结构–过程–结果理念下集束化护理在胆结石患者围术期中的应用效果分析

Cluster Nursing under the Structure-Process-Outcome Concept in the Perioperative Period of Patients with Gallstones Application Effect Analysis

摘要: 目的：研究结构–过程–结果理念下集束化护理干预在胆结石患者围术期中的应用效果。方法：纳入2021年2月至2022年3月临安区第一人民医院普外二科接受手术治疗的胆结石患者78例，按照随机数字表法将其分为试验组(39例)和对照组(39例)，对照组实施围术期常规的集束化护理干预措施，试验组则实施结构–过程–结果理念下集束化护理干预。分析比较两组患者围术期情绪状态(焦虑评分、抑郁评分)、术中生命体征(心率、呼吸频率)、术后恢复(术后肛门排气时间、术后下床活动时间、住院时间)、术后并发症(呕吐、感染、便秘、引流管压迫等)以及护理满意度等。结果：试验组患者焦虑自评量表(Self-rating Anxiety Scale, SAS)评分、抑郁自评量表(Self-rating Depression Scale, SDS)评分低于对照组，差异有统计学意义(P < 0.05)。试验组心率(Heart rate, HR)、呼吸频率(Respiratory rate, RR)水平均低于对照组差异有统计学意义(P < 0.05)。试验组患者的术后肛门排气时间、下床活动时间、住院时间均低于对照组，差异有统计学意义(P < 0.05)。试验组并发症发生率为7.69%，并发症发生率较对照组的低28.21%，差异有统计学意义(P < 0.05)。试验组的护理总满意率为97.44%，显著高于对照组的护理总满意率的79.49% (P < 0.05)。结论：结构–过程–结果理念下集束化护理干预可更好缓解胆结石患者围术期负性情绪，改善术中相关指标水平，降低术后并发症的发生率，缩短患者的康复时间，提高患者的满意度，值得临床进一步推广。

Abstract: Objective: To study the effect of cluster nursing intervention in patients with gallstones in the perioperative period under the structure-process-outcome concept. Methods: A total of 78 patients with gallstones who underwent surgical treatment in the Department of General Surgery II of The First People’s Hospital of Lin’an District from January 2020 to March 2021 were included. They were randomly divided into an experimental group (39 cases) and a control group (39 cases) using a random number table. The control group received perioperative routine cluster nursing intervention, and the experimental group received cluster nursing intervention under the structure-process-outcome concept. The perioperative emotional status (anxiety score, depression score), intraoperative vital signs (heart rate, respiratory rate), postoperative recovery (postoperative anal exhaust time, the starting time of out-of-bed activity, hospital stay), postoperative complications (vomiting, infection, constipation, drainage tube compression, etc.), and nursing satisfaction were compared and analyzed between the two groups. Results: The SAS score and SDS score of the experimental group were lower than those of the control group, and the difference was statistically significant (P < 0.05). The HR and RR levels in the experimental group were lower than those in the control group with statistically significant differences (P < 0.05). The postoperative anal exhaust time, the starting time of out-of-bed activity, and the hospital stay of the experimental group were all lower than those of the control group, and the differences were statistically significant (P < 0.05). The incidence of complications in the experimental group was 7.69%, which was 28.21% lower than that in the control group, with a statistically significant difference (P < 0.05). The total nursing satisfaction rate in the experimental group was 97.44%, significantly higher than the nursing satisfaction rate in the control group, which was 79.49% (P < 0.05). Conclusion: Under the structure-process-outcome concept, cluster nursing intervention can better alleviate the perioperative negative emotions of patients with gallstones, improve the level of intraoperative relevant indicators, reduce the incidence of postoperative complications, shorten the recovery time of patients, and improve the satisfaction of patients, which is worthy of further clinical promotion.