-
胃癌是一种常见的消化系统恶性肿瘤,90%以上病人确诊后已处于胃癌进展期,需要采取手术切除治疗[1]。近年来, 腹腔镜技术广泛应用于胃癌根治术中, 该技术具有微创、疗效高及安全性高等特点[2], 在治疗的同时,需配合有效护理干预,确保临床效果。有效的术前访视是围术期护理必不可少的内容,成功的术前访视对减轻病人心理应激反应、减少并发症、提高病人依从性等发挥重要作用,进一步为手术及麻醉安全提供重要保障[3]。家庭参与式护理(family integrated care,FIC)模式是由国外学者O′BRIEN等[4]提出的概念,是一种护理新模式。本研究拟将家庭参与式术前访视模式应用于腹腔镜胃癌根治术中,评价这种访视模式的临床应用价值。现作报道。
-
观察组病人术前自身准备完善率为92.50%(37/40),高于对照组75.00%(30/40)(χ2=4.50,P < 0.05)。
-
组间比较,访视前2组病人手术信息认知度差异无统计学意义(P>0.05),访视后2组病人手术信息认知程度差异有统计学意义(P < 0.01);组内比较,2组病人访视前和访视后手术信息认知程度差异均有统计学意义(P < 0.01)(见表 1)。
分组 n 访视前 访视后 t P 对照组 40 4.68±1.12 7.55±1.06 11.22 < 0.01 观察组 40 4.70±1.02 8.38±0.93 17.02 < 0.01 t — 0.10 3.71 — — P — >0.05 < 0.01 — — 表 1 2组病人访视前后手术信息认知程度比较(x±s; 分)
-
2组病人及家属术前访视前SAS评分差异均无统计学意义(P>0.05),访视后2组病人及家属SAS评分均有明显下降(P < 0.05~P < 0.01)(见表 2、3)。
分组 n 访视前 访视后 t P 对照组 40 52.43±6.8 49.35±5.62 3.12 < 0.01 观察组 40 53.4±4.38 45.33±6.01 6.99 < 0.01 t — 0.76 3.07 — — P — >0.05 < 0.01 — — 表 2 2组病人术前访视前后SAS评分比较(x±s; 分)
分组 n 访视前 访视后 t P 对照组 40 51.6±7.14 48.93±4.27 2.25 < 0.05 观察组 40 51.23±4.88 45.23±6.08 4.16 < 0.01 t — 0.27 3.15 — — P — >0.05 < 0.01 — — 表 3 2组病人家属访视前后SAS评分比较(x±s; 分)
-
观察组病人满意度为95.00%(38/40), 高于对照组的80.00%(32/40)(χ2=4.11, P < 0.05)。
家庭参与的腹腔镜术前访视模式对腹腔镜胃癌根治术病人满意度的影响
Influence of a family-involved preoperative laparoscopic visit model on patient satisfaction in laparoscopic radical gastric cancer surgery
-
摘要:
目的 评价家庭参与的腹腔镜术前访视模式对腹腔镜胃癌根治术病人满意度的影响。 方法择期普外科行腹腔镜胃癌根治术的病人80例作为研究对象,采用随机数字表法将其分为观察组和对照组,每组各40例。对照组采用常规术前访视,观察组采取家庭参与式术前访视模式。比较2组病人术前准备完善程度,2组病人手术前后手术信息的认知程度、病人进入手术室后病人及家属焦虑的程度及病人满意度。 结果观察组病人术前自身准备完善率为92.50%(37/40),高于对照组75.00%(30/40)(χ2=4.50,P < 0.05)。组间比较, 访视前2组病人手术信息认知度差异无统计学意义(P>0.05),访视后2组病人手术信息认知程度差异有统计学意义(P < 0.01);组内比较,2组病人访视前和访视后手术信息认知程度差异均有统计学意义(P < 0.01)。组内比较观察组病人满意度95.00%(38/40), 高于对照组的80.00%(32/40)(χ2=4.11, P < 0.05)。 结论基于家庭参与的腹腔镜术前访视能有效的提高腹腔镜手术病人术前准备的完善程度,同时可减轻病人及家属焦虑程度,提高病人的满意度。 Abstract:ObjectiveTo evaluate the effect of a family-involved preoperative laparoscopic visit model on patient satisfaction with laparoscopic radical gastric cancer surgery. MethodsEighty patients with gastric cancer who underwent laparoscopic radical surgery were selected and divided into experimental group and control group using the random number table method, with 40 cases in each group.The control group was given a routine preoperative visit, and the observation group was given a family-involved preoperative visit.The degree of preoperative preparation of the patients in the two groups, the cognition of the surgical information before and after the operation, the anxiety degree of the patients and their families after the patients