基于COM-B理论的围手术期护理在脊髓电刺激治疗带状疱疹后神经痛患者中的应用  

Application of perioperative care based on COM-B theory in patients with postherpetic neuralgia treated with spinal cord stimulation

作　　者：唐倩 孙丽华 冯洁 范雪松 顾光丽 鲁婕清 袁敏 TANG Qian;SUN Lihua;FENG Jie;FAN Xuesong;GU Guangli;LU Jieqing;YUAN Min(School of Nursing,Guizhou Medical University,Guiyang 550001,Guizhou,China;Department of Pain,the Affiliated Hospital of Guizhou Medical University,Guiyang 550001,Guizhou,China)

机构地区：[1]贵州医科大学护理学院,贵州贵阳550001 [2]贵州医科大学附属医院疼痛科,贵州贵阳550001

出　　处：《护士进修杂志》2025年第6期604-610,共7页Journal of Nurses Training

基　　金：贵州医科大学护理学科专项科研项目(编号:YJ22021)。

摘　　要：目的探讨基于能力、机会、动机-行为理论(capability,opportunity,and motivation behavior theory,COM-B)的围手术期护理在脊髓电刺激(spinal cord stimulation,SCS)治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)患者中的应用效果。方法采用便利抽样法,选取2023年2—11月在贵州省某三级甲等医院疼痛科80例自愿接受SCS治疗的PHN患者为研究对象,按照入院时间,将2023年2—6月的40例患者作为对照组,将2023年7—11月的40例患者作为观察组。对照组在围手术期接受常规护理指导,而观察组接受基于COM-B理论的围手术期护理干预。在术前7 d、术后第7天采用疼痛数字评分量表(numerical rating scale,NRS)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、中文版慢性病管理自我效能感量表(chinese version of the self-efficacy to manage chronic disease scale,C-SEMCD)及健康状况调查问卷(the short-from-36 health survey,SF-36)对患者进行评价。结果干预后,观察组的NRS评分、SAS评分、SDS评分均低于对照组(P<0.05);观察组C-SEMCD、SF-36总分均高于对照组,差异均有统计学意义(P<0.05)。结论基于COM-B理论的围手术期护理干预可以减轻SCS治疗PHA患者疼痛程度,改善其情绪状态,增强自我效能感,利于提升其生活质量水平。Objective To explore the application effect of perioperative care based on capability,opportunity,and motivation behavior theory(COM-B)in patients with spinal cord stimulation(SCS)postherpetic neuralgia(PHN).Methods A total of 80 PHN patients who voluntarily underwent SCS in the pain department of a tertiary hospital in Guizhou province from February to November 2023 were selected as the study subjects by convenience sampling method,and 40 patients from February to June 2023 were selected as the control group and 40 patients from July to November 2023 were selected as the observation group according to the admission time.The control group received conventional nursing guidance during the perioperative period,while the observation group received perioperative nursing guidance based on COM-B theory.The numerical rating scale(NRS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Chinese version of the self-efficacy to manage chronic disease scale(C-SEMCD),and the short-from-36 health survey(SF-36)were used as the outcome indicators for the evaluations on the 7 preoperative days and the 7 postoperative days.Results After the intervention,the NRS scores,SAS scores,and SDS scores of the observation group were lower than those of the control group(P<0.05);the C-SEMCD and SF-36 total scores of the observation group were higher than those of the control group,and the differences were all statistically significant(P<0.05).Conclusion Perioperative nursing guidance based on COM-B theory can reduce the pain level of PHN patients,improve their emotional state,enhance their self-efficacy,and facilitate the quality of life level.

关 键 词：COM-B理论 围手术期 脊髓电刺激 带状疱疹后神经痛 护理 

分 类 号：R473[医药卫生—护理学]