基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用

doi:10.3760/cma.j.issn.1007-1245.2022.02.030

国际医药卫生导报 ›› 2022, Vol. 28 ›› Issue (2): 266-269.DOI: 10.3760/cma.j.issn.1007-1245.2022.02.030

基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用

吴冬玲，刘婉明，蔡银燕，刘琳

广州医科大学附属第一医院肝胆外科，广州 510120

收稿日期:2021-06-15 出版日期:2022-01-15 发布日期:2022-03-09
通讯作者: 吴冬玲，Email：wdl05hb@163.com

Application of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation

Wu Dongling, Liu Wanming, Cai Yinyan, Liu Lin

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China

Received:2021-06-15 Online:2022-01-15 Published:2022-03-09
Contact: Wu Dongling, Email: wdl05hb@163.com

摘要/Abstract

摘要： 目的探讨基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带胆管出院患者中的干预效果。方法采用目的抽样法。选取 2019年 1月至 12月在广州医科大学附属第一医院行B超引导下经皮肝Ⅰ期胆道造瘘取石手术且带胆管出院患者86例，根据患者入院时间先后分为对照组和试验组，各 43例。对照组男 14例、女 29例，年龄（53.50±12.35）岁；试验组男 16例、女 27例，年龄（52.50±11.26）岁。对照组给予常规健康教育，试验组采用基于授权理论的健康教育路径干预。采用自我护理能力测定量表、胆管自我管理行为调查表、患者满意度问卷测评两组患者自我护理能力、胆管自我管理行为、满意度及出院1个月内留置胆管相关并发症发生情况。计量资料组间比较采用独立样本t检验，计数资料组间比较采用χ2 检验。结果干预后，试验组患者的自我护理能力总分为（124.74±4.09）分，明显高于对照组的（110.81±4.45）分，试验组患者的胆管自我管理水平、满意度评分分别为（5.28±0.91）、（95.80±2.37）分，高于对照组的（4.09±1.27）、（91.70±4.15）分，差异均有统计学意义（均P<0.05）。试验组患者出现胆管堵塞、非计划性拔管、胆道感染并发症的总发生率为9.3%（4/43），低于对照组的25.58%（11/43），差异有统计学意义（P<0.05）。结论在经皮肝Ⅰ期胆道造瘘取石术后带胆管出院患者中实施基于授权理论的健康教育路径，可降低胆管相关并发症的发生率，改善自我管理行为，提高就诊满意度。

关键词: 授权理论, 健康教育, 临床路径, 经皮肝穿刺术, 肝胆管结石, 居家护理, 管道护理

Abstract: Objective To explore the application effect of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation (PTOBF). Methods The purpose sampling method was adopted. A total of 86 patients discharged with biliary drainage tube after PTOBF in The First Affiliated Hospital of Guangzhou Medical University from January to December 2019 were selected and were divided into an experimental group and a control group according to the time of admission, with 43 cases in each group. In the control group, there were 14 males and 29 females, with an age of (53.50±12.35) years old; there were 16 males and 27 females in the experimental group, with an age of (52.50±11.26) years old. The control group received routine health education, and the experimental group received health education pathway based on empowerment theory. The self-care ability, biliary drainage tube self-management behavior, satisfaction, and indwelling biliary drainage tube related complications within 1 month in the two groups were evaluated by Self-Care Ability Measurement Scale, Biliary Drainage Tube Self-Management Behavior Questionnaire, and Patient Satisfaction Questionnaire. The independent sample t test was used for comparison of the measurement data between groups, and χ2 test was used for comparison of the count data between groups. Results After the intervention, the score of self-care ability in the experimental group was (124.74±4.09), which was significantly higher than (110.81±4.45) in the control group; the scores of biliary drainage tube self-management behavior and satisfaction of the experimental group were (5.28±0.91) and (95.80 ±2.37), which were higher than (4.09±1.27) and (91.70 ±4.15) in the control group, with statistically significant differences (all P<0.05). The total incidence of biliary drainage tube blockage, unplanned extubation, infection of biliary tract in the observation group was 9.3% (4/43), which was lower than 25.58% (11/43) in the control group, with a statistically significant difference (P<0.05). Conclusions Health education pathway based on empowerment theory can reduce the incidence of biliary drainage tube related complications in patients discharged with biliary drainage tube after PTOBF, improve the patients' self-management behavior, and improve their satisfaction.

Key words: Empowerment theory, Health education, Clinical pathway; Percutaneous transhepatic puncture, Hepatolithiasis, Home care, Catheter management

吴冬玲, 刘婉明, 蔡银燕, 刘琳. 基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用[J]. 国际医药卫生导报, 2022, 28(2): 266-269.

