基于知信行理论的护理干预在食管癌根治术患者中的影响  

Nursing intervention based on the theory of knowledge,attitude/belief,practice in patients undergoing radical oesophageal cancer surgery

作　　者：毛志蒙 孙云[1] 汤平 王兰[1] 顾晓娟[1] MAO Zhimeng;SUN Yun;TANG Ping;WANG Lan;GU Xiaojuan(Jiangsu Subei People's Hospital,Yangzhou 225002,China)

机构地区：[1]江苏省苏北人民医院,江苏省扬州市225002

出　　处：《护理实践与研究》2025年第3期443-451,共9页Nursing Practice and Research

基　　金：扬州市护理学会软科学研究培育课题(立项编号:202303)。

摘　　要：目的探讨基于知信行理论的护理干预模式在食管癌根治术患者中的应用效果。方法选取2023年2—4月医院收治的食管癌根治术患者54例作为对照组,实施常规护理;选取2023年5—7月医院收治的食管癌根治术患者54例作为观察组,在对照组的基础上实施基于知信行理论的护理干预措施。比较两组患者干预前后的康复指标、营养指标、并发症发生率、生活质量、出院满意度。结果干预后,观察组康复指标维度中的首次咳出痰液、首次下床活动、首次经口进食、鼻肠管拔除及术后住院时间均短于对照组,差异有统计学意义(P<0.05);两组患者术后2 d、6 d、30 d三个时点的营养指标数据进行比较,4个时点均随时间呈逐渐先下降再升高趋势,差异有统计学意义(P_(时间)<0.05),术后各个指标均为观察组高于对照组,组间比较差异有统计学意义(P_(组间)<0.05),随观察时间延长,两组患者血红蛋白水平和PNI得分比较组间差异逐渐增大(P_(交互)<0.05);两组患者入院时,出院后1、2、3个月整体营养状况主观评估量表的评分进行比较,4个时点各指标评分均随时间呈逐渐升高再下降的趋势,时间差异有统计学意义(P_(时间)<0.05);并且术后指标均以观察组低于对照组,差异有统计学意义(P_(组间)<0.05),同时随着观察时间延长,组间差异逐渐增大(P_(交互)<0.05);食管癌化疗患者生活质量测定量表得分,4个时点均随时间呈逐渐先下降再升高的趋势,时间比较差异有统计学意义(P_(时间)<0.05);出院时、出院后1个月、出院后3个月时各指标均为观察组高于对照组,组间比较差异有统计学意义(P_(组间)<0.05),出院时差异最大,随出院时间的延长,两组间的差异逐渐减小(P_(交互)<0.05);观察组术后并发症发生率均低于对照组,差异有统计学意义(P<0.05);两组患者在护理技术、服务态度得分比较差异无统计学意义(P>0.05),但观察�Objective To explore the application effect of a nursing intervention model based on the theory of knowledge,attitude/belief,practice in patients undergoing radical surgery for oesophageal cancer.Methods Fiftyfour patients undergoing radical oesophageal cancer surgery admitted to the hospital from February to April 2023 were selected as the control group,and routine nursing was implemented.54 patients undergoing radical oesophageal cancer surgery admitted to the hospital from May to July 2023 were selected as the observation group,and nursing interventions based on the theory of knowledge,attitudel/belief,practice and acting were implemented based on the control group.The rehabilitation index,nutrition index,complication rates,quality of life and discharge satisfaction were compared between the two groups before and after the intervention.Results After intervention,the observation group rehabilitation index dimension of the first coughing up sputum,the first time to get out of bed,the first time to eat by mouth,nasoenteric tube removal and postoperative hospital stay are shorter than the control group,the difference is statistically significant(P<0.05);the two groups of patients 2 d,6 d,30 d postoperative three points of nutritional indicators for comparison,four points of time were gradually decrease with time and then show a incerase trend,the difference is statistically significant(P<0.05).Each postoperative index of the obaervation group were higher than the control group,the difference between groups were statistically significant(P<0.05).The total protein,serum albumin,haemoglobin and prognostic nutritional index of the observation group were higher than those of the control group,and all four time points showed a gradual trend of decreasing and then increasing over time,with statistically significant differences(P<0.05).When comparing the scores on the subjective assessment scale of the patients'overall nutritional status at 1,2 and 3 months after discharge,the observation group was lower than the control

关 键 词：知信行模式 护理干预 食管癌 康复效果 营养指标 生活质量 

分 类 号：R473.73[医药卫生—护理学]