目标导向式不良行为扭转干预对老年胃溃疡出血内镜治疗术后自护能力及遵医行为的影响  

Effects of goal-directed adverse behavior reversal intervention on self-care ability and medical compliance behavior in elderly patients with gastric ulcer bleeding after endoscopic treatment

作　　者：李雯茜 梁明慧 李建美 Li Wenxi;Liang Minghui;Li Jianmei(Department of Emergency,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing,100050,P.R.China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《老年医学与保健》2024年第5期1402-1407,共6页Geriatrics & Health Care

摘　　要：目的探讨目标导向式不良行为扭转干预对老年胃溃疡出血内镜治疗术后自护能力及遵医行为的影响。方法选取2021年8月—2023年1月在首都医科大学附属北京友谊医院收治的270例老年胃溃疡出血患者作为研究对象,采用随机数字表法将其分为2组:观察组和对照组,每组135例。2组均接受相同的补充血容量治疗,对照组接受常规护理干预,观察组接受目标导向式不良行为扭转延续护理干预。比较2组SAS、SDS评分、术中应激生理指标值、遵医行为的差异;在干预前后,分别采用自我能力实施量表(ESCA)评分评价患者的自护能力,采用生活质量调查表(SF-36)评分评价患者的生活质量,比较2组间的差异。结果内镜术前和术后1 d,2组患者的SAS和SDS评分均低于同组干预前(P<0.05),且观察组SAS和SDS评分均低于对照组(P<0.05)。观察组术中心率(HR)、呼吸率(RR)、平均动脉压(MAP)均低于对照组(均P<0.05)。干预后,观察组ESCA各维度评分均高于对照组(P<0.05);观察组SF-36各项评分均高于对照组(P<0.05);观察组自我护理、治疗配合、规范用药、定期复查遵医嘱达标率均高于对照组(P<0.05)。结论目标导向式不良行为扭转干预在老年胃溃疡出血患者中的应用,临床效果良好,可有效提高患者的自护能力,改善其生活质量,并提高其遵医行为,具有一定的临床应用价值。Objective To explore the effects of goal-directed adverse behavior reversal intervention on self-care ability and medical compliance behavior in elderly patients with gastric ulcer bleeding after endoscopic treatment.Methods A total of 270 elderly patients with gastric ulcer bleeding admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from August 2021 to January 2023 were selected as study subjects.A random number table method was used to divide them into two groups:observation group and control group,with 135 cases in each group.Both groups received the same supplemental blood volume therapy.The control group received routine nursing intervention,while the observation group received goal-directed adverse behavior reversal and continuous nursing intervention.The differences in anxiety(SAS)score,depression(SDS)score,intraoperative stress physiological indicators,and medical compliance behavior were compared between the two groups.Before and after the intervention,the self-care ability of the patients was evaluated by the Self-Care Ability Scale(ESCA)score,and their quality of life was evaluated by the Short Form Health Survey(SF-36),and the differences between the two groups were compared.Results The scores of SAS and SDS of both groups before endoscopic surgery and 1 day after endoscopic surgery were significantly lower than those of the same group before intervention(P<0.05),and the observation group were significantly lower than the control group(P<0.05).The heart rate(HR),respiratory rate(RR),and mean arterial pressure(MAP)during the operation of the observation group were significantly lower than those of the control group,with significant differences(P<0.05).After intervention,the ESCA scores in all dimensions of the observation group were higher than those of the control group(P<0.05);the SF-36 score was higher than that of the control group(P<0.05);the compliance rates of self-care,treatment coordination,standardized drug use,regular follow-up with medical advice were higher th

关 键 词：老年 胃溃疡出血 目标导向式不良行为扭转干预 自护能力 遵医行为 焦虑 应激状态 

分 类 号：R473.6[医药卫生—护理学]