急诊外科组织胶水患儿的心理干预效果研究：基于多理论整合模型的随机对照试验

A Study on the Psychological Intervention Effect for Pediatric Patients with Tissue Adhesive in Emergency Surgery: A Randomized Controlled Trial Based on an Integrated Multi-Theory Model

摘要: 目的：探讨基于多理论整合的心理干预模型对急诊外科接受组织胶水伤口闭合治疗的患儿治疗依从性的影响。方法：采用随机对照研究设计，选取2024年1月截至2025年12月某三甲医院急诊外科使用组织胶水进行伤口闭合的患儿480例，按随机数字表法分为干预组(n = 240)和对照组(n = 240)。对照组接受急诊外科常规护理及基本操作告知，干预组在常规护理基础上实施“3R模型 + 七阶段心理反应识别 + 家长安抚”框架的系统性心理干预。比较两组患儿的治疗依从性、医疗恐惧评分、操作配合度及家长满意度。结果：干预组治疗依从率为91.25% (219/240)，显著高于对照组的68.75% (165/240)，差异有统计学意义(χ² = 38.94, P < 0.001)。干预组医疗恐惧评分[(12.38 ± 3.56)分比(18.74 ± 4.21)分]、操作中哭闹发生率(19.58%比42.08%)及操作时间[(4.52 ± 1.38) min比(6.87 ± 2.05) min]均显著低于对照组(P < 0.05)，家长满意度[(94.26 ± 5.13)分比(81.47 ± 8.62)分]显著高于对照组(P < 0.05)。结论：基于多理论整合的心理干预方案能显著提高急诊外科组织胶水患儿治疗接受度，降低医疗恐惧，改善操作配合度，值得临床推广。

Abstract: Objective: This paper aims to evaluate the effect of a multi-theory integrated psychological intervention model on treatment compliance in pediatric patients undergoing tissue adhesive wound closure in the emergency department. Methods: A randomized controlled trial was conducted in 480 children who received tissue adhesive wound closure in the emergency department of a tertiary hospital from January 2024 to December 2025. The participants were randomly assigned to an intervention group (n = 240) receiving a systematic psychological intervention based on the “3R model (Regulate-Relate-Reason) + seven-stage psychological reaction identification + parental reassurance” framework in addition to routine care, or a control group (n = 240) receiving routine care only. Outcomes included treatment adherence, medical fear score,patient cooperation, and parental satisfaction. Results: The treatment compliance rate was significantly higher in the intervention group than in the control group [91.25% (219/240) vs. 68.75% (165/240), χ² = 38.94, P < 0.001]. The intervention group also showed significantly lower medical fear scores [(12.38 ± 3.56) vs. (18.74 ± 4.21)], lower incidence of crying during the procedure (19.58% vs. 42.08%), and shorter procedure time [(4.52 ± 1.38) min vs. (6.87 ± 2.05 min)], and higher parental satisfaction [(94.26 ± 5.13) vs. (81.47 ± 8.62)] compared with the control group (all P < 0.05). Conclusion: The multi-theory integrated psychological intervention significantly improves treatment acceptance, reduces medical fear, and enhances behavioral cooperation in children undergoing tissue adhesive wound closure in the emergency setting, supporting its clinical promotion.