摘要
目的探讨基于自我管理导向的5A护理模式在肝癌肝切除术患者中的应用效果,以期为肝癌肝切除患者的护理干预提供参考。方法选取2021年10月—2023年10月于南京大学医学院附属盐城第一医院进行肝切除术的125例肝癌患者,采用随机数字表法分为对照组(62例)和观察组(63例)。对照组患者接受常规护理模式干预,观察组患者接受基于自我管理导向的5A护理模式干预。比较2组患者干预前后的自我管理能力、生活质量,术后康复情况以及并发症发生情况。结果观察组患者术后通气时间、术后引流时间、伤口愈合时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。2组患者干预前自我管理能力量表(ESCA)的自我概念、自我护理责任感、自我护理技能、健康知识水平4个维度评分及总分比较,差异均无统计学意义(P>0.05);2组患者干预后ESCA量表的4个维度评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。2组患者干预前生活质量测定量表简表(SF-36)的生理职能、生理功能、社会功能、躯体疼痛、情感职能、精神健康、活力、总体健康8个维度评分比较,差异均无统计学意义(P>0.05);2组患者干预后SF-36量表的8个维度评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为1.59%(1/63),低于对照组的12.90%(8/62),差异有统计学意义(χ^(2)=6.664,P=0.010)。结论对肝癌肝切除术患者采用基于自我管理导向的5A护理模式干预,能够有效促进患者术后康复,提升患者自我管理能力,提高患者生活质量,降低并发症发生风险,值得在临床推广。
Objective To explore the application of the self-management-oriented 5A nursing model in patients undergoing hepatectomy for liver cancer,in order to provide a reference for nursing intervention in patients undergoing liver cancer resection.Methods A total of 125 liver cancer patients who underwent hepatectomy at the Yancheng First Hospital Affiliated of Nanjing University Medical College,from October 2021 to October 2023,were selected and divided into a control group(62 cases)and an observation group(63 cases)using the random number table method.Patients in the control group received the conventional nursing model intervention,while those in the observation group received intervention based on the self-management-oriented 5A nursing model.The self-management ability and quality of life before and after intervention,postoperative recovery,and incidence of complications in the two groups of patients were compared.Results The time to postoperative ventilation,postoperative drainage time,wound healing time,and length of hospital stay of patients in the observation group were all significantly shorter than those in the control group(P<0.05).No statistically significant differences were found in the four subscales(self-concept,self-care responsibility,self-care skills,and health knowledge level)of the Exercise of Self-care Agency(ESCA)and the total score between the two groups before intervention(P>0.05).The four subscales and total scores of the ESCA scale in both groups were increased after intervention,and the observation group was higher than the control group,with statistically significant differences(P<0.05).No statistically significant differences were noted in the eight dimensions(role physical,physical functioning,social functioning,bodily pain,role emotional,emotional well-being,energy/vitality,and general health perceptions)of the 36-Item Short-Form Health Survey(SF-36)between the two groups before intervention(P>0.05).The eight subscales of the SF-36 scale in both groups were significantly increased after intervention,and the observation group was significantly higher than the control group(P<0.05).The incidence of postoperative complications in the observation group was 1.59%(1/63),which was lower than that in the control group of 12.90%(8/62),with a statistically significant difference(χ^(2)=6.664,P=0.010).Conclusion The intervention of the self-management-oriented 5A nursing model in patients undergoing hepatectomy for liver cancer can effectively promote postoperative recovery,enhance self-management ability,increase quality of life,and reduce the risk of complications,which is worth promoting in clinical practice.
作者
应杰萍
陈璐
朱素文
周勇
成迎春
王跃琴
Ying Jieping;Chen Lu;Zhu Suwen;Zhou Yong;Cheng Yingchun;Wang Yueqin(Gulou Clinical Medical College of Jiangsu University,Zhenjiang Jiangsu 212000,China;Nursing department Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210000,China;Department of General Surgery,Yancheng First Hospital Affiliated of Nanjing University Medical College,Yancheng Jiangsu 224000,China)
出处
《保健医学研究与实践》
2024年第5期143-148,共6页
Health Medicine Research and Practice
基金
江苏省卫生健康委员会面上项目(NO.M2020100)。
关键词
自我管理
5A护理模式
肝癌
肝切除术
术后康复
生活质量
自我管理能力
Self-management
5A nursing model
Liver cancer
Hepatectomy
Postoperative recovery
Quality of life
Selfmanagement ability