entered the operating room, and patient satisfaction were compared between two groups. ResultsThe preoperative self-preparation rate of patients in the observation group was 92.50%(37/40), which was higher than that in the control group(75.00%, 30/40)(χ2=4.50, P < 0.05).Before the visit, there was no significant difference in the cognition of surgical information between the two groups(P>0.05), while there was significant difference in the cognition of surgical information between the two groups after the visit(P < 0.01).The patient satisfaction in the observation group was 95.00%(38/40), which was higher than that in the control group(80.00%, 32/40)(χ2=4.11, P < 0.05). ConclusionsPreoperative laparoscopic visits based on family participation can effectively improve the perfection of the preoperative preparation of patients undergoing laparoscopic surgery, reduce the anxiety of patients and their families, and improve patient satisfaction. -
Key words:
- laparoscopy /
- preoperative visit /
- family /
- satisfaction
-
表 1 2组病人访视前后手术信息认知程度比较(x±s; 分)
分组 n 访视前 访视后 t P 对照组 40 4.68±1.12 7.55±1.06 11.22 < 0.01 观察组 40 4.70±1.02 8.38±0.93 17.02 < 0.01 t — 0.10 3.71 — — P — >0.05 < 0.01 — — 表 2 2组病人术前访视前后SAS评分比较(x±s; 分)
分组 n 访视前 访视后 t P 对照组 40 52.43±6.8 49.35±5.62 3.12 < 0.01 观察组 40 53.4±4.38 45.33±6.01 6.99 < 0.01 t — 0.76 3.07 — — P — >0.05 < 0.01 — — 表 3 2组病人家属访视前后SAS评分比较(x±s; 分)
分组 n 访视前 访视后 t P 对照组 40 51.6±7.14 48.93±4.27 2.25 < 0.05 观察组 40 51.23±4.88 45.23±6.08 4.16 < 0.01 t — 0.27 3.15 — — P — >0.05 < 0.01 — — -
[1] 刘传筹. 腹腔镜胃癌根治术与开腹手术治疗进展期胃癌的效果[J]. 数理医药学杂志, 2020, 33(2): 188. [2] 何小霞, 李宝钏. 腹腔镜与开腹根治术对进展期胃癌患者机体炎症反应、免疫功能及疼痛因子的影响[J]. 中国现代医学杂志, 2021, 31(6): 23. [3] 殷逸雯. 术前访视在手术室工作中的应用效果及现状分析[J]. 饮食保健, 2019, 6(8): 201. [4] O'BRIEN K, BRACHT M, MACDONELL K, et al. A pilot cohort analytic study of family integrated care in a canadian neonatal intensive care unit[J]. BMV Pregnancy Child birth, 2013, 13(Suppl1): S12. [5] 秦淑玉, 唐佳, 李冬雪. 多元化术前访视模式在手术室择期手术患者中的应用研究[J]. 重庆医学, 2017, 46(14): 3. [6] 周丽丽, 刘红丽. 家属参与式术前访视在老年患者手术治疗中的应用效果[J]. 临床医学研究与实践, 2021, 6(26): 3. [7] 廖敏, 柯雅娟, 汤婷, 等. 微信公众平台服务在术前访视中的应用效果评价[J]. 护理学杂志, 2016, 31(2): 58. [8] 吴玮杰, 张春, 陈涵, 等. ERAS背景下术前访视的新走向[J]. 系统医学, 2018, 3(23): 3. [9] 陈柏坤, 黄静. 手术室护士进行术前访视的作用探讨[J]. 中医药管理杂志, 2018, 26(4): 2. [10] LIU Z, WANG Y, WANG Y, et al. Dexmedetomidine attenuates inflammatory reaction in the lung tissues of septic mice by activating cholinergic anti-inflammatory pathway[J]. Int Immunopharmac, 2016, 35: 210. doi: 10.1016/j.intimp.2016.04.003 [11] 张秀华, 余巍, 孙莹, 等. 家属参与术前宣教模式对患者术前血压的影响[J]. 微量元素与健康研究, 2018, 35(3): 2.