骨科护士对加速康复外科人工关节置换术患者护理的知信行分析研究
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摘要
目的研究加速康复模式下护士对人工关节置换术(Total Joint Arthroplasty, TJA)患者护理的知识、信念和行为(知信行)的现状及其影响因素。方法采用自行设计的知信行问卷,对已开展加速康复外科(Enhanced recovery after surgery, ERAS)技术的新疆医科大学第一附属医院80名骨科护士对人工关节置换术患者护理的知识、信念、行为3个维度进行现状调查,经单因素方差分析影响骨科护士ERAS知信行的相关因素。结果骨科护士在TJA中运用ERAS的知识维度总分为(64.15±0.91)分,在患者术前及术后的知识得分较高,而在ERAS的实施状况和术中应用ERAS技术的得分较低;态度维度总分为(8.56±0.29)分、行为维度总分为(19.53±0.37)分;单因素方差分析结果表明年龄在21～30岁、学历为硕士研究生及以上、职称为主任护师、在本科室工作年限3～5年的骨科护士ERAS知信行得分较其他护士高,差异有统计学意义(P<0.01)。结论 80名骨科护士将ERAS技术运用于TJA的知信行状况有差异,这与开展ERAS技术的重视与支持程度、多学科协作力度与医务人员的理念等因素有关。
Objective To explore the status and the influencing factors of knowledge, attitude and practice(KAP) about enhanced recovery after surgery(ERAS) applied in total joint arthroplasty(TJA) among nurses. Methods Survey on the status quo from three dimensions of knowledge, belief and behavior of 80 orthopedic nurses in the First Affiliated Hospital of Xinjiang Medical University with the technology of ERAS were investigated by self-designed questionnaire. The related factors were analyzed by one-way ANOVA. Results The total score of awareness about ERAS was(64.15±0.91), and the score during preoperative and postoperative of TJA was relatively high, the score of ERAS′ implementation status and intraoperative application were(8.56±0.29)and(19.53±0.37)respectively. The results of one-way ANOVA showed orthopedic nurses aged 21～30, with master′s degree or above, titled chief nurse and working in the Department for 3～5 years were higher than those of other nurses(P<0.01). Conclusion There were differences in the knowledge and behavior of 80 orthopedic nurses in applying ERAS technology to TJA, which might be related to the importance and support of ERAS technology, the multi-disciplinary cooperation and the concept of medical staff.
Objective To explore the status and the influencing factors of knowledge, attitude and practice(KAP) about enhanced recovery after surgery(ERAS) applied in total joint arthroplasty(TJA) among nurses. Methods Survey on the status quo from three dimensions of knowledge, belief and behavior of 80 orthopedic nurses in the First Affiliated Hospital of Xinjiang Medical University with the technology of ERAS were investigated by self-designed questionnaire. The related factors were analyzed by one-way ANOVA. Results The total score of awareness about ERAS was(64.15±0.91), and the score during preoperative and postoperative of TJA was relatively high, the score of ERAS′ implementation status and intraoperative application were(8.56±0.29)and(19.53±0.37)respectively. The results of one-way ANOVA showed orthopedic nurses aged 21～30, with master′s degree or above, titled chief nurse and working in the Department for 3～5 years were higher than those of other nurses(P<0.01). Conclusion There were differences in the knowledge and behavior of 80 orthopedic nurses in applying ERAS technology to TJA, which might be related to the importance and support of ERAS technology, the multi-disciplinary cooperation and the concept of medical staff.
引文
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[8] 张霞,姜红萍.早期预警性护理对高龄人工全髋关节置换术患者应激反应及术后并发症的影响[J].国际护理学杂志,2018,37(4):450-453.
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[10] 杨翠萍,李建松.快速康复外科理念在手术室护理中的应用体会[J].中外医学研究,2017,27(15):117-118.
[11] 张馨予,宁宁,李佩芳,等.外科医护人员加速康复外科理念知信行现状及影响因素分析[J].中华现代护理杂志,2016,22(33):4790-4795.
[12] 胡惠惠,任泽强,谭迎春,等.医护人员加速康复外科的认知水平及影响因素分析[J].徐州医学院学报,2014,34(12):926-929.
[13] 刘静,赵体玉,郭月.武汉市535名手术室护士科研能力现状及影响因素分析[J].护理学报,2016,23(13):41-44.
[14] 黎介寿,江志伟.加速康复外科的临床意义不仅仅是缩短住院日[J].中华消化外科杂志,2015,14(1):22-24.
[15] GUSTAFSSON U O,SCOTT M J,SCHWENK W,et al.Guidelines for perioperative care in elective colonic surgery:Enhanced Recovery After Surgery (ERAS) Society recommendations[J].Clin Nutr,2012,31(6):783-800.
[16] NYGREN J,THACKER J,CARLI F,et al.Guidelines for perioperative care in elective rectal/pelvic surgery:Enhanced Recovery After Surgery (ERAS) Society recommendations.[J].Clin Nutr,2012,31(6):801-816.
