基于信息-动机-行为技巧模型的护理干预在隐匿性阴茎矫形术患儿围手术期护理中的应用  

Application of nursing intervention based on the information-motivation-behavioral skills model in perioperative nursing of children with concealed penis phalloplasty

作　　者：郑萍[1] 洪志华[2] 朱孝红 万丽[3] 刘林[3] Zheng Ping;Hong Zhihua;Zhu Xiaohong;Wan Li;Liu Lin(Department of Pediatrics,Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314000,China;Department of Pediatric Surgery,Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314000,China;Department of Surgical Anesthesiology,Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院儿科,嘉兴314000 [2]嘉兴市妇幼保健院小儿外科,嘉兴314000 [3]嘉兴市妇幼保健院手术麻醉科,嘉兴314000

出　　处：《中华现代护理杂志》2024年第19期2614-2619,共6页Chinese Journal of Modern Nursing

摘　　要：目的:探究基于信息-动机-行为技巧(IMB)模型的护理干预在隐匿性阴茎矫形术患儿围手术期护理中的应用效果。方法:采用便利抽样法,于2022年1月—2023年1月选取嘉兴市妇幼保健院收治的接受小儿隐匿阴茎矫形术治疗的86例患儿为研究对象,随机分为观察组和对照组,各43例。对照组采用常规护理模式,观察组在常规护理的基础上实施基于IMB模型的护理干预。记录两组患儿术前访视后(T 0)、离开准备间时(T 1)、麻醉诱导前(T 2)、离开麻醉恢复室时(T 3)及术后24 h随访(T4)5个时间点的心率(HR)和平均动脉压(MAP)水平,并采用儿童情绪适应量表学前版(CEAS-P)、改良耶鲁术前焦虑量表(m-YPAS)、诱导期合作度量表(ICC)、儿童苏醒期躁动评分(PAED)对患儿进行评估。结果:干预后观察组的CEAS-P评分高于对照组,m-YPAS、ICC、PAED评分低于对照组,差异均有统计学意义(P均<0.01)。两组接受隐匿阴茎矫形术患儿不同时间点HR与MAP水平的组内比较,差异均有统计学意义(P均<0.01)。观察组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时的HR与MAP水平均低于对照组,差异均有统计学意义(P均<0.05)。护理干预随着时间变化对患儿HR与MAP影响的交互作用比较,差异有统计学意义(P<0.01)。结论:基于IMB模型的护理干预可有效缓解隐匿性阴茎矫形术患儿围手术期心理焦虑,提高手术安全性。Objective To explore the application effect of nursing intervention based on the information-motivation-behavioral skills(IMB)model in perioperative nursing of children undergoing concealed penis phalloplasty.Methods Using the convenient sampling method,a total of 86 children who were admitted to and underwent concealed penis phalloplasty in Jiaxing Maternity and Child Health Care Hospital were selected as the research objects from January 2022 to January 2023.They were randomly divided into the observation group and the control group,with 43 cases in each group.The control group was treated with routine nursing mode,and the observation group was treated with IMB model nursing intervention based on routine nursing.The heart rate(HR)and mean arterial pressure(MAP)levels of children in the two groups were recorded at five time points,such as after preoperative visit(T 0),when leaving the preparation room period(T 1),before anesthesia induction(T 2),when leaving the anesthesia recovery room(T 3)and 24 h postoperative follow-up(T 4).The children were evaluated using Children's Emotional Adjustment Scale Preschool Version(CEAS-P),Modified Yale Preoperative Anxiety Scale(m-YPAS),the Induction Compliance Checklist(ICC)and Pediatric Anesthesia Emergence Delirium(PAED).Results After intervention,the CEAS-P scores in the observation group were higher than those in the control group,while the m-YPAS,ICC and PAED scores were lower than those in the control group,and the differences were statistically significant(all P<0.01).There were statistically significant differences in HR and MAP levels of children undergoing concealed penis phalloplasty between the two groups at different time points(P<0.01).HR and MAP levels at T_(0)、T_(1)、T_(2)、T_(3) and T_(4) in observation group were lower than those in control group,and the differences were statistically significant(all P<0.05).There was statistically significant differences in the interaction between nursing intervention and HR and MAP over time(P<0.01).Conclusions Nursing

关 键 词：围手术期 信息-动机-行为技巧模型 隐匿性阴茎 改良隐匿性阴茎矫形术 焦虑 

分 类 号：R473.72[医药卫生—护理学]