社区医院延续性护理对日间手术患者护理需求满足效果分析
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摘要
目的探讨社区医院延续性护理对日间手术患者护理需求的满足效果。方法选择2012年4月-2015年3月在日间手术病房住院的60例患者,按入院顺序分为对照组与观察组,每组各30例患者。对照组予以健康指导,观察组给予延续性护理,两组患者均进行问卷调查,总结患者术后护理需求,分析不同护理方式对患者护理需求的满足情况,采用生活质量问卷调查表(QLQ-C30)评价两组患者术后1、3个月生活质量的变化,统计两组患者术后并发症发生情况,采用改良巴氏指数表评定患者术后1、3个月日常生活能力的变化。结果日间手术患者对术后切口护理、换药,术后用药,饮食指导,术后指导,健康教育等方面护理需求高,对口腔、管道护理,理疗等需求低。观察组患者对护理服务的满意率为96.7%,对照组患者对护理服务的满意率为66.7%,两组比较差异有统计学意义(P<0.05)。观察组患者术后切口渗血、愈合不良、感染、尿潴留等并发症的合计发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者术后1、3个月生活质量评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者生活自理能力优于对照组,差异有统计学意义(P<0.05),完全自理比例高于对照组,轻度缺陷比例低于对照组。结论采用社区医院延续护理,可提高日间手术患者对护理服务的满意度,改善患者生活质量,促进其术后恢复。
Objective To explore the effect of community-hospital continuous nursing on the satisfaction of day surgery patients in terms of their nursing needs.Methods Sixty patients hospitalized in the day surgery ward in our hospital from April 2014 to March 2015 were enrolled in this study.According to the order of admission,they were divided into control group and observation group with 30 patients in each.Patients in the control group were given health guidance,while those in the observation group were given continuous nursing.Questionnaire survey was conducted in both the two groups.The nursing needs of patients at er surgery were summarized,and the satisfaction of patients' nursing needs through dif erent nursing methods were analyzed.Quality of life questionnaire-C30 was used to evaluate the quality of life of the two groups of patients one month and three months at er surgery,and the incidence of postoperative complications of the two groups was statistically analyzed.The changes of daily life ability of patients one month and three months at er surgery were evaluated by the modii ed PAP index.Results Day surgery patients had a high demand for postoperative incision care,dressing change,postoperative medication,dietary guidance,postoperative guidance,health education and other aspects of health care needs.There was little demand for oral pipeline care and physical therapy.The satisfaction rate of patients in the observation group toward nursing service(96.7%) was signii cantly higher than that in the control group(66.7%)(P < 0.05).The incidence of postoperative wound bleeding,poor healing,infection,urinary retention and other complications in the observation group was lower than those in the control group,but only the dif erence in the incidence of infection was statistically signii cant(P < 0.05).One month and three months at er surgery,the quality of life in the observation group was signii cantly better than that in the control group(P < 0.05).The complete self-care ratio in the observation group was higher than that in the control group,and the proportion of slight defect in the observation group was lower than that of the control group(P < 0.05).Conclusion Continuous community-hospital nursing can improve the satisfaction of patients toward nursing service,promote patients' quality of life,and facilitate patients' recovery at er surgery.
Objective To explore the effect of community-hospital continuous nursing on the satisfaction of day surgery patients in terms of their nursing needs.Methods Sixty patients hospitalized in the day surgery ward in our hospital from April 2014 to March 2015 were enrolled in this study.According to the order of admission,they were divided into control group and observation group with 30 patients in each.Patients in the control group were given health guidance,while those in the observation group were given continuous nursing.Questionnaire survey was conducted in both the two groups.The nursing needs of patients at er surgery were summarized,and the satisfaction of patients' nursing needs through dif erent nursing methods were analyzed.Quality of life questionnaire-C30 was used to evaluate the quality of life of the two groups of patients one month and three months at er surgery,and the incidence of postoperative complications of the two groups was statistically analyzed.The changes of daily life ability of patients one month and three months at er surgery were evaluated by the modii ed PAP index.Results Day surgery patients had a high demand for postoperative incision care,dressing change,postoperative medication,dietary guidance,postoperative guidance,health education and other aspects of health care needs.There was little demand for oral pipeline care and physical therapy.The satisfaction rate of patients in the observation group toward nursing service(96.7%) was signii cantly higher than that in the control group(66.7%)(P < 0.05).The incidence of postoperative wound bleeding,poor healing,infection,urinary retention and other complications in the observation group was lower than those in the control group,but only the dif erence in the incidence of infection was statistically signii cant(P < 0.05).One month and three months at er surgery,the quality of life in the observation group was signii cantly better than that in the control group(P < 0.05).The complete self-care ratio in the observation group was higher than that in the control group,and the proportion of slight defect in the observation group was lower than that of the control group(P < 0.05).Conclusion Continuous community-hospital nursing can improve the satisfaction of patients toward nursing service,promote patients' quality of life,and facilitate patients' recovery at er surgery.
引文
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2 杨霞,卢惠娟,赵爱平.早期心理与信息支持对甲状腺日间手术患者术前应激的影响[J].护理学杂志,2011,2(2):54-56.
3 张丽青,郑冬华,许多,等.4C模式在日间手术治疗无张力腹股沟疝修补术患者延续护理中的应用[J].中国护理管理,2015,15(11):1405-1407.
