基于KANO模型的护理干预在心脏起搏器植入者居家护理中的应用  

Application of nursing intervention based on KANO model in home care of pacemaker implants

作　　者：吴秀华[1] 朱夏玲[1] 叶莉[1] 王莉丽[1] WU Xiuhua;ZHU Xialing;YE Li;WANG Lili(Interventional Surgery Room,Lishui Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院介入手术室,浙江丽水323000

出　　处：《中华全科医学》2025年第3期521-524,533,共5页Chinese Journal of General Practice

基　　金：浙江省基础公益研究计划项目(LGF21H170001);丽水市科技计划项目(2023GYX30)。

摘　　要：目的通过KANO模型需求分析,拟定和实施个性化护理方案,为临床护理工作开拓思路。方法选取2022年1月-2023年3月就诊于丽水市中心医院择期行心脏起搏器植入手术患者151例,采用随机数字表法分为对照组(76例)和KANO组(75例),分别给予常规延续性护理干预、基于KANO模式的护理干预。最终各73例、74例入组,比较2组疾病相关知识掌握程度、遵医依从性、并发症发生率及生活质量评分。结果KANO组护理后自身疾病知识、自我护理知识、起搏器具体知识及起搏器植入后使用知识知晓率分别为89.19%、87.84%、79.73%、85.14%,均高于对照组的64.38%、64.38%、57.53%、63.01%(P<0.05);KANO组遵医依从性评分中每日测量脉搏[(3.09±0.56)分]、按时服药[(3.01±0.47)分]、坚持锻炼[(2.88±0.45)分]、术后注意事项[(2.90±0.34)分]均高于对照组的(2.53±0.41)分、(2.44±0.36)分、(2.19±0.37)分、(2.23±0.46)分(P<0.05);KANO组并发症发生率(6.76%vs.20.55%)低于对照组(χ^(2)=5.946,P=0.015);KANO组生活质量评分高于对照组(P<0.05)。结论基于KANO模式的护理干预在提高心脏起搏器植入居家患者疾病相关知识掌握程度和遵医行为,减少并发症的发生,提高生活质量方面优势明显。Objective To develop and implement personalized nursing plans through KANO model demand analysis,and to develop ideas for clinical nursing work.Methods A total of 151 patients who received pacemaker implantation surgery in Lishui Central Hospital from January 2022 to March 2023 were selected and divided into a control group(76 cases)and a KANO group(75 cases)by random number table method,and were given conventional continuous nursing intervention or nursing intervention based on KANO model,respectively.Finally,73 and 74 cases were enrolled in each group,and the mastery of disease-related knowledge,compliance,complication rate,and quality of life score were compared between the two groups.Results The awareness rates of"self-disease knowledge,self-care knowledge,pacemaker specific knowledge,and pacemaker implantation knowledge"in the KANO group after nursing were 89.19%,87.84%,79.73%,and 85.14%,respectively,which were higher than 64.38%,64.38%,57.53%,and 63.01%in the control group(P<0.05).Medical compliance score:daily pulse measurement[(3.09±0.56)points],regular medication[(3.01±0.47)points],exercise[(2.88±0.45)points],postoperative precautions[(2.90±0.34)points]in the KANO group were higher than(2.53±0.41)points,(2.44±0.36)points,(2.19±0.37)points,(2.23±0.46)points in control group(P<0.05).The incidence of complications(6.76%vs.20.55%)in the KANO group was lower than that of the control group(χ^(2)=5.946,P=0.015).The quality of life score in the KANO group was higher than that of the control group(P<0.05).Conclusion Nursing intervention based on the KANO model has obvious advantages in improving disease-related knowledge and compliance behavior of home patients with cardiac pacemaker implantation,reducing the occurrence of complications,and improving the quality of life.

关 键 词：心脏起搏器 延续性护理 KANO模型 依从性 并发症 

分 类 号：R473.54[医药卫生—护理学] R318.11[医药卫生—临床医学]