头颈癌气管切开患者出院准备计划方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2025.15.006

摘要/Abstract

摘要：

目的构建头颈癌气管切开患者出院准备计划方案，并探讨其应用效果，为提高头颈癌气管切开患者的居家自我护理能力提供参考。方法通过文献分析及专家函询，构建头颈癌气管切开患者出院准备计划方案。采用便利抽样法，选取2023年5月—2025年2月在山东省济南市某三级甲等综合医院耳鼻喉科住院治疗的160例头颈癌气管切开患者作为研究对象，采用区组随机化方法，将其分为试验组和对照组，每组各80例。试验组应用头颈癌气管切开患者出院准备计划方案，对照组采取常规护理及健康教育。收集患者入院至出院后1个月的相关数据，比较两组干预前后正念觉知水平、自我护理能力及出院准备度情况。结果头颈癌气管切开患者出院准备计划方案包括前意向、意向、准备、行动、维持5个阶段。两组无样本脱落。试验组正念觉知水平、自我护理能力、出院准备度评分均高于对照组，差异具有统计学意义（P<0.001）。结论该研究构建的头颈癌气管切开患者出院准备计划方案科学合理、安全可行，可有效提高患者的出院准备度及正念觉知水平，提升居家自我护理能力。

关键词: 气管切开, 跨理论模型, 出院准备计划, 正念觉知, 自护能力, 护理

Abstract:

Objective To construct a discharge preparation plan for patients with head and neck cancer undergoing tracheotomy and explore its application effect to provide a reference for improving the at-home self-care ability of tracheostomy patients with head and neck cancer. Methods The discharge preparation plan for patients with head and neck cancer undergoing tracheotomy was constructed through literature analysis and expert consultation. A total of 160 patients with tracheotomy for head and neck cancer who were hospitalized in the Department of Otolaryngology and Head and Neck Surgery of a tertiary A general hospital in Jinan City，Shandong Province from May 2023 to February 2025 were selected by convenience sampling method as the study subjects，and were divided into an experimental group and a control group by block randomization method，with 80 cases in each group. The experimental group received a discharge preparation plan for patients undergoing tracheotomy for head and neck cancer，while the control group received routine nursing and health education. Data from admission to 1 month after discharge were collected. The levels of mindfulness awareness，self-care ability，and discharge readiness were compared between 2 groups of patients before and after intervention. Results The constructed discharge preparation plan includes 5 stages（pre-contemplation，contemplation，preparation，action，and maintenance）. There were no sample dropouts in either group of patients. The experimental group had higher levels of mindfulness awareness，self-care ability and discharge readiness scores than the control group，and the differences were statistically significant（P<0.001）. Conclusion The discharge preparation plan for patients with head and neck cancer undergoing tracheotomy is scientifically reasonable，safe，and feasible，which can effectively improve patients’ discharge preparation and mindfulness level，and enhance their self-care ability.

Key words: Tracheotomy, Transtheoretical Model, Discharge Preparation Plan, Mindfulness Awareness, Self-Care Ability, Nursing Care

赵昕, 吴钰, 朱辉, 李祖红, 朱丽娜, 王玥琦, 冯倩倩, 李辉. 头颈癌气管切开患者出院准备计划方案的构建及应用研究[J]. 中华护理杂志, 2025, 60(15): 1829-1836.

ZHAO Xin, WU Yu, ZHU Hui, LI Zuhong, ZHU Lina, WANG Yueqi, FENG Qianqian, LI Hui. Construction and application research of a discharge preparation plan for patients with head and neck cancer undergoing tracheotomy[J]. Chinese Journal of Nursing, 2025, 60(15): 1829-1836.

图/表 5

表1 头颈癌气管切开患者出院准备计划方案

Table 1 Discharge preparation plan for patients with head and neck cancer undergoing tracheotomy

表2 两组一般资料的比较

Table 2 Comparison of general information in 2 groups

表3 干预前后两组正念注意觉知量表得分比较（分，$\bar{x} \pm s$）

Table 3 Comparison of scores of mindfulness awareness in 2 groups before and after the intervention （scores，$\bar{x} \pm s$）

表4 干预前后两组自我护理能力测定量表各维度得分比较（分，$\bar{x} \pm s$）

Table 4 Comparison of scores of self-care ability in 2 groups before and after the intervention（scores，$\bar{x} \pm s$）

表5 两组出院准备度量表得分比较（分，$\bar{x} \pm s$）

Table 5 Comparison of scores of discharge readiness in 2 groups before and after the intervention（scores，$\bar{x} \pm s$）

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