基于斯金纳强化理论的健康教育联合CICARE沟通对脊髓损伤患者间歇性导尿依从性、负性情绪及生活质量的影响  

Effect of health education based on Skinner's reinforcement theory combined with CICARE communication on compliance of intermittent catheterization,negative emotions,and quality of life in patients with spinal cord injury

作　　者：周晓燕[1] 吕开月 程树锦 农瑾雯 付晶晶 李雨航 刘海兰[1] 韦钰晴[2] 刘海华[3] ZHOU Xiao-yan;LYU Kai-yue;CHENG Shu-jin;NONG Jin-wen;FU Jin-jin;LI Yu-hang;LIU Hai-lan;WEI Yu-qing;LIU Hai-hua(Department of Rehabilitation Medicine,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,Guangxi,CHINA;Department of Emergency,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,CHINA;Department of Neurosurgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,CHINA)

机构地区：[1]广西中医药大学附属瑞康医院康复医学科,广西南宁530011 [2]广西医科大学第一附属医院急诊科,广西南宁530021 [3]广西医科大学第一附属医院神经外科,广西南宁530021

出　　处：《海南医学》2024年第12期1797-1802,共6页Hainan Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费课题(编号:Z20211644);广西壮族自治区卫生健康委员会自筹经费课题(编号:Z20201365);广西壮族自治区中医药管理局自筹经费科研课题(编号:GXZYA20230258)。

摘　　要：目的探讨基于斯金纳强化理论的健康教育联合CICARE沟通对脊髓损伤患者间歇性导尿依从性、负性情绪及生活质量的影响。方法采用目的抽样法,选取2021年12月至2022年11月在广西中医药大学附属瑞康医院康复医学科住院的85例脊髓损伤患者作为研究对象,按病区分为观察组43例和对照组42例,对照组接受常规护理,观察组在对照组的基础上给予基于斯金纳强化理论的健康教育联合CICARE沟通干预。在干预1个月后采用间歇性导尿依从性评估量表(ICAS)评估患者的导尿依从性;在干预前和干预1个月后分别采用神经源性膀胱症状评分表(NBSS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)、WHO生活质量测定量表简表(WHOQOL-BREF)评估患者的神经源性膀胱症状、负性情绪(焦虑、抑郁症状)和生活质量。结果观察组患者干预1个月后的ICAS分级明显优于对照组,差异具有统计学意义(P<0.05);干预1个月后,两组患者的SAS评分和SDS评分均降低,且观察组患者SAS评分、SDS评分分别为(38.55±3.10)分、(39.83±3.59)分,明显低于对照组的(50.77±3.75)分、(51.67±4.92)分,差异均有统计学意义(P<0.05);干预1个月后,观察组患者的NBSS总分为(26.44±7.34)分,明显低于对照组的(34.71±12.56)分,差异有统计学意义(P<0.05);干预1个月后,观察组患者的WHOQOL-BREF总分为(51.12±5.89)分,明显高于对照组的(44.98±7.22)分,差异具有统计学意义(P<0.05)。结论基于斯金纳强化理论的健康教育联合CICARE沟通可提高脊髓损伤患者间歇性导尿依从性,改善其负性情绪和神经源性膀胱症状,提高生活质量。Objective To explore the effect of health education based on Skinner's reinforcement theory combined with CICARE communication on compliance of intermittent catheterization,negative emotions,and quality of life in patients with spinal cord injury.Methods Using purposive sampling method,eighty-five patients with spinal cord injury who were hospitalized in the Department of Rehabilitation Medicine,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from December 2021 to November 2022 were selected as objects.According to the ward,the patients were divided into an observation group(n=43)and a control group(n=42).The patients in the control group received routine nursing,and those in the observation group were given health education based on Skinner's reinforcement theory combined with CICARE communication.The Intermittent Catheterization Adherence Scale(ICAS)was used to evaluate the compliance of catheterization after 1 month of intervention.Neurogenic Bladder Symptom Score(NBSS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),and WHO quality of life scale(WHOQOL-BREF)were used to evaluate neurogenic bladder symptoms,negative emotions(anxiety,depression),and quality of life before intervention and at 1 month after intervention.Results At one month after intervention,the ICAS grade in the observation group was significantly better than that in the control group(P<0.05);the SAS score and SDS score of the two groups decreased,and the SAS score and SDS score in the observation group were(38.55±3.10)points,(39.83±3.59)points,respectively,which were significantly lower than(50.77±3.75)points,(51.67±4.92)points in the control group,with statistically significant differences(P<0.05);the total score of NBSS in the observation group was(26.44±7.34)points,which was significantly lower than(34.71±12.56)points in the control group(P<0.05);the total score of WHOQOL-BREF in the observation group was(51.12±5.89)points,which was significantly higher than(44.98±7.22)points in the control gro

关 键 词：脊髓损伤 神经源性膀胱 斯金纳强化 CICARE沟通 间歇性导尿 依从性 负性情绪 生活质量 

分 类 号：R473.6[医药卫生—护理学]