个体化知信行健康教育模式改善PTBD术后护理效果的研究

程亚丽，冯爱芳，侯美蓉，薛峰

（西安交通大学第一附属医院肝胆外科，陕西 西安，710061）

浏览次数：249次 下载次数：326次

摘要：

目的 分析个体化的知信行健康教育对于PTBD术后患者并发症的改善情况，探索科学有效的健康教育模式，为提高PTBD患者术后的护理水平提供理论依据。方法 研究对象为2011年1月至2014年8月就诊于我院肝胆外科行PTBD术患者，将研究对象随机分为干预组和对照组，干预组在进行常规健康教育的基础上给予个体化知信行健康教育，对照组进行常规健康教育，比较两组患者PTBD术后脱管和感染的发生情况。结果 干预组患者对疾病和PTBD 术相关知识的了解程度、心理状态、对待治疗态度及术后带管时间的接受程度，出院后对引流管的自我护理情况均显著优于对照组（P<0.05）；干预组患者脱管和术后感染的发生率均显著低于对照组（P<0.05）。结论 个性化知信行健康教育能够有效改善PTBD 术后护理效果，降低脱管和术后感染的发生率。

关键词：知信行模式；健康教育；经皮肝胆管穿刺引流术

中图分类号：R473.6文献标志码：A文章编号：2096-1413(2017)13-0002-03

Study on improving the nursing efficacy for patients with PTBD by individual knowledge attitude

belief practice health education model
CHENG Ya-li, FENG Ai-fang, HOU Mei-rong, XUE Feng
(Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi an Jiaotong University, Xi an 710061, China)

ABSTRACT: Objective To explore a scientific and effective health education model by applying individual knowledge attitude belief practice model (KAP) to patients with percutaneous transhepatic biliary frainage (PTBD), and provide scientific evidences for improving the nursing efficacy to patients with PTBD. Methods Between January 2011 and August 2014, a total of 108 patients with PTBD were sorted out and divided into intervention group and control group randomly. The patients in the intervention group received individual KAP health education on the basis of routine health education, while the patients in the control group received routine health education only. Results The patients in intervention group were significantly better than the control group in understanding of knowledge about the disease and PTBD, psychological states, the attitude toward treatment, acceptance of the time with drainage tube, and the self-care situation of drainage tube post-discharge (P<0.05). And the incidence rate of drainage tube dislodgement, postoperative infection in the intervention group were significantly lower than those in the control group (P<0.05). Conclusion Individual KAP health education could effectively improve the nursing efficacy for patients with PTBD, and reduce the incidence of drainage tube dislodgement and postoperative infection.
KEYWORDS: knowledge attitude belief practice model; health education; percutaneous transhepatic biliary drainage

参考文献：
[1] 戴社教,李红,王深皓,等.经皮经肝穿刺介入治疗恶性梗阻性黄疸261例并发症分析与处理[J].陕西医学杂志,2012,41(10):1333-1335.
[2] NENNSTIEL S,WEBER A,FRICK G,et al.Drainage-related compli原 cations in percutaneous transhepatic biliary drainage: an analysis over 10 years[J].J Clin Gastroenterol,2015,49(9):764-770.
[3] TAPPING CR,BYASS OR,CAST JE.Percutaneous transhepatic biliary drainage (PTBD) with or without stenting-complications, restent rate and a new risk stratification score[J].Eur Radiol,2011,21(9):1948-1955.
[4] 赵瑞峰,贾春怡,赵佳.PTCD 相关并发症探讨[J].临床消化病杂志,2013,25(6):324-326.
[5] 莫淑贞,欧阳欣,康友根.连续性个性化健康教育在经皮经肝穿刺胆道引流长期置管患者中的应用[J].当代护士,2013(8):58-60.
[6] 朱滨,袭燕,迟蔚蔚,等.山东省三级医院护理人力资源现状调查[J].卫生软科学,2014,28(3):141-143.
[7] 王一娟,王明诚,闫晓飞,等.某大型综合医院护理人力资源配置研究[J].中国医院管理,2013,33(4):45-47.