赋权激励干预模式在口腔颌面日间手术患者中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2024.09.035

摘要/Abstract

摘要：

目的　旨在分析赋权激励干预模式在口腔颌面日间手术患者中的应用效果。方法　选取延安大学附属医院于2021年1月至2023年10月日间病房收治的口腔颌面日间手术患者128例进行随机对照实验，采用随机数字表法分为对照组和观察组，各64例。对照组中，男32例，女32例，年龄（42.44±8.04）岁，复杂牙拔除15例、口腔颌面部血管瘤切除16例、口腔黏液性囊肿切除16例、舌系带切开17例；观察组中，男33例，女31例，年龄（43.16±7.97）岁，复杂牙拔除16例、腔颌面部血管瘤切除15例、黏液性囊肿切除18例、舌系带切开15例。对照组接受常规护理干预；观察组在常规护理干预的基础上接受赋权激励干预模式。比较两组患者围手术期的收缩压（SBP）、舒张压（DBP），干预后3个月焦虑及恐惧程度［改良的Corah's牙科焦虑量表（MDAS）、Stouthard牙科恐惧量表（DFI）］，手术配合度，护理服务质量［采用服务质量量表（SERVQUAL）］，出院准备度［出院准备度量表（RHDS）］。数据采用SPSS 26.0软件分析，组间比较用t检验、χ²检验。结果　观察组术前、术中10 min、术后10 min的SBP分别为（114.55±7.31）mmHg（1 mmHg =0.133 kPa）、（129.28±9.31）mmHg、（122.57±8.34）mmHg，DBP分别为（76.93±5.12）mmHg、（92.03±6.27）mmHg、（82.94±6.10）mmHg；对照组SBP分别为（116.41±6.58）mmHg、（136.93±8.98）mmHg、（128.72±7.63）mmHg，DBP分别为（78.08±4.71）mmHg、（96.36±5.85）mmHg、（86.38±5.48）mmHg；SBP：F_时间=161.218、F_组间=36.518、F_交叉=4.649，P_时间<0.001、P_组间<0.001、P_交叉=0.010；DBP：F_时间=300.236、F_组间=24.392、F_交叉=2.878，P_时间<0.001、P_组间<0.001、P_交叉=0.058。干预后3个月，两组MDAS、DFI评分均低于干预前，且观察组低于对照组［（6.19±1.19）分比（9.59±1.71）分、（62.49±6.19）分比（75.09±7.89）分］（均P<0.001）；观察组患者手术配合度为89.06%（57/64），高于对照组［68.75%（44/64）］（P=0.005）；观察组护理服务质量中移情性、反应性、可靠性、保证性、有形性、出院准备总分均高于对照组［（4.14±0.34）分比（3.78±0.40）分、（4.41±0.19）分比（4.01±0.30）分、（4.21±0.29）分比（3.73±0.37）分、（4.18±0.34）分比（3.57±0.38）分、（4.10±0.36）分比（3.67±0.39）分、（105.94±7.82）分比（100.08±8.55）分］，差异均有统计学意义（均P<0.001）。结论　赋权激励干预模式能有效提高口腔颌面日间手术患者的围手术期管理效果，减少患者焦虑和恐惧，具有临床应用价值。

关键词:

口腔颌面日间手术, 赋权激励干预模式, 围手术期管理, 护理服务质量, 出院准备度

Abstract:

Objective　To analyze the effect of the empowerment incentive intervention mode for patients undergoing oral and maxillofacial day surgery. Methods　A total of 128 patients who were admitted to the day ward for oral and maxillofacial day surgery at Hospital Affiliated to Yan'an University from January 2021 to October 2023 were selected for the randomized controlled trial. The patients were divided into a control group and an observation group by the random number table method, with 64 cases in each group. There were 32 males and 32 females in the control group; they were (42.44±8.04) years old; 15 cases underwent complex tooth extraction, 16 cases oral and maxillofacial hemangioma excision, 16 cases mucous cyst excision, and 17 cases frenulotomy. There were 33 males and 31 females in the observation group; they were (43.16±7.97) years old; 16 cases underwent complex tooth extractions, 15 cases hemangioma excisions, 18 cases mucous cyst excisions, and 15 cases frenulotomy. The control group took routine nursing intervention; in addition, the observation group took empowerment incentive intervention. The perioperative systolic blood pressures (SBP) and diastolic blood pressures (DBP), levels of anxiety and fear [the Modified Corah's Dental Anxiety Scale (MDAS) and the Stouthard Dental Fear Scale (DFI)] 3 months after the intervention, cooperation during surgery, quality of nursing service [the Service Quality Scale (SERVQUAL)], and readiness for discharge [the Readiness for Hospital Discharge Scale (RHDS)] were compared between the two groups. The data were analyzed by the SPSS 26.0 software. t and χ² tests were applied. Results　The SBP's and DBP's before the surgery, minute 10 in the surgery, and after the surgery in the observation group were (114.55±7.31) mmHg (1 mmHg=0.133 kPa), (129.28±9.31) mmHg, and (122.57±8.34) mmHg and (76.93±5.12) mmHg, (92.03±6.27) mmHg, and (82.94±6.10) mmHg; those in the control group were (116.41±6.58) mmHg, (136.93±8.98) mmHg, and (128.72±7.63) mmHg and (78.08±4.71) mmHg, (96.36±5.85) mmHg, and (86.38±5.48) mmHg; the SBP's of both groups: F_time=161.218, F_{between groups}=36.518, F_interaction=4.649; P_time<0.001, P_{between groups}<0.001, P_interaction=0.010; the DBP's of both groups: F_time=300.236, F_{between groups}=24.392, F_interaction=2.878; P_time<0.001, P_{between groups}<0.001, P_interaction=0.058. After the intervention, the scores of MDAS and DFI were lower than those before the intervention in both groups, and the scores in the observation group were lower than those in the control group [(6.19±1.19) vs. (9.59±1.71) and (62.49±6.19) vs. (75.09±7.89)] (all P<0.001). The surgical cooperation rate in the observation group was higher than that in the control group [89.06% (57/64) vs. 68.75% (44/64); P<0.001]. The scores of empathy transfer, responsiveness, reliability, assurance, tangibility, and total readiness for discharge of nursing service quality in the observation group were higher than those in the control group were all significantly higher than those in the control group [(4.14±0.34) vs. (3.78±0.40), (4.41±0.19) vs. (4.01±0.30), (4.21±0.29) vs. (3.73±0.37), (4.18±0.34) vs. (3.57±0.38), (4.10±0.36) vs. (3.67±0.39), and (105.94±7.82) vs. (100.08±8.55)], with statistical differences (all P<0.001). Conclusion　The empowerment incentive intervention mode for patients undergoing daytime oral and maxillofacial surgery can effectively improve the perioperative management effect and reduce their anxiety and fear, and has clinical application value.

Key words:

Oral and maxillofacial day surgery, Empowerment incentive intervention mode, Perioperative management, Quality of nursing service, , Readiness for hospital discharge

任塞红安晓燕艾苗苗封帆.

赋权激励干预模式在口腔颌面日间手术患者中的应用效果 [J]. 国际医药卫生导报, 2024, 30(9): 1564-1569.

Ren Saihong, An Xiaoyan, Ai Miaomiao, Feng Fan.

Effect of empowerment motivation intervention mode for patients undergoing daytime oral and maxillofacial surgery [J]. International Medicine and Health Guidance News, 2024, 30(9): 1564-1569.

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