基于供给侧改革的5A管理模式对老年原发性闭角型青光眼复合式小梁切除术患者围手术期自我效能的影响

Effects of 5A management mode based on supply-side reform on perioperative self-efficacy of elderly patients with primary an-gle-closure glaucoma undergoing combined trabeculectomy

中文关键词: 老年  原发性闭角型青光眼  复合式小梁切除术  供给侧改革  5A管理模式  自我效能

英文关键词: elderly  primary angle-closure glaucoma  combined trabeculectomy  supply-side reform  5A management mode  self efficacy

中文摘要:

      目的 观察基于供给侧改革的5A管理模式对老年原发性闭角型青光眼复合式小梁切除术患者围手术期自我效能的影响,为治疗该病症提供方法.方法 选取2018 年1 月—2021 年10 月安徽医科大学附属阜阳人民医院眼科收治的老年原发性闭角型青光眼患者60 例,采用摸球法分成对照组与观察组,每组30 例.对照组予以常规干预措施,观察组在对照组患者的治疗基础上实施基于供给侧改革的5A管理模式.比较2 组自我效能GSES评分、生活质量SF-36 评分、焦虑SAS评分、抑郁SDS评分和术后并发症发生率,以及正确用药、监测眼压、定时复查和按摩眼球等遵医行为.结果 干预前,2 组患者GSES评分和SF-36 评分差异均无统计学意义(P＞0.05).干预后,2 组患者GSES评分与SF-36 评分均较同组干预前显著增高(P＜0.05),SAS评分和SDS评分均较同组干预前显著降低(P＜0.05);观察组GSES评分和SF-36评分均显著高于对照组(P＜0.05),SAS评分和SDS评分均显著低于对照组(P＜0.05);观察组术后并发症发生率显著低于对照组[6.67%(2/30)vs 26.67%(8/30)](P＜0.05);观察组正确用药、监测眼压、定时复查和按摩眼球等遵医行为均显著优于对照组(P＜0.05).结论 基于供给侧改革的5A管理模式对老年原发性闭角型青光眼复合式小梁切除术患者围手术期自我效能、生活质量、遵医行为及不良心理状态有明显改善作用,可能降低术后并发症发生率,具有一定的临床应用价值.

英文摘要:

      Objective To observe the effects of 5A management mode based on supply-side reform on perioperative self-efficacy of elderly patients with primary angle-closure glaucoma undergoing combined trabeculectomy,and provide a meth-od for the treatment of the disease.Methods 60 elderly patients with primary angle-closure glaucoma admitted to Department of Ophthalmology,Fuyang People's Hospital Affiliated to Anhui Medical University from January 2018 to October 2021 were selected and divided into control group and observation group by ball-touching method,with 30 cases in each group.The con-trol group adopted routine intervention measures,while the observation group adopted the 5A management mode based on sup-ply-side reform on the basis of the control group.The GSES score of self-efficacy,SF-36 score of quality of life,SAS score of anxiety,SDS score of depression and the incidence of postoperative complications were compared between the two groups,as well as medical compliance behaviors such as correct medication,monitoring intraocular pressure,regular reexamination and eyeball massage.Results Before intervention,there was no significant difference in GSES score and SF-36 score between the two groups(P＞0.05).After the intervention,the GSES score and SF-36 score of the two groups were significantly higher than those of the same group before the intervention(P＜0.05),and the SAS score and SDS score were significantly lower than those of the same group before the intervention(P＜0.05).After the intervention,the GSESscore and SF-36 score of the observation group were significantly higher than those of the control group(P＜0.05),and the SAS score and SDS score of the observation group were significantly lower than those of the control group(P＜0.05).The incidence of postoperative complica-tions in the observation group was significantly lower than that in the control group[6.67%(2/30)vs 26.67%(8/30),(P＜0.05)].The observation group was significantly better than the control group in correct medication,monitoring intraocular pressure,regular reexamination and eyeball massage and other compliance behaviors(P＜0.05).Conclusion The 5A man-agement mode based on the supply-side reform can significantly improve the perioperative self-efficacy,quality of life,medical compliance behavior and adverse psychological state of elderly patients with primary angle-closure glaucoma after combined tra-beculectomy,and can reduce the incidence of postoperative complications,which has certain clinical value.