基于行为改变轮理论的护理干预模式在手部烧伤患者功能锻炼中的应用  

Nursing interventions based on the theory of behavior change wheel in function exercise for patients with hand burns

作　　者：苏婷 吴春晖 SU Ting;WU Chunhui(Department of Burn and Plastic Surgery,General Hospital of Ningxia Medical University,Yinchuan,Ningxia,750004)

机构地区：[1]宁夏医科大学总医院烧伤整形美容科,宁夏银川750004

出　　处：《中西医结合护理》2025年第2期40-45,共6页Chinese Journal of Integrative Nursing

摘　　要：目的探讨基于行为改变轮(BCW)理论为指导的护理干预模式在手烧伤患者功能锻炼中的应用效果。方法采用抽样法选取2023年1月—12月医院烧伤科收治的手部烧伤患者82例,分为研究组与对照组,各41例。对照组给予常规护理,研究组在对照组的基础上采用BCW理论构建的健康教育模式,从能力、机会、动机三个方面运用多项干预功能及多种行为改变方式对患者进行针对性的护理干预,帮助患者建立正确手部康复功能锻炼的信念和动机。比较两组患者手指关节总主动活动度(TAM)、温哥华瘢痕评估量表(VSS)、瘢痕美容评估与评级量表(SCAR)和手功能康复锻炼依从性评分。结果干预后,两组TAM评分均较干预前提高,且研究组TAM评分高于对照组,差异有统计学意义(P<0.01)。干预后,两组患者VSS、SCAR评分较干预前降低,且研究组VSS、SCAR评分低于对照组,差异有统计学意义(P<0.01)。两组患者住院期间、出院后1个月、出院后2个月锻炼依从性比较,研究组均优于对照组。结论基于BCW理论为指导的护理干预方案能改善患者的关节TAM和手部瘢痕情况,提高患者功能锻炼依从性,促进手部功能快速康复,对手部烧伤患者康复锻炼起积极促进作用。Objective To investigate the effects of nursing interventions based on the theory of behavior change wheel in function exercise for patients with hand burns.Methods A total of 82 patients with hand burns were divided into the study group and control group,with 41 cases in each group.All patients received routine interventions.A health education model using the theory of behavior change wheel was conducted,and targeted interventions on ability,opportunity and motivation of patients were carried out to enhance the patient awareness and compliance with function exercise in the observation group.Scores of Total Active Movement of fingers(TMA),Vancouver Scar Scale(VSS),Scar Cosmesis Assessment and Rating(SCAR)Scale and self-made exercise compliance assessment of two groups were compared.Results TAM score increased in both two groups after intervention,and TAM score of the study group was higher than that of the control group(P<0.01).Scores of VSS and SCAR decreased in both two groups after intervention,and scores of VSS and SCAR of the study group were lower than those of the control group(P<0.01).The exercise compliance rate of the study group was higher than that of control group at hospitalization,1 month and 2 months after discharge,respectively.Conclusion Nursing interventions based on the theory of behavior change wheel could effective improve the recovery of finger TAM and diminish the scar tissue,improve the compliance with function exercise,and improve the recovery of hand function of patients with hand burns.

关 键 词：行为改变轮理论 手烧伤 护理干预 康复锻炼 

分 类 号：R644[医药卫生—外科学]