Ma Li, Yu Ying, Zhao Bin-Juan, Yu Yan-Nan, Li Yu
Department of Nursing, Xi'an International Medical Center Hospital, Xi'an 710100, Shaanxi Province, China.
Department of Hepatobiliary, Pancreatic and Spleen Surgery, Xi'an International Medical Center Hospital, Xi'an 710100, Shaanxi Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2232-2241. doi: 10.4240/wjgs.v16.i7.2232.
The incidence of cholecystolithiasis is on the rise. Use of information, motivation, and behavioral skills can play a positive role in promoting changes in individual health behaviors. However, reports on the effects of information-motivation-behavioral (IMB) skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent.
To explore the application of IMB skills model based high-quality nursing in patients with gallstones.
Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control, high-quality, and combined nursing groups, with 72 patients in each group. The control, high-quality, and combination groups received conventional, high-quality, and IMB skills model based perioperative nursing services, respectively. Differences in clinical indicators, stress levels, degree of pain, emotional state, and quality of life were observed, and complications and nursing satisfaction among the three groups were evaluated.
After nursing, the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group, with the recovery of gastrointestinal function being the fastest in the combined nursing group ( < 0.05). After nursing intervention, cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery, with the combined nursing group having the closest to normal levels ( < 0.05). After 3 and 7 d of intervention, the patients' pain significantly improved, which was more prominent in the high-quality and combination groups. Meanwhile, the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups ( < 0.05). After nursing intervention, the emotional states of all patients improved, and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups. The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group, with the combined nursing group having the highest quality of life score. After intervention, the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group ( < 0.05), but the difference between the combination and high-quality nursing groups was not significant. Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group, with the nursing satisfaction being the highest in the combination group ( < 0.05).
IMB skills model based nursing can improve surgical stress levels, degrees of pain, emotional state, quality of life, and nursing satisfaction of patients with gallstones and reduce the incidence of complications.
胆囊结石的发病率呈上升趋势。信息、动机和行为技能的运用在促进个体健康行为改变方面可发挥积极作用。然而，关于基于信息 - 动机 - 行为（IMB）技能模型的优质护理作为胆结石患者围手术期护理干预效果的报道尚不存在。
探讨基于IMB技能模型的优质护理在胆结石患者中的应用。
选取2022年1月至2023年1月在我院接受治疗的216例胆囊结石患者，分为对照组、优质护理组和综合护理组，每组72例。对照组、优质护理组和综合护理组分别接受常规、优质和基于IMB技能模型的围手术期护理服务。观察临床指标、应激水平、疼痛程度、情绪状态和生活质量的差异，并评估三组的并发症情况及护理满意度。
护理后，优质护理组和综合护理组胃肠道功能恢复时间显著短于对照组，综合护理组胃肠道功能恢复最快（P<0.05）。护理干预后，优质护理组和综合护理组术后24小时皮质醇和去甲肾上腺素水平比对照组更接近正常，综合护理组水平最接近正常（P<0.05）。干预3天和7天后，患者疼痛明显改善，优质护理组和综合护理组更显著。同时，综合护理组疼痛评分显著低于对照组和优质护理组（P<0.05）。护理干预后，所有患者情绪状态均改善，综合护理组患者评分显著低于对照组和优质护理组。优质护理组和综合护理组患者护理干预后的生活质量较对照组显著提高，综合护理组生活质量评分最高。干预后，优质护理组和综合护理组并发症发生率显著低于对照组（P<0.05），但综合护理组与优质护理组之间差异不显著。优质护理组和综合护理组患者护理满意度显著高于对照组，综合护理组护理满意度最高（P<0.05）。
基于IMB技能模型的护理可改善胆结石患者的手术应激水平、疼痛程度、情绪状态、生活质量和护理满意度，并降低并发症发生率。
