目的：探讨基于知识转化循证实践（knowledge-to-action,KTA）模式的健康教育对于结直肠癌手术患者围术期中的应用价值。方法：选择2022年10月—2023年12月安庆市立医院收治的结直肠癌患者119例作为研究对象,按随机数字表法分为对照组（n=59）和观察组（n=60）。对照组接受常规围术期护理干预,观察组在对照组的基础上接受基于KTA模式的健康教育的围术期护理。两组均干预至患者出院,比较两组的康复情况[排气时间、首次排便时间、首次下床活动时间],并以生活自理能力评分（activity of daily living,ADL）比较自理能力、视觉模拟评分（visual analogue scale,VAS）比较疼痛程度、Braden量表评价压力性损伤、采用健康调查量表（36-item short form health survey,SF-36）比较生活质量。结果：观察组排气时间、排便时间和下床活动时间均短于对照组;干预后观察组ADL量表的躯体生活自理量表、工具性日常生活活动量表评分均低于对照组;干预后观察组VAS量表评分低于对照组、Braden量表评分高于对照组;干预后观察组SF-36量表各维度评分均高于对照组。结论：基于KTA模式的健康教育可加快结直肠癌手术患者术后恢复进程,提高患者术后自理能力,降低术后疼痛感和压力性损伤发生风险,并提高患者生活质量,临床应用价值较高。
Abstract
Objective To investigate the application value of health education based on the knowledge-to-action (KTA) framework in perioperative period of patients undergoing colorectal cancer surgery. Methods A total of 119 patients with colorectal cancer admitted to Anqing Municipal Hospital from October 2022 to December 2023 were selected as the study subjects. Using the random number table method, the subjects were divided into a control group (n=59) and an observation group (n=60), receiving routine perioperative nursing intervention and perioperative nursing of health education based on KTA framework, respectively. Both groups received intervention till discharge. Rehabilitation status (exhaust time, time to first bowel movement and time to first off-bed activity) of the two groups was compared. The Activity of Daily Living (ADL) scale, Visual Analogue Scale (VAS), Braden Scale and 36-Item Short Form Health Survey (SF-36) were used to evaluate self-care ability, pain degree, pressure injury and quality of life, respectively. Results Compared to the control group, exhaust time, time to first bowel movement and time to first off-bed activity in the observation group were shorter. After intervention, PSMS score and IADL score of the observation group were lower. After intervention, VAS scores of the observation group were lower and Braden Scale scores of the observation group were higher. After intervention, SF-36 scores in all dimensions of the observation group were higher. Conclusion Health education based on KTA framework can accelerate postoperative recovery process of patients with colorectal cancer, improve their postoperative self-care ability, reduce postoperative pain and the risk of pressure injury, and improve their life quality.
关键词
知识转化循证实践模式 /
健康教育 /
结直肠癌手术 /
围术期 /
应用价值
Key words
knowledge-to-action framework /
health education /
colorectal cancer surgery /
perioperative period /
application value
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基金
安徽省教育厅高校科研项目“失巢凋亡影响胃印戒细胞癌侵袭及转移的机制”（2023AH050577）
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