先天性巨结肠根治术后患儿TRI家庭护理模式构建及干预效果评价  

Construction of TRI family nursing model and evaluation of intervention effect in children after congenital megacolon radical operation

作　　者：李静[1] 阐玉英[2] 郭宏卿[3] 姚文英[2] 张芳[2] Li Jing;Chan Yuying;Guo Hongqing;Yao Wenying;Zhang Fang(Department of General Surgery,Children's Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215000;Department of Nursing,Children's Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215000;Department of Neonatology,Children's Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215000)

机构地区：[1]苏州大学附属儿童医院普外科,江苏苏州215000 [2]苏州大学附属儿童医院护理部,江苏苏州215000 [3]苏州大学附属儿童医院新生儿科,江苏苏州215000

出　　处：《中外女性健康研究》2019年第21期18-21,共4页Women＇s Health Research

摘　　要：目的:探讨基于时机理论(TRI)的家庭护理模式构建对先天性巨结肠根治术后患儿及其照护者干预效果。方法:选取2015年10月至2019年5月本院收治的行巨结肠根治术的先天性巨结肠患儿80例作为研究对象,采用便利取样法,选取2015年10月至2017年6月患儿及照护者各40例作为对照组,2017年7月至2019年5月患儿及照护者各40例作为观察组。对照组接受普外科常规护理和随访,观察组针对患儿及其照护的疾病不同分期(疾病准备期、围手术期、排便训练期和适应期)实施以TRI为指导的阶段性家庭护理干预措施,通过提高照护者的照顾能力来改善患儿的预后。比较两组患儿疾病准备期出院1周、1个月、根治术后24h、术后出院后1周、1个月和3个月时照护体验的动态变化,包括照护者照护焦虑自评SAS、照顾能力FCTI及患儿术后并发症发生率。结果:疾病准备期出院1周随访,两组患儿照护者SAS评分比较无明显差异(P>0.05);出院1个月及根治术后24h、术后出院后1周、1个月和3个月时,观察组患儿照护者SAS评分均明显低于对照组(P<0.05);疾病准备期出院1周随访,两组患儿照护者FCTI评分比较无明显差异(P>0.05),其他时间段均显著低于对照组(P<0.001);出院3个月的并发症统计结果显示,观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:通过TRI家庭护理模式的应用,先天性巨结肠患儿照护者的焦虑评分明显降低,照护能力明显提高,患儿术后并发症发生率明显降低,门诊非计划随访率和再入院率明显减少,为先天性巨结肠患儿的居家护理提供了实践依据。Objective:To explore the intervention effect of home care model based on timing theory(TRI)on children and their caregivers after radical resection of congenital megacolon.Methods:Eighty children with congenital megacolon who underwent megacolon radical surgery admitted to our hospital from October 2015 to May 2019 were selected as subjects.The convenience sampling method was used to select patients from October 2015 to June 2017.Forty children and caregivers were used as the control group,and 40 children and caregivers from July 2017 to May 2019 were used as observation groups.The control group received routine nursing and follow-up of general surgery.The observation group implemented TRI-guided phased family nursing interventions for different stages of the disease and disease(disease preparation period,perioperative period,defecation training period and adaptation period).Improve the prognosis of children by improving the caregivers'care.The dynamic changes of the nursing experience were compared between the two groups in the disease preparation period:1 week,1 month,24 hours after radical surgery,1 week,1 month and 3 months after discharge,including caregiver anxiety self-assessment SAS,care capacity FCTI and the incidence of postoperative complications in children.Results:There was no significant difference in SAS scores between the two groups of patients during the disease preparation period(P>0.05);1 month after discharge and 24 hours after radical surgery,1 week,1 month and 3 months after discharge.At the time of observation,the SAS scores of the caregivers in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the FCTI scores between the two groups(P>0.05).The segmental mean was significantly lower than the control group(P<0.001);the complication rate of discharge at 3 months showed that the incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statisticall

关 键 词：先天性巨结肠 根治术 时机理论 家庭护理 焦虑 照护能力 

分 类 号：R47[医药卫生—护理学]