4 姜宝法,刘春晓,崔永春,等.EORTC QLQ-C30的信度、效度研究[J].中国临床心理学杂志,2005,13(1):31-32,36.
5 闵瑜.改良Barthel指数(简体中文版)评定脑卒中患者的效度和信度研究[D].广州:中山大学,2006.
6 郭晶,刘素珍.日间手术“医院-社区延伸康复模式”的研究现状[J].中国全科医学,2013,16(8):943-945.
7 吕艳冰,张文婧,李林.日间PPH手术260例围术期护理对策及模式[J].齐鲁护理杂志,2015,21(4):58-59.
8 张丽青,蒋碧媛,许多,等.日间手术患者术后护理需求的调查[J].解放军护理杂志,2015,32(10):52-53,65.
9 陈勤芳,夏平英,李瑞兰.一体化持续护理模式在日间吻合器痔上黏膜环切术中的应用[J].中华现代护理杂志,2012,18(25):3028-3030.
10 郭晶,刘素珍.日间手术患者对医院社区延续性服务的评价结果分析[J].中国实用护理杂志,2014,30(13):10-13.
11 Mccloud C,Harrington A,King L.Understanding people’s experience of vitreo-retinal day surgery:a Gadamerian-guided study[J].J Adv Nurs,2012,68(1):94-103.
12 方荣华,张晓蓉.日间手术病房患者护理需求的调查[J].中华现代护理杂志,2012,18(19):2299-2301.
13 张丽青,陈丽莉,林卫红,等.日间腹股沟疝修补术术后延续性护理模式应用的效果评价[J].中国实用护理杂志,2012,28(15):20-21.
14 夏平英,周剑英,方芳.日间手术病房护理管理问题分析[J].中国实用护理杂志,2011,27(增刊1):205.
15 郭晶,刘素珍,李继平.日间手术患者就医满意度调查及其影响因素分析[J].中国护理管理,2014,14(7):728-730.
16 Arshinof SA.Same-day cataract surgery should be the standard of care for patients with bilateral visually signii cant cataract[J].Surv Ophthalmol,2012,57(6):574-579.
17 Berg K,Arestedt K,Kjellgren K.Postoperative recovery from the perspective of day surgery patients:a phenomenographic study[J].Int J Nurs Stud,2013,50(12):1630-1638.
18 Jawaheer G,Evans K,Marcus R.Day-caselaparoscopic cholecystectomy in childhood:outcomes from a clinical care pathway[J].Eur J Pediatr Surg,2013,23(1):57-62.
2 杨霞,卢惠娟,赵爱平.早期心理与信息支持对甲状腺日间手术患者术前应激的影响[J].护理学杂志,2011,2(2):54-56.
3 张丽青,郑冬华,许多,等.4C模式在日间手术治疗无张力腹股沟疝修补术患者延续护理中的应用[J].中国护理管理,2015,15(11):1405-1407.
4 姜宝法,刘春晓,崔永春,等.EORTC QLQ-C30的信度、效度研究[J].中国临床心理学杂志,2005,13(1):31-32,36.
5 闵瑜.改良Barthel指数(简体中文版)评定脑卒中患者的效度和信度研究[D].广州:中山大学,2006.
6 郭晶,刘素珍.日间手术“医院-社区延伸康复模式”的研究现状[J].中国全科医学,2013,16(8):943-945.
7 吕艳冰,张文婧,李林.日间PPH手术260例围术期护理对策及模式[J].齐鲁护理杂志,2015,21(4):58-59.
8 张丽青,蒋碧媛,许多,等.日间手术患者术后护理需求的调查[J].解放军护理杂志,2015,32(10):52-53,65.
9 陈勤芳,夏平英,李瑞兰.一体化持续护理模式在日间吻合器痔上黏膜环切术中的应用[J].中华现代护理杂志,2012,18(25):3028-3030.
10 郭晶,刘素珍.日间手术患者对医院社区延续性服务的评价结果分析[J].中国实用护理杂志,2014,30(13):10-13.
11 Mccloud C,Harrington A,King L.Understanding people’s experience of vitreo-retinal day surgery:a Gadamerian-guided study[J].J Adv Nurs,2012,68(1):94-103.
12 方荣华,张晓蓉.日间手术病房患者护理需求的调查[J].中华现代护理杂志,2012,18(19):2299-2301.
13 张丽青,陈丽莉,林卫红,等.日间腹股沟疝修补术术后延续性护理模式应用的效果评价[J].中国实用护理杂志,2012,28(15):20-21.
14 夏平英,周剑英,方芳.日间手术病房护理管理问题分析[J].中国实用护理杂志,2011,27(增刊1):205.
15 郭晶,刘素珍,李继平.日间手术患者就医满意度调查及其影响因素分析[J].中国护理管理,2014,14(7):728-730.
16 Arshinof SA.Same-day cataract surgery should be the standard of care for patients with bilateral visually signii cant cataract[J].Surv Ophthalmol,2012,57(6):574-579.
17 Berg K,Arestedt K,Kjellgren K.Postoperative recovery from the perspective of day surgery patients:a phenomenographic study[J].Int J Nurs Stud,2013,50(12):1630-1638.
18 Jawaheer G,Evans K,Marcus R.Day-caselaparoscopic cholecystectomy in childhood:outcomes from a clinical care pathway[J].Eur J Pediatr Surg,2013,23(1):57-62.