基于信息-知识-信念-行为理论的多学科协作护理在胸腔镜下肺叶切除术患者中的应用效果  

Application effect of multidisciplinary collaborative nursing based on the Information-Knowledge-Attitude-Practice theory in patients undergoing lobectomy via thoracoscopy

作　　者：侯冰冰 马胤 王伟[1] 杨晓歆[1] 高岩[1] HOU Bingbing;MA Yin;WANG Wei;YANG Xiaoxin;GAO Yan(the Fifth Ward of Thoracic Surgery Department,Nanjing Thoracic Hospital/Brain Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu,210000)

机构地区：[1]江苏省南京市胸科医院/南京医科大学附属脑科医院胸外科五区,江苏南京210000

出　　处：《实用临床医药杂志》2025年第3期89-93,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金项目(81700068)。

摘　　要：目的分析信息-知识-信念-行为(IKAP)理论下多学科协作护理在胸腔镜下肺叶切除术患者中的应用效果。方法选取168例胸腔镜下肺叶切除术患者作为研究对象,采用随机数字表法分为对照组和观察组,每组84例。对照组实施常规护理,观察组在对照组基础上实施基于IKAP理论的多学科协作护理。观察并比较2组患者的术后恢复情况和干预前后肺功能指标[用力肺活量(FVC)、每分钟最大通气量(MVV)、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)]水平、自我效能感[一般自我效能感量表(GSES)得分]、自我管理能力[慢性病自我管理问卷(CDSMQ)得分]。结果观察组术后首次下床活动时间、首次排气时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。干预前,2组患者FVC、MVV、FEV_(1)/FVC、CDSMQ得分、GSES得分比较,差异均无统计学意义(P>0.05);干预后,观察组FVC、MVV、FEV_(1)/FVC和CDSMQ得分、GSES得分均高于对照组,差异有统计学意义(P<0.05)。结论基于IKAP理论的多学科协作护理可有效促进胸腔镜下肺叶切除术后患者的恢复,提升患者术后肺功能、自我管理能力及自我效能感,进而提高康复质量。Objective To analyze the application effect of multidisciplinary collaborative nursing based on the Information-Knowledge-Attitude-Practice(IKAP)theory in patients undergoing lobectomy via thoracoscopy.Methods A total of 168 patients undergoing lobectomy via thoracoscopy were selected,and randomly divided into control group and observation group using a random number table,with 84 patients in each group.The control group received routine nursing,while the observation group received multidisciplinary collaborative nursing based on the IKAP theory in addition to routine nursing.The postoperative recovery,pulmonary function indicators[forced vital capacity(FVC),maximum voluntary ventilation(MVV)and ratio of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)],self-efficacy[General Self-Efficacy Scale(GSES)score]and self-management ability[Chronic Disease Self-Management Questionnaire(CDSMQ)score]before and after intervention were observed and compared between the two groups.Results The observation group had shorter first ambulation time,first flatus time and length of hospital stay compared with the control group(P<0.05).Before intervention,there were no statistically significant differences in FVC,MVV,FEV_(1)/FVC,CDSMQ scores and GSES scores between the two groups(P>0.05).After intervention,the observation group had higher FVC,MVV,FEV_(1)/FVC,CDSMQ scores and GSES scores compared with the control group(P<0.05).Conclusion Multidisciplinary collaborative nursing based on the IKAP theory can effectively promote the recovery process in patients undergoing lobectomy via thoracoscopy,improve postoperative pulmonary function,self-management ability,and self-efficacy,thereby enhancing the quality of rehabilitation.

关 键 词：胸腔镜下肺叶切除术 信息-知识-信念-行为理论 多学科协作护理 肺功能 自我效能感 自我管理能力 

分 类 号：R734.2[医药卫生—肿瘤] R615[医药卫生—临床医学] R473.73