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冠状动脉搭桥手术患者的结构化术后指导以及患者的知识掌握情况与依从性

Structured postoperative teaching and knowledge and compliance of patients who had coronary artery bypass surgery.

作者信息

Marshall J, Penckofer S, Llewellyn J

出版信息

Heart Lung. 1986 Jan;15(1):76-82.

PMID:3484735
Abstract

A convenience sample of two comparable groups of patients who had coronary artery bypass surgery was studied to assess the effectiveness of a structured teaching guide used by nurses in educating the patient and his family about normal postoperative recovery. Preoperative health assessments were performed on 64 patients, and risk factors for heart disease were identified for each individual. One group was educated by an unstructured method; the other group received structured teaching with the use of a guide developed by nurses experienced in recovery after open heart surgery. Knowledge was assessed before instituting teaching and on discharge from the hospital. All patients were again assessed 6 weeks after discharge for postoperative health and compliance with their health risk factors identified earlier. An analysis of variance with repeated measures revealed that both groups had higher total knowledge scores after surgery. Most postoperative health behaviors (angina, smoking, hypertension, and diet) were comparable between groups. However, those patients who had structured postoperative teaching walked more blocks after surgery (mean = 15.61) than those patients who received routine teaching (mean = 7.00) (p less than 0.005), although these two groups were not equivalent before surgery. In addition, the patients who had structured teaching had higher total compliance scores (mean = 86.8) than those who had unstructured teaching (mean = 79.5) (p less than 0.05). Therefore although structured teaching may not have initially affected patient's knowledge, it may have had an impact on their compliance with postoperative health behaviors.

摘要

选取两组接受冠状动脉搭桥手术的可比患者作为便利样本,以评估护士使用结构化教学指南对患者及其家属进行术后正常康复教育的效果。对64例患者进行术前健康评估,并确定每个人的心脏病风险因素。一组采用非结构化方法进行教育;另一组使用由心脏直视手术后康复经验丰富的护士编写的指南进行结构化教学。在开始教学前和出院时评估知识水平。所有患者在出院后6周再次接受评估,以了解术后健康状况以及对之前确定的健康风险因素的依从性。重复测量方差分析显示,两组患者术后的总知识得分均较高。两组之间的大多数术后健康行为(心绞痛、吸烟、高血压和饮食)具有可比性。然而,接受结构化术后教学的患者术后步行的街区数(平均 = 15.61)比接受常规教学的患者(平均 = 7.00)多(p < 0.005),尽管这两组在手术前并不等同。此外,接受结构化教学的患者的总依从性得分(平均 = 86.8)高于接受非结构化教学的患者(平均 = 79.5)(p < 0.05)。因此,虽然结构化教学可能最初并未影响患者的知识水平,但它可能对患者术后健康行为的依从性产生了影响。

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