[17] LASSEN K,COOLSEN M E,SLIM K,et al.Guidelines for perioperative care for pancreaticoduodenectomy:Enhanced Recovery After Surgery (ERAS) Society recommendations [J].World J Surg ,2013,31(6):240-258.
[18] 江志伟,李宁.结直肠手术应用加速康复外科中国专家共识(2015版)[J].中国实用外科杂志,2015,35(8):841-843.
[19] 孙旭,李庭,杨明辉,等.加速康复外科的发展与在骨科的应用[J].骨科临床与研究杂志,2017,2(2):114-116.
[20] SIBIBA U S,MACDOALD J H,King P J.Predictors of hospital length of stay in enhanced recovery after surgery program for primary total hip arthroplasty[J].J Arthroplasty,2016,31(10):2119-2123.
[21] 张继芝,李秀娥,徐玉芝,等.多学科合作加速康复外科工作模式下的护理管理实践及效果评价[J].中国护理管理,2018,18(4):546-552.
[22] 张馨予,宁宁,李佩芳,等.外科医护人员加速康复外科理念知信行现状及影响因素分析[J].中华现代护理杂志,2016,22(33):4790-4794.
[2] KEHLET H,WILMORE D W.Multimodal stratigies to improves surgical outcome[J].Am J Surg,2002,183(6):630-641.
[3] KEHLET H,WILMORE D W.Fast-track surgery[J].Br J Surg,2005,92(1):3-4.
[4] PENG C,YI W M,TAN Z X,et al.Application of enhanced recovery after surgery(ERAS) concept in the treatment of cholelithiasis:a randomized controlled clinical trial[J].J Hepato Surg,2016,28(3):171-180.
[5] 江志伟,李宁,黎介寿.加速康复外科的概念及临床意义[J].中国实用外科杂志,2007,27(2):131-133.
[6] 王伟,刘军,周胜虎,等.人工关节置换术后假体周围感染与术前贫血的研究进展[J].中国骨伤,2018,31(10):92-96.
[7] 赵改云,许燕玲.人工关节置换术后康复训练依从性影响因素研究现状[J].解放军护理杂志,2018(16):41-45.
[8] 张霞,姜红萍.早期预警性护理对高龄人工全髋关节置换术患者应激反应及术后并发症的影响[J].国际护理学杂志,2018,37(4):450-453.
[9] HUSTED H,HOLM G.Fast track in total hip and knee arthroplasty experiences from Denmark Hvidovre University Hospital[J].Injury,2006,37(5):31- 35.
[10] 杨翠萍,李建松.快速康复外科理念在手术室护理中的应用体会[J].中外医学研究,2017,27(15):117-118.
[11] 张馨予,宁宁,李佩芳,等.外科医护人员加速康复外科理念知信行现状及影响因素分析[J].中华现代护理杂志,2016,22(33):4790-4795.
[12] 胡惠惠,任泽强,谭迎春,等.医护人员加速康复外科的认知水平及影响因素分析[J].徐州医学院学报,2014,34(12):926-929.
[13] 刘静,赵体玉,郭月.武汉市535名手术室护士科研能力现状及影响因素分析[J].护理学报,2016,23(13):41-44.
[14] 黎介寿,江志伟.加速康复外科的临床意义不仅仅是缩短住院日[J].中华消化外科杂志,2015,14(1):22-24.
[15] GUSTAFSSON U O,SCOTT M J,SCHWENK W,et al.Guidelines for perioperative care in elective colonic surgery:Enhanced Recovery After Surgery (ERAS) Society recommendations[J].Clin Nutr,2012,31(6):783-800.
[16] NYGREN J,THACKER J,CARLI F,et al.Guidelines for perioperative care in elective rectal/pelvic surgery:Enhanced Recovery After Surgery (ERAS) Society recommendations.[J].Clin Nutr,2012,31(6):801-816.
[17] LASSEN K,COOLSEN M E,SLIM K,et al.Guidelines for perioperative care for pancreaticoduodenectomy:Enhanced Recovery After Surgery (ERAS) Society recommendations [J].World J Surg ,2013,31(6):240-258.
[18] 江志伟,李宁.结直肠手术应用加速康复外科中国专家共识(2015版)[J].中国实用外科杂志,2015,35(8):841-843.
[19] 孙旭,李庭,杨明辉,等.加速康复外科的发展与在骨科的应用[J].骨科临床与研究杂志,2017,2(2):114-116.
[20] SIBIBA U S,MACDOALD J H,King P J.Predictors of hospital length of stay in enhanced recovery after surgery program for primary total hip arthroplasty[J].J Arthroplasty,2016,31(10):2119-2123.
[21] 张继芝,李秀娥,徐玉芝,等.多学科合作加速康复外科工作模式下的护理管理实践及效果评价[J].中国护理管理,2018,18(4):546-552.
[22] 张馨予,宁宁,李佩芳,等.外科医护人员加速康复外科理念知信行现状及影响因素分析[J].中华现代护理杂志,2016,22(33):4790-4794.
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