摘要
目的探讨基于问题学习(problem-based learning,PBL)结合微视频健康教育方案在经皮肝穿刺胆道引流(PTCD)带管患者中的应用价值。方法采用前瞻性对照研究,将南通市第一人民医院介入科2018年3月至12月收治的45例恶性梗阻性黄疸行PTCD治疗留置管道的患者作为研究对象,以2017年1月至10月收治的45例恶性梗阻性黄疸PTCD治疗留置管道的患者作为对照组。对照组采用常规的健康教育、出院指导、出院后电话随访;研究组采用PBL结合微视频的教育方案,出院后,在电话回访的基础上配合使用移动终端信息交流工具。分别于入组时、出院后3个月门诊复诊时对两组患者进行问卷调查,评估患者PTCD管相关知识知晓率、患者生活质量状况及患者居家护理管道并发症(管道脱落、堵塞、伤口周围皮肤损伤、胆道感染)的发生率。结果研究组患者PTCD管道护理知晓率、引流液量色观察知晓率、并发症识别知晓率分别为97.8%、100%、93.3%,明显高于对照组,差异具有统计学意义(P<0.05);研究组患者居家护理管道并发症发生率(其中管道堵塞4.4%、管道脱落或移位2.2%、胆道感染4.4%、伤口周围皮肤损伤4.4%)明显低于对照组,差异有统计学意义(P<0.05);研究组患者躯体功能、角色功能、情绪功能、认知功能、社会功能评分依次为(75.19±6.35)、(74.22±5.14)、(73.83±4.25)、(74.36±6.22)、(72.05±5.17)高于对照组,差异具有统计学意义(P<0.05)。结论PBL结合微视频的健康教育方案明显提高患者PTCD相关知识的知晓率,有效降低PTCD带管患者出院后居家管道并发症的发生率,保障患者安全,并提高患者的生活质量。
Objective To explore the application value of the health education program based on problem-based learning(PBL)combined with micro-video in educating patients who are carrying percutaneous transhepatic cholangial drainage(PTCD)indwelling tube.Methods A prospective controlled study was conducted in 45 patients with malignant obstructive jaundice(study group),who were carrying indwelling PTCD tube after receiving PTCD treatment during the period from March to December in 2018 at the Second Affiliated Hospital of Nantong University of China.Other 45 patients with malignant obstructive jaundice,who were admitted to the same hospital during the period from January to October in 2017,were used as the control group.For the patients in the control group,routine health education,guidance at discharge,and telephone follow-up after discharge were adopted;while for the patients in the study group,PBL combined with micro-video education program and post-discharge education by using mobile terminal information exchange tool on the basis of telephone return visit were carried out.A questionnaire surveys were conducted among the patients of both groups at the time of enrollment and 3 months after discharge so as to evaluate the patients'cognition about the nursing knowledge of PTCD tube,the quality of life of patients,and the incidence of PTCD tube complications(such as shedding and occlusion of tube,skin injury around wound,bile duct infection)occurring in home self-nursing.Results The cognition rates about the nursing knowledge ofPTCD tube,the observation of drainage fluid color and the complication identification ability in the study group were 97.8%,100%,and 93.3%respectively,which were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The PTCD tube complications occurring in home self-nursing included occlusion of tube(4.4%),shedding or displacement of tube(2.2%),biliary tract infection(4.4%)and skin damage around the wound(4.4%),the incidences of which were obviously lower than those in the control group,and the differences were statistically significant(P<0.05).The evaluation scores of patients'physical function,role function,emotional function,cognitive function and social function in the study group were(75.19±6.35)points,(74.22±5.14)points,(73.83±4.25)points,(74.36±6.22)points and(72.05±5.17)points respectively,which were much higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The health education program based on PBL combined with micro-video can remarkably improve the patients'cognition rate about the nursing knowledge of PTCD tube and reduce the the incidence of post-discharge PTCD tube complications occurring in home self-nursing in patients carrying indwelling PTCD tube,thus,to ensure the safety of patients and improve the patients'quality of life.
作者
范本芳
杨海霞
何伯圣
王丽华
FAN Benfang;YANG Haixia;HE Bosheng;WANG Lihua(The Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226001,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第6期621-625,共5页
Journal of Interventional Radiology
基金
江苏省南通市卫生健康委科研课题项目(MB2019002)。
关键词
PBL
微视频
健康教育
PTCD带管患者
生活质量
problem-based learning
micro-video
health education
patient carrying indwelling PTCD tube
quality of life
