Abstract:

Objective　To analyze the effect of evidence-based theory of operation room responsibility nursing for patients taking thyroid surgery. Methods　One hundred and seven patients undergoing thyroid surgery in Zhumadian Central Hospital from June 2021 to September 2022 were selected for the randomized controlled trial, and were divided into an observation group (54 cases) and a reference group (53 cases) by the random number table method. There were 32 males and 21 females in the reference group; they were 26-63 years old. There were 33 males and 21 females in the observation group; they were 25-62 years old. The reference group took traditional nursing intervention; in addition, the observation group took evidence-based nursing intervention under the operation room responsibility system. The satisfaction with nursing services, pain levels, vital signs, incidences of complications, and psychological statuses [Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)], quality of life (WHOQOL BREF), and comfort (GCQ) before and after the intervention were compared between the two groups. χ² and t tests were applied. Results　After the intervention, the satisfaction rate of nursing services in the observation group was higher than that in the reference group [98.15% (53/54) vs. 81.13% (43/53)], with a statistical difference (χ²=8.397, P<0.05). After the intervention, the total incidence of complications in the observation group was lower than that in the reference group [1.85% (1/54) vs. 15.09% (8/53)] with a statistical difference (χ²=4.491, P<0.05). After the intervention, the diastolic blood pressure, systolic blood pressure, and heart rate in the observation group were lower than those in the reference group [(72.71±4.54) mmHg (1 mmHg=0.133 kPa) vs. (79.58±5.31) mmHg, (121.86±5.61) mmHg vs. (132.81±7.07) mmHg, and (79.14±3.73) beats/min vs. (91.21±4.37) beats/min], with statistical differences (t=7.198, 8.883, and 15.377; all P<0.05). After the intervention, the scores of HAMA, HAMD, and VAS in the observation group were lower than those in the reference group, while the scores of WHOQOL-BREF and GCQ in the observation group were higher than those in the reference group [(32.18±1.78) vs. (39.68±2.27), (42.33±2.89) vs. (48.18±3.41), (4.58±0.28) vs. (6.13±0.17), (99.79±6.67) vs. (90.51±7.93), and (96.65±9.25) vs. (88.95±9.74)], with statistical differences (t=19.038, 9.580, 34.533, 6.556, and 4.194, all P<0.05). Conclusion　The application of evidence-based theory in operation room responsibility nursing for patients undergoing thyroid surgery during the perioperative period can reduce their pain, improve their comfort, nursing service satisfaction, psychological status, and quality of life, and stabilize their vital signs.

Key words:

Thyroid surgery, Evidence-based theory, Responsibility nursing in operation room, Perioperative period, Complications

摘要：

目的　分析循证理论的手术室责任制护理在甲状腺手术患者中的应用效果。方法　选取驻马店市中心医院2021年6月至2022年9月收治的107例甲状腺手术患者进行随机对照试验。采用随机数字表法将其分为观察组（54例）、参照组（53例）。参照组男32例，女21例，年龄26～63岁；观察组男33例，女21例，年龄25～62岁。参照组采用传统护理干预，观察组在参照组基础上采用循证理论下的手术室责任制护理干预。比较两组护理服务满意度、疼痛程度、生命体征、并发症发生情况及干预前后心理状况［汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）］、生存质量［生存质量测定量表简表（WHOQOL-BREF）］、舒适度［舒适状况量表（GCQ）］。采用χ²检验和t检验。结果　干预后，观察组护理服务满意率高于参照组［98.15%（53/54）比81.13%（43/53）］，差异有统计学意义（χ²=8.397，P<0.05）。干预后，观察组并发症总发生率低于参照组［1.85%（1/54）比15.09%（8/53）］，差异有统计学意义（χ²=4.491，P<0.05）。干预后，观察组舒张压、收缩压、心率均低于参照组［（72.71±4.54）mmHg（1 mmHg=0.133 kPa）比（79.58±5.31）mmHg、（121.86±5.61）mmHg比（132.81±7.07）mmHg、（79.14±3.73）次/min比（91.21±4.37）次/min］，差异均有统计学意义（t=7.198、8.883、15.377，均P<0.05）。干预后，观察组HAMA、HAMD、VAS评分均低于参照组，WHOQOL-BREF、GCQ评分均高于参照组［（32.18±1.78）分比（39.68±2.27）分、（42.33±2.89）分比（48.18±3.41）分、（4.58±0.28）分比（6.13±0.17）分、（99.79±6.67）分比（90.51±7.93）分、（96.65±9.25）分比（88.95±9.74）分］，差异均有统计学意义（t=19.038、9.580、34.533、6.556、4.194，均P<0.05）。结论　应用循证理论下的手术室责任制护理于甲状腺手术患者围手术期，可减轻患者疼痛程度，提升患者舒适度、护理服务满意度，改善患者心理状况，平稳其生命体征，提高其生存质量。

关键词:

甲状腺手术, 循证理论, 手术室责任制护理, 围手术期, 并发症