腰椎后路融合术信息-动机-行为模型的护理干预△

Nursing intervention for posterior lumbar interbody fusion based on information-motivation-behavior model

摘要:

[目的]探索基于信息-动机-行为（information-motivation-behavior, IMB）技巧模型的护理干预方案在腰椎后路融合术（posterior lumbar interbody fusion, PLIF）的应用效果。[方法]选取 2023 年 5—10 月在本院行 PLIF 的 100 例腰椎退行性疾病患者作为研究对象，按随机数字表法将其分为两组。其中，50 例患者接受 IMB 护理，另外 50 例患者接受常规护理，比较两组的临床资料。[结果]两组患者在手术时间、术中失血量、术后引流量和总并发症的差异无统计学意义（P＞0.05）。但是，IMB 组术后卧床时间 [(3.4±0.4) d vs (4.2±0.5) d, P＜0.001]、住院时间 [(11.0±2.3) d vs (12.1±3.5) d, P=0.049]，以及出院时和术后 1 个月 VAS 评分 [(4.1±0.7) vs (4.5±0.7), P=0.010; (1.1±0.7) vs (1.5±0.9), P=0.032]，ODI 评分 [(51.4±1.9) vs (55.1±1.7), P＜0.001; (21.3±2.1) vs (23.5±2.1), P＜0.001]，依从性评分 [(54.6±1.7) vs (49.7±3.2), P＜0.001; (57.0±2.4) vs (53.9±1.9), P＜0.001]，HADS-D 评分 [(8.7±1.5) vs (9.4±1.9), P=0.046; (5.9±1.6) vs (6.7±1.5), P=0.020] 以及出院时的 HADS-A 评分 [(8.2±1.8) vs (9.5±1.7), P＜0.001] 均显著优于常规组。[结论]基于 IMB 模型的护理干预方案可以减轻 PLIF 患者术后疼痛，促进患者腰椎功能的恢复，提高其锻炼依从性，降低焦虑抑郁的发生，缩短患者住院时间。

Abstract:

[Objective] To evaluate the clinical outcome of the nursing intervention based on information-motivation-behavior (IMB) model for posterior lumbar interbody fusion (PLIF). [Methods] A total of 100 patients who were undergoing PLIF for lumbar degenerative diseases in our hospital from May to October 2023 were enrolled into this study and divided into 2 groups by random number table method. Of them, 50 patients received IMB care, while other 50 patient underwent conventional care. The clinical data of the two groups were compared. [Results] There were no significant differences in operation time, intraoperative blood loss, postoperative drainage and total complications between the two groups (P＞0.05). However, the IMB group proved significantly superior to the conventional group in terms of postoperative bed rest time [(3.4±0.4) days vs (4.2±0.5) days,P＜0.001] and hospital stay [(11.0±2.3) days vs (12.1±3.5) days, P=0.049], as well as VAS score [(4.1±0.7) vs (4.5±0.7), P=0.010; (1.1±0.7) vs (1.5±0.9), P=0.032], ODI score [(51.4±1.9) vs (55.1±1.7), P＜0.001; (21.3±2.1) vs (23.5±2.1), P＜0.001], compliance score [(54.6±1.7) vs (49.7±3.2), P＜0.001; (57.0±2.4) vs (53.9±1.9), P＜0.001], HADS-D score [(8.7±1.5) vs (9.4±1.9), P=0.046; (5.9±1.6) vs (6.7±1.5), P=0.020] at discharge and 1 month after surgery, additionally, HADS-A score [(8.2±1.8) vs (9.5±1.7), P＜0.001] at discharge. [Conclusion] IMB based nursing intervention can reduce postoperative pain of PLIF, promote the recovery of lumbar function, improve their exercise compliance, reduce the occurrence of anxiety and depression, and shorten the hospital stay.