| 吴爱荣,韦翠翠,彭雪娟,邱雪寒,詹水荣,解海霞.目标管理在脊髓损伤患者肠道自我管理中的效果评价[J].上海护理,2023,23(S1): |
| 目标管理在脊髓损伤患者肠道自我管理中的效果评价 |
| The effect of target management on bowel self-management in patients with spinal cord injury |
| DOI： |
| 中文关键词: 脊髓损伤 神经源性肠 目标管理 自我护理能力 |
| 英文关键词:spinal cord injury neurogenic bowel target management self care ability |
| 基金项目:2019年上海市“医苑新星”青年医学人才培养资助计划（沪卫人事[2020]87号）；上海市残疾人联合会2018年度残疾人康复科研入围项目（K2018034） |
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| 中文摘要: |
| 目的 探讨目标管理在脊髓损伤患者肠道自我管理中的应用效果。方法 选取2019年1-12月上海某大学附属康复医院脊髓损伤康复科收治的符合入选条件的胸段脊髓损伤诊断神经源性肠的患者62例为研究对象，随机数字表法分为对照组31例，给予常规肠道护理；观察组31例在常规肠道护理的基础上，应用目标管理的方法，促进医治护患共同参与到患者肠道管理中，实现以患者为中心，多学科团队合作的工作模式，并按时间轴制定具体、可量化、可实施的阶段目标，小组成员每周进行一次目标进展的讨论，及时发现问题和解决问题，保证按时间点达到阶段目标，最终达到患者肠道自我管理的总体目标。比较两组患者的大便控制情况、满意度、肠道功能和生存质量评分。结果 观察组患者干预后肠道功能改善、生活质量评分、患者参与情况均明显优于对照组，差异均有统计学意义（P ?0.05）。观察组患者干预后大便控制等级评分：1级0人（0%），2级2人（6.5%），3级6人（19.4%），4级9人（29.0%），5级14人（45.2%）。对照组患者干预后大便控制等级评分：1级3人（9.7%），2级6人（22.6%），3级7人（22.6%），4级9人（29.0%）,5级6人（19.4%），2组患者干预后大便控制等级较干预前均有改善，且观察组患者干预后大便控制等级评分明显优于对照组，自理能力水平明显提高，差异有统计学意义（Z=-2.671, P ?0.05）。结论 目标管理可促进脊髓损伤患者参与到自我护理行为中，提高患者肠道自我管理能力和生活质量，值得临床推广应用。 |
| 英文摘要: |
| Objective To investigate the effect of target management on bowle self-management in patients with spinal cord injury. Methods A total of 62 eligible patients with thoracic spinal cord injury diagnosed with neurogenic bowel who were admitted to the Spinal Cord Injury Rehabilitation Department of a University Affiliated Rehabilitation Hospital in Shanghai from January to December 2019 were selected as the study subjects. The group was divided into control group (31) and experimental group (31) by random number table method. Both groups were given regular bowel care, target management were added to the observation group. Target management can promote the participation of doctors, nurses and patients in intestinal management of patients, realize the patient-centered, multidisciplinary team cooperation mode, and formulate specific, quantifiable and implementable stage goals according to the timeline.The group members discussed the progress of the goal once a week, found and solved problems in time, ensured that the stage goal was reached according to the time point, and finally achieved the overall goal of bowel self-management of patients. The stool control ability, satisfaction degree, bowel function and quality of life scores of 2 groups were compared.
Results After intervention, the bowel function, quality of life score and patient satisfaction degree in the observation group were significantly better than control group, with statistical significance (P ?0.05).The grade scores of stool control in the observation group after intervention: grade 1, 0 patient (0%), grade 2, 2 patients (6.5%), grade 3, 6 patients (19.4%), grade 4, 9 patients (29.0%) and grade 5, 14 patients (45.2%). The grade scores of Stool control grade score of control group after intervention: 3 patients (9.7%) in grade 1, 6 patients (22.6%) in grade 2, 7 patients (22.6%) in grade 3, 9 patients (29.0%) in grade 4, and 6 patients (19.4%) in grade 5. Stool control grade of patients in both groups improved after intervention compared with before, and observation group was significantly better than that of control group, and self-care ability level was significantly improved.The difference was statistically significant (Z=-2.671, P ?0.05).Conclusion Target management can promote spinal cord injury patients to participate in self-care behavior, improve bowel self-management ability and quality of life of patients, worthy of clinical application. |
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