Wu Dongling, Liu Wanming, Cai Yinyan, Liu Lin. Application of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation[J]. International Medicine and Health Guidance News, 2022, 28(2): 266-269.

参考文献

[1] Mori T, Sugiyama M, Atomi Y. Gallstone disease: management of intrahepatic stones[J]. Best Pract Res Clin Gastroenterol, 2006, 20(6): 1117-1137. DOI: 10.1016/j. bpg.2006.05.010.

[2] 王平,刘成成,陶海粟,等 .经皮肝Ⅰ期胆道造瘘取石治疗有胆道手术史患者的肝内胆管结石[J]. 中华肝胆外科杂志, 2019,25(2):106-110. DOI:10.3760/cma.j.issn.1007-8118. 2019.02.007.

[3] 朱灿华,王平,孙北望,等 .超声引导经皮肝Ⅰ期胆道造瘘联合硬质胆道镜治疗复杂肝胆管结石[J].中华肝胆外科杂志, 2020,26(2):103-107. DOI:10.3760/cma.j.issn.1007-8118. 2020.02.005.

[4] Kearney BY, Fleischer BJ. Development of an instrument to measure exercise of self-care agency[J]. Res Nurs Health, 1979, 2(1): 25-34. DOI: 10.1002/nur.4770020105.

[5] 胡爱玲,张美芬,张俊娥,等 . 结肠造口患者适应状况及相关因素的研究[J]. 中华护理杂志,2010,45(2):109-111. DOI: 10.3761/j.issn.0254-1769.2010.02.004.

[6] 李淑霞,张振路. 哮喘患者自我护理能力与健康行为的相关性分析[J]. 中华护理杂志,2005,40(3):193-195.

[7] Nakayama F, Soloway RD, Nakama T, et al. Hepatolithiasis in East Asia. Retrospective study[J]. Dig Dis Sci, 1986, 31(1): 21-26. DOI: 10.1007/BF01347905.

[8] Shoda J, Tanaka N, Osuga T. Hepatolithiasis--epidemiology and pathogenesis update[J]. Front Biosci, 2003, 8: e398-e409. DOI: 10.2741/1091.

[9] 梁铜玲.解析胆道手术后带T型管患者的临床护理要点[J]. 中国妇幼健康研究,2016,27(S2):454-455.

[10] 陈妍妍 . 基于授权理论的健康教育在2型糖尿病患者中的应用研究[D]. 天津:天津医科大学,2014. DOI:10.7666/d. Y2698918.

[11] Gibson CH. A concept analysis of empowerment[J]. J Adv Nurs, 1991, 16(3): 354-361. DOI: 10.1111/j. 1365-2648. 1991.tb01660.x.

[12] 余林欢,欧庭用,林艳霞,等 . 胆道梗阻经皮经肝行胆管引流带管出院患者居家自我管理与生活体验的质性研究[J]. 国际医药卫生导报,2021,27(13):1955-1958. DOI:10.3760/ cma.j.issn.1007-1245.2021.13.012.

[13] 王娟,赵宝兰,曲桂玉 . 看图对话对糖尿病患者行健康教育的影响因素分析[J]. 齐鲁护理杂志,2018,24(1):61-63. DOI: 10.3969/j.issn.1006-7256.2018.01.023.

[14] 徐向静,李小峰.糖尿病"看图对话"交流工具的临床应用研究新进展[J].全科护理,2017,15(35):4383-4386.

[15] 柏晓玲,王天兰,石国凤,等 . 临床护理路径在脑梗死患者健康教育中应用效果的 Meta分析[J]. 中华医院管理杂志, 2016,32(2):158-160. DOI:10.3760/cma.j.issn.1000-6672. 2016.02.025.

[16] 马兴涛,张蜀豫,徐丽丽 . 跟踪电话随访对胰十二指肠切除术后带管出院患者自我护理能力的影响[J]. 上海护理, 2018,18(8):46-49. DOI:10.3969/j.issn.1009-8399. 2018. 08.011.

[17] 钟彩英,吴翠平,何向华,等 . 椎管内神经纤维瘤手术患者临床护理路径的构建与应用效果[J]. 安徽医药,2015, 23(3): 593-594,595. DOI:10.3969/j.issn.1009-6469.2015.03.062.

基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用

Application of health education pathway based on empowerment theory in patients discharged with biliary drainage tube after percutaneous transhepatic one-step biliary fistulation

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