目的 探讨基于健康信念模式的精准多元化干预对白内障日间手术患者的干预效果。方法 选取2024年5月—2024年6月江苏省某三甲医院收治的410例白内障日间手术患者作为A组,均行常规干预方法;选取2024年7月—2024年8月江苏省某三甲医院收治的423例白内障日间手术患者作为B组,均行基于健康信念模式的精准多元化干预。两组均干预至患者出院,并随访1个月。比较两组患者健康知识掌握程度、心理韧性、自我效能（干预前、随访1个月后）;并发症发生情况（干预及随访期间）;护理满意度、疼痛程度（随访1个月后）。结果 两组患者疾病类型、性别、年龄的一般资料无明显差别。与治疗前比较,随访1个月后,两组白内障相关知识、术前准备要点、术后注意事项、出院康复知识各个评分、心理韧性量表、自我效能感量表评分均升高,其中B组较A组更高,B组治疗前与随访1个月后上述各指标评分的差值均高于A组。干预及随访期间,B组并发症低于A组。随访1个月后,较A组,B组中度、轻度疼痛的患者占比更低,无痛的患者占比则更高。随访1个月后,B组护理满意率高于A组。结论 基于健康信念模式的精准多元化干预可有效提高白内障日间手术患者健康知识掌握程度、自我效能,提高了病人的心理弹性,减轻了病人的疼痛水平,减少了并发症的发生率,并且对护理工作更加满意。
Abstract
Objective To explore the effect of accurate and diversified intervention based on health belief model on cataract patients undergoing daytime surgery. Methods 410 patients with cataract who underwent day surgery in a 3A hospital in Jiangsu Province from May 2024 to June 2024 were selected as the group A, and all of them were treated with routine intervention methods. From July 2024 to August 2024, 423 cataract patients in a 3A hospital in Jiangsu Province were selected as the group B, and all of them underwent accurate and diversified intervention based on health belief model. Both groups intervened until the patients were discharged from hospital and were followed up for one month. The mastery of health knowledge, psychological resilience, self-efficacy (before intervention and after one month of follow-up), complications (during intervention and follow-up), satisfaction and pain (after one month of follow-up) were compared between the two groups. Results There was no significant difference in the general data of disease type, sex and age between the two groups. Compared with before treatment, after one month's follow-up, the scores of cataract-related knowledge, preoperative preparation points, postoperative precautions, discharge rehabilitation knowledge, tenacity, self-improvement, optimism, emotional control, health management, compliance with medical drugs and pain control in the two groups all increased, especially in the group B, the difference of each index in the group B before treatment and after 1 month of follow-up was higher than that in the group A. During the intervention and follow-up, the incidence of complications in the group B was 3.55%, which was lower than that in the group A (10.00%). After one month's follow-up, compared with the group A, the proportion of patients with moderate and mild pain pain in the group B was lower, while the proportion of patients without pain was higher (P<0.05). After one month's follow-up, the nursing satisfaction rate of the group B was 98.82%, which was higher than that of the group A (92.44%). Conclusion Accurate and diversified intervention based on health belief model can effectively improve the mastery of health knowledge and self-efficacy of patients undergoing cataract day surgery, improve their psychological elasticity, reduce their pain level, reduce the incidence of complications, and be more satisfied with their nursing work.
关键词
白内障 /
日间手术 /
健康信念模式 /
精准性多元化干预 /
干预效果
Key words
cataract /
daytime surgery /
health belief model /
accurate and diversified intervention /
intervention effect
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参考文献
[1] CHEN C, SUN Y, CHEN C, et al.Development and validation of a patient discharge readiness scale for daytime cataract surgery (DRS-CAT)[J]. J Perianesth Nurs, 2024, 39(2): 195-201.
[2] BANSAL M, THAKUR A, JESHAN M, et al.Visual and clinical outcomes after bilateral implantation of a novel extended depth of focus lens post cataract surgery[J]. Indian J Ophthalmol, 2024, 72(9): 1267-1274.
[3] NISHAD A, MALIK P, DEWAN T.Effect of ageing and cataract formation on the raman spectroscopic profile of human lens: an observational study[J]. Indian J Ophthalmol, 2024, 72(9): 1346-1351.
[4] 陈晨, 孙怡雯, 张梦月, 等. 护患双方对白内障日间手术病人出院准备度评估的差异及影响因素[J]. 护理研究, 2023, 37(24): 4357-4368.
