加速康复外科在全髋关节置换患者围手术期管理中实施的现状调查及影响因素分析  

Implementation status and influencing factors of enhanced recovery after surgery in perioperative management of total hip arthroplasty patients

作　　者：王佳音 侯晨昕 杨聪颖 金晓燕[1] Wang Jiayin;Hou Chenxin;Yang Congying;Jin Xiaoyan(School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]北京大学护理学院,北京100191

出　　处：《中华现代护理杂志》2024年第7期937-943,共7页Chinese Journal of Modern Nursing

基　　金：2020年度“未名护理”领军人才科研创新孵化基金(LJRC20YB05)。

摘　　要：目的:了解加速康复外科(ERAS)在全髋关节置换患者围手术期管理中的实施现状及其影响因素。方法:本研究采用横断面调查的方式,采用目的抽样法,于2022年5-12月选取北京市9家ERAS试点医院的186名骨科护士为研究对象。采用自行设计的问卷对ERAS实施现状进行调查。采用Pearson相关分析护士ERAS实施现状自评问卷得分与ERAS行为意向问卷得分的相关性,采用多重线性回归分析ERAS在全髋关节置换患者围手术期实施的影响因素。结果:本研究共发放问卷186份,回收有效问卷186份,问卷有效回收率为100.00%(186/186)。ERAS实施现状问卷总得分为(116.49±20.71)分,各维度的标化得分由高至低分别是随访管理[(80.22±20.44)分]、术中[(78.98±15.17)分]、术前[(74.72±14.09)分]和术后[(69.77±15.94)分];ERAS行为意向问卷总得分为(77.39±15.08)分,各维度的标化得分由高至低依次为主观规范[(79.93±19.01)分]、行为意向[(77.69±19.61)分]、行为态度[(74.19±15.77)分]和知觉行为控制[(64.41±14.69)分]。护士职称、对ERAS的熟悉程度、是否接受过ERAS培训以及主观规范是ERAS实施现状得分的影响因素( P<0.05),共解释总变异的40.9%。 结论:应该加强护士ERAS相关的培训,增加相关知识的熟悉程度,采用多种激励措施进一步提升ERAS方案在临床中的应用。ObjectiveTo explore the implementation status and influencing factors of enhanced recovery after surgery(ERAS)in perioperative management of patients undergoing total hip arthroplasty.MethodsThis study was a cross-sectional study.From May to December 2022,purposive sampling was used to select 186 orthopedic nurses from 9 ERAS pilot hospitals in Beijing as the research subject.A self-designed questionnaire was used to investigate the implementation status of ERAS.Pearson correlation was used to analyze the correlation between Nurse ERAS Implementation Status Questionnaire scores and ERAS Behavioral Intention Questionnaire scores.Multiple linear regression was used to analyze the influencing factors of ERAS in perioperative nursing of patients undergoing total hip arthroplasty.ResultsA total of 186 questionnaires were distributed and 186 valid questionnaires were collected,with an effective response rate of 100.00%(186/186).The total score of the Nurse ERAS Implementation Status Questionnaire was(116.49±20.71),and the standardized scores for each dimension from high to low were follow-up management(80.22±20.44),intraoperative period(78.98±15.17),preoperative period(74.72±14.09),and postoperative period(69.77±15.94).The total score of the ERAS Behavioral Intention Questionnaire was(77.39±15.08),and the standardized scores of each dimension from high to low were subjective norm(79.93±19.01),behavioral intention(77.69±19.61),behavioral attitude(74.19±15.77),and perceived behavioral control(64.41±14.69).The nurse's professional title,familiarity with ERAS,ERAS training,and subjective norm were the influencing factors of the specific implementation status score of ERAS(P<0.05),explaining 40.9%of the total variance.ConclusionsNurses should strengthen training on ERAS,increase their familiarity with knowledge,and adopt various incentive measures to further enhance the implementation of ERAS programs in clinical practice.

关 键 词：横断面调查 加速康复外科 髋关节置换术 实施现状 影响因素 

分 类 号：R473.6[医药卫生—护理学]