基于IMB模型的渐进性分期康复护理在腰椎间盘突出症术后的应用  

Application of progressive staged rehabilitation nursing based on IMB model in postoperative lumbar discherniation

作　　者：陈从 张敏[1] 郑艳[1] 宋瑞鹏[1] CHEN Cong;ZHANG Min;ZHENG Yan;SONG Rui-peng(WardⅡ,Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院骨科二病区,河南郑州450000

出　　处：《海南医学》2024年第14期2093-2097,共5页Hainan Medical Journal

基　　金：河南省高等学校重点科研项目计划(编号:22B320015)。

摘　　要：目的研究基于信息-动机-行为技巧(IMB)模型的渐进性分期康复护理在腰椎间盘突出症术后的应用效果。方法选择2021年2月至2023年11月郑州大学第一附属医院收治的156例腰椎间盘突出症患者作为研究对象,按随机数表法分为对照组和研究组各78例,对照组患者予以常规护理,研究组患者予以基于IMB模型的渐进性康复护理,两组患者均护理至出院,并随访3个月。随访3个月后回院复查时,比较两组患者护理干预前后的腰椎功能评分、视觉模拟评分(VAS)评分、焦虑自评量表(SAS)评分和遵医行为评分,同时比较两组患者术后切口感染、神经根水肿和下肢静脉血栓的发生情况。结果干预前,两组患者的腰椎功能评分比较差异无统计学意义(P>0.05);随访3个月后,两组患者的日本骨科学会(JOA)评分均高于干预前,Oswestry功能障碍指数(ODI)评分均低于干预前,且研究组患者的JOA评分为(25.19±1.01)分,明显高于对照组的(21.74±2.02)分,ODI评分为(6.98±1.15)分,明显低于对照组的(9.27±1.71)分,差异均有统计学意义(P<0.05);干预前,两组患者的VAS评分、SAS评分和遵医行为评分比较差异均无统计学意义(P>0.05);随访3个月后,两组患者的VAS评分、SAS评分均低于干预前,遵医行为评分均高于干预前,且研究组患者VAS评分和SAS评分分别为(1.42±0.45)分、(40.33±5.19)分,明显低于对照组的(2.01±0.53)分、(45.37±4.81)分,遵医行为评分为(66.33±9.54)分,明显高于对照组的(57.07±8.12)分,差异均有统计学意义(P<0.05);研究组患者的并发症总发生率为2.56%,明显低于对照组的11.54%,差异有统计学意义(P<0.05)。结论基于IMB模型的渐进性分期康复护理可提高LDH术后患者的康复依从性,促进患者腰椎功能恢复,改善患者心理状态和减轻术后疼痛,且术后并发症发生率低。Objective To study the application effect of progressive staged rehabilitation nursing based on information-motivation-behavior skill(IMB)model in postoperative lumbar disc herniation.Methods A total of 156 patients with lumbar disc herniation admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to November 2023 were selected and divided into a control group and a study group according to random number table method,with 78 cases in each group.Patients in the control group were given routine nursing,while patients in the study group were given progressive staged rehabilitation nursing based on IMB model.Both groups of patients were cared until discharge,and then followed up for 3 months.After 3 months of follow-up,the lumbar function scores,Visual Analogue Scale(VAS)scores,Self-rating Anxiety Scale(SAS)scores,and compliance behavior scores of the two groups were compared before and after nursing intervention.Meanwhile,the incidence of postoperative incision infection,nerve root edema,and venous thrombosis of lower limbs were compared between the two groups.Results Before intervention,there was no significant difference in lumbar function scores between the two groups(P>0.05).After intervention,the Japanese Orthopedic Association(JOA)scores of the two groups were significantly higher than those before intervention,and the Oswestry dysfunction index(ODI)scores were significantly lower than those before intervention;the JOA score of the patients in the study group was(25.19±1.01)points,which was significantly higher than(21.74±2.02)points of the control group,and the ODI score was(6.98±1.15)points,which was significantly lower than(9.27±1.71)points of the control group;the differences were statistically significant(P<0.05).Before intervention,there was no significant difference in VAS score,SAS score,and compliance behavior score between the two groups(P>0.05).After intervention,the VAS score and SAS score of the two groups were significantly lower than those before intervention,an

关 键 词：腰椎间盘突出症 信息-动机-行为技巧模型 渐进性分期康复护理 遵医性 

分 类 号：R473.6[医药卫生—护理学]