计划-执行-检查-行动循环护理管理在妇科手术中的效果：系统评价和荟萃分析。
The effect of Plan-Do-Check-Act cycle nursing management of gynecological surgery: a systematic review and meta-analysis.
机构信息
Obstetrics Department, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China.
出版信息
Ann Palliat Med. 2021 Jul;10(7):8072-8081. doi: 10.21037/apm-21-1590.
BACKGROUND
The Plan-Do-Check-Act cycle (PDCA) (also known as the Daiming cycle) is widely used in surgical management and can standardize nursing management and improve nursing quality. This meta-analysis evaluated the application of the PDCA cycle during nursing management following gynecological surgery.
METHODS
PubMed, Web of Science, Embase, CNKI, Wanfang, and other databases were searched for studies on applying the PDCA cycle in nursing management following gynecological and obstetric surgery. Articles published between 2013 to 2020 in English and Chinese were included. The obtained data are subjected to meta-analysis using Stata16.0 analysis software. Reported outcomes included: satisfaction with care, nursing quality evaluation, and assessments using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS).
RESULTS
A total of 14 articles were included, with a total of 1,629 participants. Meta-analysis showed that satisfaction with gynecological surgery nursing using PDCA cycle management in the intervention groups was higher than in the control groups, OR =6.57 (95% CI, 4.01, 10.76), P<0.001. The perception of nursing quality was higher in the intervention groups than in the control groups, SMD =4.98 (95% CI, 3.32, 6.64, P<0.001. SAS scores of the intervention groups were lower than that of the control groups, SMD =-2.22 (95% CI, -2.80, -1.65), P<0.001. SDS scores of the intervention groups were lower than that of the control groups, SMD =-2.37 (95% CI, -3.15, -1.60), P<0.001.
DISCUSSION
The application of PDCA cycle nursing management for gynecological surgery can significantly improve patients' satisfaction with nursing, including the quality of nursing. At the same time, it can effectively reduce the anxiety and depression of surgical patients, which benefits the surgery process. Given these benefits, it has a high likelihood of being incorporated into clinical practice.
背景
计划-执行-检查-处理（PDCA）循环（也称为戴明循环）在外科管理中得到广泛应用，可以规范护理管理，提高护理质量。本荟萃分析评估了 PDCA 循环在妇科手术后护理管理中的应用。
方法
检索 PubMed、Web of Science、Embase、CNKI、万方等数据库，纳入 2013 年至 2020 年发表的英文和中文关于 PDCA 循环在妇科和产科手术后护理管理中应用的研究。使用 Stata16.0 分析软件对获得的数据进行荟萃分析。报告的结果包括：护理满意度、护理质量评估以及使用焦虑自评量表（SAS）和抑郁自评量表（SDS）进行的评估。
结果
共纳入 14 篇文章，共 1629 名参与者。荟萃分析显示，采用 PDCA 循环管理的妇科手术护理干预组的护理满意度高于对照组，OR=6.57（95%CI，4.01，10.76），P<0.001。干预组对护理质量的感知高于对照组，SMD=4.98（95%CI，3.32，6.64），P<0.001。干预组的 SAS 评分低于对照组，SMD=-2.22（95%CI，-2.80，-1.65），P<0.001。干预组的 SDS 评分低于对照组，SMD=-2.37（95%CI，-3.15，-1.60），P<0.001。
讨论
PDCA 循环护理管理在妇科手术中的应用，能显著提高患者对护理的满意度，包括护理质量。同时，它可以有效降低手术患者的焦虑和抑郁程度，有利于手术过程。鉴于这些益处，它很有可能被纳入临床实践。
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