基于行为改变轮理论的随访管理在原位回肠新膀胱重建术后患者中的应用效果  

The effect of follow-up management based on behavior change wheel theory in patients after orthotopic neobladder

作　　者：李雨威 李珍燕 李娇 蒋泽波 李雪梅 LI Yuwei;LI Zhenyan;LI Jiao;JIANG Zebo;LI Xuemei(Urology Institute of People Liberation Army,the First Affiliated Hospital,Army Medical University,Chongqing,400038,China)

机构地区：[1]陆军军医大学第一附属医院全军泌尿外科研究所,重庆市400038

出　　处：《护理管理杂志》2024年第9期743-749,共7页Journal of Nursing Administration

摘　　要：目的探讨基于行为改变轮理论的随访管理在原位回肠新膀胱重建术后患者中的应用效果。方法将89例行原位回肠新膀胱重建术的膀胱癌患者随机分为对照组和干预组,对照组44例行常规随访管理,干预组45例在此基础上行基于行为改变轮理论的随访管理,比较干预前后两组原位回肠新膀胱重建术后患者自我护理能力、排控尿情况、尿流动力学、生活质量。结果术后第3、6个月,干预组自我护理能力评分、排尿间隔时间、尿量、膀胱内压以及生活质量8个维度评分显著高于对照组,夜尿次数、残余尿量较对照组更少,膀胱容量较对照组更大,最大尿流率较对照组更快(P<0.05);术后12个月,干预组仅自我护理能力评分较对照组更高,最大尿流率较对照组更快,残余尿量较对照组更少,生活质量4个维度评分显著高于对照组(P<0.05)。结论基于行为改变轮理论的随访管理可提高膀胱癌患者术后早期自我护理能力,加速新膀胱功能恢复进程,从而提升其生活质量。Objective To explore the effect of follow-up management based on behavior change wheel theory in patients after orthotopic ileal neobladder reconstruction.Methods There were 89 patients with bladder cancer who underwent orthotopic neobladder had been randomly divided into two groups,44 patients in the control group received routine follow-up management,and 45 patients in the intervention group received follow-up management based on the behavior change wheel theory.Comparisons were made between the groups regarding their self-care ability,wination and contiol of urine,urodynamics,and quality of life.Results Three and six months after surgery,the intervention group had higher self-care ability score,urination interval time,urine volume,bladder pressure and quality of life score than the control group,compared with the control group,the number of nocturnal urination and residual urine volume were less,the bladder volume was larger,and the maximum urine flow rate was faster(P<0.05).And 12 months after surgery,the intervention group only had higher self-care ability score,faster maximum urine flow rate,less residual urine volume and higher quality of life score in 4 dimensions than the control group(P<0.05).Conclusion The follow-up management based on behavior change wheel theory can improve the early self-care ability of patients with bladder cancer after surgery,accelerate the recovery process of new bladder function,so as to improve their quality of life.

关 键 词：膀胱癌 原位回肠新膀胱重建术 行为改变轮理论 随访管理 排控尿 

分 类 号：R473.73[医药卫生—护理学]