基于科伯经验学习理论的首次经桡动脉冠状动脉介入诊疗患者术前教育方案构建与应用  

Construction and application of preoperative education program for patients with first transradial coronary intervention based on Kolb experiential learning theory

作　　者：赵丽娜 王艳玲[1] 张海泳[2] 刘莉[2] 关晓楠[2] 张建军[2] Zhao Lina;Wang Yanling;Zhang Haiyong;Liu Li;Guan Xiaonan;Zhang Jianjun(School of Nursing,Capital Medical University,Beijing100069,China;Department of Cardiology,Shijingshan District Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing100043,China)

机构地区：[1]首都医科大学护理学院,北京100069 [2]首都医科大学附属北京朝阳医院石景山院区心内科,北京100043

出　　处：《中华心力衰竭和心肌病杂志（中英文）》2024年第3期193-200,共8页Chinese Journal of Heart Failure and Cardiomyopathy

摘　　要：目的基于科伯(Kolb)经验学习理论构建针对首次经桡动脉冠状动脉介入诊疗患者的术前教育方案并评价其实施效果。方法通过文献检索和半结构式访谈的方式构建《经桡动脉冠状动脉介入诊疗术前教育内容》,结合我院导管室的实际情况录制术前教育视频,基于Kolb经验学习理论构建《经桡动脉冠状动脉介入诊疗术前教育方案》。选择2022年10月至2023年5月就诊于首都医科大学附属北京朝阳医院心内科首次拟行经桡动脉冠状动脉介入诊疗的患者245例为研究对象,使用抽签法分为试验组和对照组。试验组在常规护理的基础上接受《经桡动脉冠状动脉介入诊疗术前教育方案》,对照组患者接受常规术前教育方式。采用《状态焦虑量表》(S-AI)、便携式超声于术前、导管室等待区对患者进行评估,采用视觉模拟评分法(VAS)和软尺于术前、术后2h、4h、6h及拆除压迫器后即刻对患者穿刺侧肢体进行评估。结果干预后,试验组患者等待手术时的焦虑程度低于对照组(P<0.001);两组患者等待手术时桡动脉直径及管腔面积比较均无差异(P均>0.05);试验组患者术后2h、4h、6h及拆除压迫器后即刻对照组患者手掌周径低于对照组(P均<0.001);试验组患者术后2h,4h,6h穿刺侧肢体疼痛评分均低于对照组(P均<0.05);两组患者拆除压迫器后即刻穿刺侧肢体疼痛评比较无统计学意义对(P>0.05)。结论基于Kolb经验学习理论的《经桡动脉冠状动脉介入诊疗术前教育方案》可以降低首次经桡动脉冠状动脉介入诊疗患者的术前焦虑程度,提高患者对手术的认知,减轻穿刺侧肢体疼痛及肿胀,提升患者的手术体验。ObjectiveBased on Kolb′s empirical learning theory,the preoperative education program for patients with first transradial coronary intervention was constructed and the implementation effect was evaluated.Methods"Preoperative Education Content of Transradial Coronary Intervention"was constructed by means of literature search and semi-structured interview.Preoperative education videos were recorded in combination with the actual situation of the catheterization room of our hospital,and"Preoperative Education Program of Transradial Coronary Intervention"was constructed based on Kolb experiential learning theory.A total of 245 patients who were admitted to the Department of Cardiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University from October 2022 to May 2023 to undergo transradial coronary intervention for the first time were selected as the study objects,and divided into test group and control group by lottery method.On the basis of routine nursing,the experimental group received the"Preoperative Education Program of Transradial Coronary Intervention",and the control group received the routine preoperative education.State Anxiety Inventory(S-AI)and portable ultrasound were used to evaluate patients before surgery and in the waiting area of the catheterization room.Visual Analogue Scale(VAS)was adopted and soft ruler were used to evaluate the patient′s punctured limb before surgery,2h,4h,6h after surgery and immediately after removal of the oppressor.ResultsAfter intervention,the anxiety level of the experimental group was lower than that of the control group(P<0.001).There were no differences in radial artery diameter and lumen area between the two groups(both P>0.05).The peripalmic diameter of experimental group was lower than that of control group at 2h,4h,6h and immediately after removal of the oppressor(all P<0.001).The limb pain scores at the puncture side of experimental group were lower than those of control group at 2h,4h and 6h after surgery(all P<0.05).There was no statistical sig

关 键 词：Kolb经验学习理论 术前教育 经桡动脉冠状动脉介入诊疗 

分 类 号：R473.5[医药卫生—护理学]