“人本位”目标管理模式在甲状腺围手术期护理中的应用效果研究(1)
摘 要：目的 探讨“人本位”目标管理模式在甲状腺围手术期护理中的应用效果。方法 将选择2016年7月～2017年6月122例接受甲状腺切除手术的患者，按入院时间分为对照组和干预组，每组61例，对照组进行常规护理，干预组在常规护理的基础上开展“人本位”整体护理，并实施目标管理，比较两组患者疼痛强度、焦虑评分、并发症的发生率、患者满意度等指标，评价护理效果。结果 干预组与对照组相比，患者术后并发症发生率、焦虑自评得分均降低，干预组术后24 h疼痛评分<3分患者多于对照组，疼痛评分>3分患者少于对照组(P<0.05)，对护理服务的满意度上升，差异有统计学意义(P<0.05)。结论 “人本位”目标管理模式能够有效降低甲状腺切除术后患者并发症的发生率，减轻患者术后疼痛程度，改善患者的焦虑状态，有利于患者的术后恢复，值得临床推广。
关键词：人本位；目标管理；甲状腺手术
中图分类号：R473.76 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.060
, 百拇医药
文章编号：1006-1959(2018)10-0172-04
Application of"Human centered"Target Management Mode in Perioperative Nursing Care of Thyroid Gland
HUANG Fang，XIE Lei，XIE Bing-yan，MA Chan，LIANG Lei
(Department of Otorhinolaryngology Head and Neck Surgery，Tianmen First People's Hospital，Tianmen 431700，Hubei，China)
Abstract：Objective To explore the effect of the“human centered”goal management model in thyroid perioperative care.Methods From July 2016 to June 2017，122 patients undergoing thyroidectomy were divided into two groups：control group and intervention group，61 cases in each group.The control group carried out routine nursing.The intervention group carried out the"human centered" holistic nursing on the basis of conventional nursing，and carried out the target management，compared the two groups of pain intensity， anxiety score，the incidence of complications，patient satisfaction and other indicators，to evaluate the nursing effect.Results Compared with the control group，the incidence of postoperative complications and anxiety self-evaluation scores in the intervention group were lower than those in the control group，and the pain score<3 at 24 hours after operation in the intervention group was higher than that in the control group.The pain score>3 in patients was less than that in the control group(P<0.05)，there was a significant difference in satisfaction with nursing service(P<0.05).Conclusion The"human centered"target management model can effectively reduce the incidence of complications after thyroidectomy，reduce the degree of postoperative pain and improve the anxiety state of the patients， which is beneficial to the recovery of patients after operation，which is worthy of clinical promotion.
, 百拇医药
Key words：Human-centered；Goal management；Thyroid surgery
甲狀腺手术切除是临床上治疗甲状腺疾病的最常用方案[1]。随着医疗技术的发展，手术的安全性及治疗效果得有了显著的提高，目前90%～95%的患者术后能基本痊愈，但治疗过程中发生并发症的概率呈现增长趋势。首先，这一现象可能与甲状腺复杂的解剖结构有关，且其周围密布着较多神经及丰富的血管，手术切除过程中可能会造成周围神经和甲状旁腺的受损，导致呼吸困难、声音嘶哑、手足抽搐、低钙血症及甲状腺危象等并发症的发生[2]。其次，手术作为一种外界刺激，是患者躯体性及心理性的应激源，且患者常常伴有甲状腺功能失调，术后的疼痛刺激及紧张、焦虑、恐惧等不良情绪[3]，可进一步致使患者免疫力及抵抗力的下降，从而增加机体术后的感染机会，影响手术的安全性及术后患者的恢复状况[4]。因此，探讨护理干预对甲状腺切除患者的影响显得极其重要。现对122例甲状腺切除患者分别采取常规护理及“人本位”目标管理模式进行护理干预进行了对比，取得较好效果，报告如下。, http://www.100md.com(黄芳 谢磊 谢冰艳)
关键词：人本位；目标管理；甲状腺手术
中图分类号：R473.76 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.060
, 百拇医药
文章编号：1006-1959(2018)10-0172-04
Application of"Human centered"Target Management Mode in Perioperative Nursing Care of Thyroid Gland
HUANG Fang，XIE Lei，XIE Bing-yan，MA Chan，LIANG Lei
(Department of Otorhinolaryngology Head and Neck Surgery，Tianmen First People's Hospital，Tianmen 431700，Hubei，China)
Abstract：Objective To explore the effect of the“human centered”goal management model in thyroid perioperative care.Methods From July 2016 to June 2017，122 patients undergoing thyroidectomy were divided into two groups：control group and intervention group，61 cases in each group.The control group carried out routine nursing.The intervention group carried out the"human centered" holistic nursing on the basis of conventional nursing，and carried out the target management，compared the two groups of pain intensity， anxiety score，the incidence of complications，patient satisfaction and other indicators，to evaluate the nursing effect.Results Compared with the control group，the incidence of postoperative complications and anxiety self-evaluation scores in the intervention group were lower than those in the control group，and the pain score<3 at 24 hours after operation in the intervention group was higher than that in the control group.The pain score>3 in patients was less than that in the control group(P<0.05)，there was a significant difference in satisfaction with nursing service(P<0.05).Conclusion The"human centered"target management model can effectively reduce the incidence of complications after thyroidectomy，reduce the degree of postoperative pain and improve the anxiety state of the patients， which is beneficial to the recovery of patients after operation，which is worthy of clinical promotion.
, 百拇医药
Key words：Human-centered；Goal management；Thyroid surgery
甲狀腺手术切除是临床上治疗甲状腺疾病的最常用方案[1]。随着医疗技术的发展，手术的安全性及治疗效果得有了显著的提高，目前90%～95%的患者术后能基本痊愈，但治疗过程中发生并发症的概率呈现增长趋势。首先，这一现象可能与甲状腺复杂的解剖结构有关，且其周围密布着较多神经及丰富的血管，手术切除过程中可能会造成周围神经和甲状旁腺的受损，导致呼吸困难、声音嘶哑、手足抽搐、低钙血症及甲状腺危象等并发症的发生[2]。其次，手术作为一种外界刺激，是患者躯体性及心理性的应激源，且患者常常伴有甲状腺功能失调，术后的疼痛刺激及紧张、焦虑、恐惧等不良情绪[3]，可进一步致使患者免疫力及抵抗力的下降，从而增加机体术后的感染机会，影响手术的安全性及术后患者的恢复状况[4]。因此，探讨护理干预对甲状腺切除患者的影响显得极其重要。现对122例甲状腺切除患者分别采取常规护理及“人本位”目标管理模式进行护理干预进行了对比，取得较好效果，报告如下。, http://www.100md.com(黄芳 谢磊 谢冰艳)