基于知信行模式的护理干预在玻璃体切除联合眼内填充术后患者中的应用  

Application effect of nursing intervention based on knowledge-attitude-practice model in position care for patients after vitrectomy combined with intraocular filling

作　　者：汤蕙滢[1] 王伟[1] 荣丽 章梦燕 张鹏飞 Tang Huiying;Wang Wei;Rong Li;Zhang Mengyan;Zhang Pengfei(Department of Ophthalmology,Tongling People’s Hospital,Tongling 244000,Anhui Province,China;Department of Ophthalmology,Yijishan Hospital,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,Anhui Province,China)

机构地区：[1]安徽省铜陵市人民医院眼科,244000 [2]安徽省皖南医学院第一附属医院弋矶山医院眼科,241000

出　　处：《现代临床护理》2024年第10期37-42,共6页Modern Clinical Nursing

基　　金：安徽省自然科学基金资助项目,项目编号为1808085MH253。

摘　　要：目的探讨采取基于知信行模式的护理干预在玻璃体切除联合眼内硅油填充术后患者体位护理中的应用效果。方法选取2022年2月至2023年11月在铜陵市某三级甲等综合医院眼科住院并行玻璃体切除联合眼内硅油填充术的患者64例作为研究对象,按照随机数字表法分为试验组32例和对照组32例。对照组采用常规护理,试验组采用基于知信行模式的护理。比较两组患者体位依从率、体位维持时间、术后3天平均每天保持头低面部朝下的时间以及体位舒适度(general comfort questionnaire,GCQ)评分、数字疼痛评分量表(numerical rating scale,NRS)与焦虑自评量表(self-rating anxiety scale,SAS)得分、术后并发症发生率。结果试验组体位总依从率较对照组高(96.88%vs 76.67%,P<0.001);试验组体位维持时间、术后3天平均每天保持头低面部朝下的时间较对照组长(15.86±1.36 vs 13.25±1.25,20.87±1.04 vs 17.56±1.29,均P<0.001);试验组GCQ评分较对照组高(87.96±5.15 vs 70.24±4.89,P<0.001);干预后试验组NRS得分(2.41±0.26 vs 3.34±0.34,P<0.001)、SAS得分(37.26±4.21 vs 44.37±4.71,P<0.001)、术后并发症总发生率(3.12%vs 23.33%,P<0.05)均低于对照组,两组比较,差异有统计学意义。结论玻璃体切除联合眼内硅油填充术后,实施基于知信行模式的护理干预可延长患者体位维持时间,提高体位依从性及体位舒适度,减轻患者疼痛程度,缓解患者焦虑情绪,降低并发症发生率。Objective To investigate the effects of knowledge-attitude-practice(KAP)model based nursing interventions on positional care in patients after vitrectomy combined with intraocular filling.Methods A total of 62 patients who underwent vitrectomy combined with intraocular silicone filling,between February 2022 and November 2023,in the Department of Ophthalmology of a GradeⅢA hospital in Tongling were selected as the study subjects.The patients were randomly divided into a control group(n=32)and an intervention group(n=32).The control group received routine nursing care,while the intervention group received KAP-model based nursing care.The two groups were compared in terms of the time of positional maintenance,the average time per day for maintaining a head-down face-down position in the first 3 days after surgery,general comfort questionnaire(GCQ),postural compliance,numerical rating scale(NRS)for pains,self-rating anxiety scale(SAS)and incidence of postoperative complications.Results In comparison with the control group,the intervention group had a longer positional maintenance time and longer average time per day for maintaining a head-down face-down position in the first 3 days after surgery(13.25±1.25 vs 15.86±1.36,20.87±1.04 vs 17.56±1.29,both P<0.001).The overall postural compliance rate in the intervention group was significantly higher(96.88%vs 76.67%,P<0.001).GCQ scores of the intervention group were higher(87.96±5.15 vs 70.24±4.89,P<0.001).NRS scores in the intervention group were significantly lower(2.41±0.26 vs 3.34±0.34,P<0.001).SAS scores in the intervention group were significantly lower(37.26±4.21 vs 44.37±4.71,P<0.001).The total incidence of postoperative complications in the intervention group was lower(3.12%vs 23.33%,P<0.05).Conclusion After vitrectomy combined with intraocular silicone filling,the implementation KAP-model based nursing care interventions prolongs the time of positional maintenance in the patients,improves positional comfort and compliance,reduces pains and relieve anx

关 键 词：玻璃体切除术 眼内填充术 体位 护理 知信行模式 舒适度 

分 类 号：R473.77[医药卫生—护理学] R473.6[医药卫生—临床医学]