[5] 周莹莹, 李贡辉. 信息-动机-行为技巧模型在白内障日间手术患者健康教育中的应用研究[J]. 护理管理杂志, 2021, 21(10): 751-756.
[6] 项彩萍, 李爱华, 燕玲, 等. 老年性白内障患者日间手术模式的构建与临床效果分析[J]. 中国临床保健杂志, 2024, 27(1): 116-119.
[7] 赵堪兴, 杨培增. 眼科学[M]. 北京: 人民卫生出版社, 2013: 148-148.
[8] 苗笛, 王红, 彭娜. 团体认知干预对恶性肿瘤终末期伴抑郁患者的效果[J]. 国际精神病学杂志, 2024, 51(5): 1568-1570, 1574.
[9] 沙璐璐, 刘长红, 刘鸿, 等. 心脏瓣膜置换术后自我效能感量表评分的影响因素分析及心理干预应用价值[J]. 实用医院临床杂志, 2022, 19(4): 71-74.
[10] 魏丽青, 王永强, 程旭东. 无痛分娩对产妇分娩结局视觉模拟疼痛评分及应激反应指标的影响[J]. 中国妇幼保健, 2022, 37(7): 1210-1213.
[11] THULASIDAS M.Comments on: outcome of manual small-incision cataract surgery in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma[J]. Indian J Ophthalmol, 2024, 72(9): 1377-1378.
[12] JØRGENSEN C C, LLAU J, JENNY Y J, et al. European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: chapter 3: day surgery and fast-track surgery[J]. European J Anaesthesiol, 2024, 41(8): 577-581.
[13] THIEL B, BLAAUBOER J, SEESING C, et al.Patient self-reported pain and nausea via smartphone following day care surgery, first year results: an observational cohort study[J]. PLOS digital health, 2024, 3(7): e0000342.
[14] 石砚, 曹娟. 白内障患者日间手术后延续性护理需求的相关因素[J]. 中国医药导报, 2022, 19(10): 190-193.
[15] 茹米亚·吾拉音, 郭强. 白内障日间手术应用人文关怀管理的效果分析[J]. 河北医药, 2023, 45(5): 792-794.
[16] 郭艳珍. 医护一体化模式下的精准护理在白内障摘除联合人工晶状体植入手术患者中应用效果观察[J]. 现代诊断与治疗, 2023, 34(17): 2676-2678.
[17] 李慧姣, 史静华, 郭丽霞, 等. 早期护理干预在行日间手术的老年白内障病人中的应用[J]. 护理研究, 2021, 35(5): 928-930.
[18] 余萍, 曹娟, 袁松涛. 基于流程化沟通的三级管理模式对白内障日间手术患者焦虑和抑郁情绪的影响[J]. 精神医学杂志, 2023, 36(5): 517-520.
[19] 王冠一, 刘淑贤, 倪如暘. 白内障日间手术流程优化效果评价[J]. 华西医学, 2023, 38(2): 185-189.
[20] 申鑫, 王文鲜, 马张芳. 智能移动健康宣教系统在视网膜脱离日间手术病人围术期的应用[J]. 护理研究, 2023, 37(12): 2239-2243.
[21] 陈姣, 李成军, 谭晓慧. 临床路径对老年性白内障手术平均住院日和平均住院费用的影响[J]. 中国病案, 2021, 22(7): 70-72.
[22] 王燕霞, 曹菁迪, 陆萍, 等. 健康信念模式在慢性阻塞性肺疾病患者健康教育中的应用[J]. 中国医药导报, 2022, 19(22): 185-188.
[23] 王佳尉, 万小祥, 史朝亮, 等. 多元化精准行为治疗对女性轻中度压力性尿失禁伴性功能障碍的临床研究[J]. 中华男科学杂志, 2023, 29(2): 138-143.
[24] 李伊婷, 李莉, 陈一萍, 等. 基于健康信念模式和计划行为理论的寻常型银屑病病人自我管理干预方案的应用效果[J]. 护理研究, 2023, 37(15): 2831-2837.
[25] 陈桂尼, 刘运仲, 王月婵, 等. 护士主导的多元化护理在心脏瓣膜疾病术后口服华法林抗凝依从性中的作用[J]. 中国临床研究, 2023, 36(11): 1744-1748, 1753.
基金
2023年度江苏省科技计划专项项目“m6A修饰调控LncRNAIPW介导的组蛋自修饰H3K9mc3在年龄相关性黄斑变性中的作用及机制研究”（BK20231371）
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