目标导向式不良行为扭转干预对老年胃溃疡出血内镜治疗术后自护能力及遵医行为的影响

Effects of goal-directed adverse behavior reversal intervention on self-care ability and medical compliance behavior in elderly patients with gastric ulcer bleeding after endoscopic treatment

中文关键词: 老年  胃溃疡出血  目标导向式不良行为扭转干预  自护能力  遵医行为  焦虑  应激状态

英文关键词: elderly  gastric ulcer bleeding  goal-directed adverse behavior reversal intervention  self-care ability  medi-cal compliance behavior  anxiety  stress state

中文摘要:

      目的 探讨目标导向式不良行为扭转干预对老年胃溃疡出血内镜治疗术后自护能力及遵医行为的影响.方法 选取2021年8月-2023年1月在首都医科大学附属北京友谊医院收治的270例老年胃溃疡出血患者作为研究对象,采用随机数字表法将其分为2组:观察组和对照组,每组135例.2组均接受相同的补充血容量治疗,对照组接受常规护理干预,观察组接受目标导向式不良行为扭转延续护理干预.比较2组SAS、SDS评分、术中应激生理指标值、遵医行为的差异;在干预前后,分别采用自我能力实施量表(ESCA)评分评价患者的自护能力,采用生活质量调查表(SF-36)评分评价患者的生活质量,比较2组间的差异.结果 内镜术前和术后1 d,2组患者的SAS和SDS评分均低于同组干预前(P＜0.05),且观察组SAS和SDS评分均低于对照组(P＜0.05).观察组术中心率(HR)、呼吸率(RR)、平均动脉压(MAP)均低于对照组(均P＜0.05).干预后,观察组ESCA各维度评分均高于对照组(P＜0.05);观察组SF-36各项评分均高于对照组(P＜0.05);观察组自我护理、治疗配合、规范用药、定期复查遵医嘱达标率均高于对照组(P＜0.05).结论 目标导向式不良行为扭转干预在老年胃溃疡出血患者中的应用,临床效果良好,可有效提高患者的自护能力,改善其生活质量,并提高其遵医行为,具有一定的临床应用价值.

英文摘要:

      Objective To explore the effects of goal-directed adverse behavior reversal intervention on self-care ability and medical compliance behavior in elderly patients with gastric ulcer bleeding after endoscopic treatment.Methods A total of 270 elderly patients with gastric ulcer bleeding admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from August 2021 to January 2023 were selected as study subjects.A random number table method was used to divide them into two groups:observation group and control group,with 135 cases in each group.Both groups received the same supplemental blood volume therapy.The control group received routine nursing intervention,while the observation group received goal-di-rected adverse behavior reversal and continuous nursing intervention.The differences in anxiety(SAS)score,depression(SDS)score,intraoperative stress physiological indicators,and medical compliance behavior were compared between the two groups.Before and after the intervention,the self-care ability of the patients was evaluated by the Self-Care Ability Scale(ES-CA)score,and their quality of life was evaluated by the Short Form Health Survey(SF-36),and the differences between the two groups were compared.Results The scores of SAS and SDS of both groups before endoscopic surgery and 1 day after en-doscopic surgery were significantly lower than those of the same group before intervention(P＜0.05),and the observation group were significantly lower than the control group(P＜0.05).The heart rate(HR),respiratory rate(RR),and mean ar-terial pressure(MAP)during the operation of the observation group were significantly lower than those of the control group,with significant differences(P＜0.05).After intervention,the ESC A scores in all dimensions of the observation group were higher than those of the control group(P＜0.05);the SF-36 score was higher than that of the control group(P＜0.05);the compliance rates of self-care,treatment coordination,standardized drug use,regular follow-up with medical advice were higher than those of the control group(P＜0.05).Conclusion The application of goal-directed adverse behavior reversal interven-tion in elderly patients with gastric ulcer bleeding has a good clinical effect.It can effectively enhance patients'self-care ability,improve their quality of life and medical compliance behavior,and has certain clinical application value.