and self-care ability of biliary calculi patients carrying T tube,and it may reduce complications and negative emotions during catheterization.

Key words: Empowerment, Biliary Calculi, T-tube Nursing, Nursing Care

任春霞, 刘付宝, 方颖, 江明媚, 赵欣婉, 宣雅君, 江莎, 夏俊, 卢灿亮, 姜小鹰. 基于授权理论护理措施在胆道结石留置T管患者中的应用[J]. 中华护理杂志, 2022, 57(12): 1468-1473.

REN Chunxia, LIU Fubao, FANG Ying, JIANG Mingmei, ZHAO Xinwan, XUAN Yajun, JIANG Sha, XIA Jun, LU Canliang, JIANG Xiaoying. Effect of an empowerment intervention on the biliary calculi surgery patients with T-Tube[J]. Chinese Journal of Nursing, 2022, 57(12): 1468-1473.

图/表 4

表1 两组一般资料比较[例（百分比,%）]

Table 1 Comparison of two general data[case（percentage,%）]

表2 两组术后相关指标比较

Table 2 Comparison of postoperative related indicators between 2 groups

表3 两组出院准备度量表评分比较（分,$\bar{x}\pm s$）

Table 3 RHDS scores in 2 groups（scores,$\bar{x}\pm s$）

表4 两组各时点医院焦虑抑郁量表评分比较（分,$\bar{x}\pm s$）

Table 4 Comparison of HADS scores between 2 groups at each time point（scores,$\bar{x}\pm s$）

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