摘要
目的探讨认知教育和行为干预在固态高分辨率食管测压(HRM)检查中的应用效果。方法将2016年4月至2017年6月在西安交通大学第一附属医院胃肠动力室行HRM检查的60例患者作为研究对象,按随机数字表法将其分成对照组30例和试验组30例,对照组采用常规方法进行检查前知情告知和检查中的配合指导,试验组采用常规告知指导方法的同时在检查前实施认知教育和行为干预,比较2组患者一次插管成功率、检查所用时间、患者对检查过程的满意度、插管过程出现的不适症状及患者对检查过程插管痛苦体验自我评定的情况。结果试验组检查所用时间为(28.50±8.75)min,对照组为(33.13±5.49)min,2组比较差异有统计学意义(t=2.584,P=0.015);试验组患者插管过程出现恶心、呕吐、呛咳的例次分别为11、0、1例,对照组分别为20、6、7例,2组比较差异有统计学意义(χ^2=5.406、4.630、5.192,均P<0.05);试验组患者对检查过程插管痛苦体验自我评价第2、3、4、5、7、8、10、11、12、13项得分分别为(1.00±0.64)、(1.37±0.85)、(2.80±0.96)、(1.50±0.51)、(0.87±0.63)、(0.77±0.50)、(0.60±0.56)、(1.07±0.25)、(0.57±0.57)、(1.50±0.63)分,对照组第2、3、4、5、7、8、10、11、12、13项得分分别为(1.50±0.51)、(2.03±0.76)、(3.50±0.82)、(2.03±0.76)、(1.20±0.61)、(1.03±0.41)、(0.83±0.53)、(1.23±0.43)、(0.87±0.57)、(2.00±1.05)分,2组比较差异有统计学意义(t=-4.130^-2.140,均P<0.05)。结论HRM是临床广泛应用于食管动力障碍性疾病及胃食管反流病监测前的一项重要检查,患者配合操作的程度直接影响高分辨率食管测压检查的效果和自我感受。医务人员在检查前予以患者认知教育和行为干预,可有效减轻患者插管所引起的不适症状及痛苦感,提高患者的配合依从性,缩短检查所用时间,提高工作效率,提高患者满意度,值得在临床检查中进一步推广应用。
Objective To explore the effect of cognitive education and behavioral intervention in solid-state high resolution esophageal manometry (HRM) examination. Methods From April 2016 to June 2017, 60 patients with solid-state HRM in the gastrointestinal motility room at the First Affiliated Hospital of Jiaotong University were as the research object. The 60 patients were divided into control group and experimental group with 30 cases each by the method of random numbers. The conventional methods was used in control group to conduct informed counseling before the examination and the coordination guidance in the examination. The conventional methods and cognitive behavioral intervention was used in experimental group at the same time. The successful rate of intubation, the time used for the examination, discomfort symptoms during intubation, the patient′s satisfaction in the whole check process and self-evaluation of intubation pain experience in two groups of patients were compared. Results The time used in the experimental group examination was (28.50±8.75) min, and the control group was (33.13±5.49) min. The difference between the two groups was statistically significant (t=2.584, P=0.015). In the experimental group, the number of nausea, vomiting, and coughing in the intubation process was 11, 0, and 1, respectively, and the control group was 20, 6, and 7, respectively. The difference was statistically significant (χ^2=5.406, 4.630, 5.192, all P<0.05). In the experimental group, the scores of the 2, 3, 4, 5, 7, 8, 10, 11, 12, and 13 items of the intubation pain experience self-evaluation in the examination process were (1.00±0.64), (1.37±0.85), (2.80±0.96), (1.50±0.51), (0.87±0.63), (0.77±0.50), (0.60±0.56), (1.07±0.25), (0.57±0.57), (1.50±0.63) points, and the 2, 3, 4, 5, 7, 8, 10, 11, 12 and 13 scores of the control group they were (1.50±0.51), (2.03±0.76), (3.50±0.82), (2.03±0.76), (1.20±0.61), (1.03±0.41), (0.83±0.53), (1.23±0.43), (0.87±0.57), (2.00±1.05) points, respectively. The difference was statistically significant (t=-4.130--2.140, all P<0.05). Conclusions HRM is an important test before the clinical application of a wide range of clinical applications for the detection of esophageal motility disorders and gastroesophageal reflux disease. The degree of patient cooperation with the operation directly affects the high-resolution esophageal manometry test results and self-experience. Medical staff can give patients cognitive education and behavioral intervention before examination, which can effectively reduce the symptoms and pain caused by intubation, improve patient compliance, shorten the time for examinations, improve work efficiency, and improve patient satisfaction. It is worth further promotion and application in clinical examination.
作者
闫小妮
殷燕
任晓阳
吕军
姚晚侠
Yan Xiaoni;Yin Yan;Ren Xiaoyang;Lyu Jun;Yao Wanxia(Deparment of Gastroenterology,the First Affilia'ted Hospital of Xi'an Jiaotong University,Xi'an 710061, China;Clinical Research Center of the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061, China;Xi'an Peihua College Nursing Department,Xi'an 710125,China)
出处
《中国实用护理杂志》
2019年第6期416-420,共5页
Chinese Journal of Practical Nursing
关键词
认知教育
行为干预
固态高分辨率食管测压
插管不适
满意度
Cognitive education
Behavioral intervention
High resolution esophageal pressure
Intubation discomfort
Satisfaction
