Application of nursing intervention based on information-motivation-behavioral skill model in CT-guided localization of patients with isolated pulmonary nodules
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摘要:目的
观察基于信息-动机-行为技巧(IMB)模型的护理干预在肺孤立性小结节(SPN)患者CT引导下定位中的应用效果。
方法选取拟行CT引导下SPN定位术的患者60例，随机分为观察组和对照组，每组30例。观察组给予基于IMB模型的护理干预，对照组给予常规护理模式。比较2组疾病认知程度、心理状态、依从性、并发症发生率及护理满意度。
结果干预后, 2组患者疾病认知评分高于干预前，且观察组高于对照组，差异有统计学意义(P < 0.05); 观察组疾病认知达标率为96.67%, 高于对照组的76.67%, 差异有统计学意义(P < 0.05)。干预后2组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于干预前，且观察组低于对照组，差异有统计学意义(P < 0.05)。干预后2组的依从性高于干预前，且观察组高于对照组，差异有统计学意义(P < 0.05)。观察组并发症总发生率低于对照组，护理满意度高于对照组，差异有统计学意义(P < 0.05)。
结论基于IMB模型的护理干预可提高CT引导下定位SPN患者的认知水平、依从性、护理满意度，缓解患者焦虑、抑郁等状态，且术后并发症发生率较低。
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关键词:
- 肺孤立性小结节 /
- 肺穿刺 /
- 信息-动机-行为技巧模型 /
- 护理
Abstract:ObjectiveTo observe the effect of nursing intervention based on information-motivation-behavioral skill (IMB) model in CT-guided localization of patients with isolated pulmonary nodules (SPN).
MethodsA total of 60 patients who planned to undergo CT-guided SPN localization were randomly divided into observation group and controlgroup, with 30 cases in each group. The observation group was given nursing intervention based on IMB model, and the control group was given conventional nursing mode. The cognitive degree of disease, psychological state, compliance, complication rate and nursing satisfaction of the two groups were compared.
ResultsAfter intervention, the cognitive scores of disease in the two groups were significantly higher than before intervention, and the observation group was significantly higher than the control group (P < 0.05); the compliance rate of disease cognition in the observation group was 96.67%, which was significantly higher than 76.67% in the control group (P < 0.05). After intervention, the scores of self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS) in the two groups were significantly lower than before intervention, and the observation group was significantly lower than the control group (P < 0.05). The compliance of the two groups was significantly higher than before intervention, and the observation group was significantly higher than the control group (P < 0.05). After intervention, the total complication rate of the observation group was significantly lower than that of the control group, and nursing satisfaction was significantly higher than that of the control group (P < 0.05).
ConclusionNursing intervention based on IMB model can improve the cognitive level, compliance and nursing satisfaction of patients with SPN positioning under CT guidance, relieve anxiety, depression and other states of patients, and has a low incidence of postoperative complications.
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表 1 2组患者一般资料比较(x±s)
组别 n 性别 年龄/岁 文化程度 结节位置 结节直径/cm 男 女 初中及以下 高中及中专 大专及以上 肺上叶 肺中或下叶 观察组 30 18 12 58.96±6.44 13 11 6 17 13 1.59±0.33 对照组 30 20 10 57.49±6.12 12 10 8 19 11 1.62±0.35 
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表 2 2组干预前后疾病认知评分比较(x±s)[n(%)]
组别 n 认知评分/分 认知达标 干预前 干预后 观察组 30 44.13±3.97 89.19±6.21*# 29(96.67)# 对照组 30 45.07±4.12 80.01±5.54* 23(76.67) 与干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 3 2组干预前后SAS和SDS评分比较(x±s)
分 组别 n 焦虑自评量表评分 抑郁自评量表评分 干预前 干预后 干预前 干预后 观察组 30 55.03±3.99 41.65±1.87*# 52.13±3.42 39.14±2.05*# 对照组 30 54.27±3.63 45.26±3.14* 51.78±3.26 43.32±2.98* 与干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 4 2组干预前后依从性比较[n(%)]
组别 n 干预前 干预后 优 良 差 优良 优 良 差 优良 观察组 30 4(13.33) 17(56.67) 9(30.00) 21(70.00) 15(50.00) 15(50.00) 0 30(100.00)*# 对照组 30 5(16.67) 18(60.00) 7(23.33) 23(76.67) 9(30.00) 17(56.67) 4(13.33) 26(86.67)* 与干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 5 2组并发症发生情况比较[n(%)]
组别 n 胸痛 咯血 气胸 胸膜反应 合计 观察组 30 2(6.67) 1(3.33) 1(3.33) 1(3.33) 5(16.67)* 对照组 30 3(10.00) 2(6.67) 2(6.67) 2(6.67) 9(30.00) 与对照组比较, *P<0.05。
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表 6 2组护理满意度比较[n(%)]
组别 n 非常满意 满意 一般 不满意 非常不满意 总满意 观察组 30 10(33.33) 18(60.00) 1(3.33) 1(3.33) 0 28(93.33)* 对照组 30 7(23.33) 15(50.00) 5(16.67) 2(6.67) 1(3.33) 22(73.33) 与对照组比较, *P < 0.05。
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