發(fā)布時間：2018-06-30 08:03

  本文選題：結(jié)腸鏡檢查 + 宣教方式　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:將吉林大學(xué)第一醫(yī)院消化內(nèi)鏡中心結(jié)腸鏡受檢者分為傳統(tǒng)紙質(zhì)宣教組(對照組)、電話組、微信組三組,通過不同宣教方式,比較結(jié)腸鏡受檢者腸道準備質(zhì)量、腸道準備依從性及其不良反應(yīng);了解三組受檢者對預(yù)約護理服務(wù)的滿意度;比較三組受檢者腸道準備質(zhì)量的影響因素,并探討不同宣教方式對其影響因素的作用。通過以上方式,為消化內(nèi)鏡中心護理管理人員推薦有利于提高結(jié)腸鏡受檢者腸道準備質(zhì)量的宣教方式。方法:1.本研究將自愿簽署知情同意書的結(jié)腸鏡受檢者分為對照組、電話組、微信組三組。對照組受檢者按照先后順序在消化內(nèi)鏡中心前臺排隊預(yù)約登記,同時負責(zé)預(yù)約的護士利用消化內(nèi)鏡中心統(tǒng)一設(shè)計的結(jié)腸鏡診療預(yù)約單對受檢者進行腸道準備相關(guān)知識紙質(zhì)宣教。2.研究者在電話組受檢者傳統(tǒng)紙質(zhì)宣教的基礎(chǔ)上,通過電話宣教方式于受檢者檢查的前一天再次告知腸道準備期間相關(guān)事宜。3.研究者在微信組受檢者傳統(tǒng)紙質(zhì)宣教的基礎(chǔ)上,通過微信宣教方式于受檢者檢查的前一天對其腸道準備注意事項進行再次宣教,通過發(fā)送文字、語音、圖片等方式讓受檢者更加客觀的理解腸道準備要求。4.三組實施完畢,研究者于受檢者檢查當(dāng)天、結(jié)腸鏡開始檢查之前的一段時間,通過自制的消化內(nèi)鏡中心結(jié)腸鏡受檢者腸道準備狀況調(diào)查問卷、消化內(nèi)鏡中心結(jié)腸鏡受檢者預(yù)約護理服務(wù)滿意度調(diào)查問卷,對符合納入、排除標準的受檢者進行調(diào)查。5.受檢者檢查完畢,由檢查醫(yī)師通過波士頓腸道準備評價量表當(dāng)場對受檢者的腸道準備質(zhì)量進行評分,并由研究者當(dāng)場收回。6.比較三組受檢者腸道準備質(zhì)量合格率、依從性、不良反應(yīng)發(fā)生率以及對預(yù)約護理服務(wù)的滿意度,并分析不同宣教方式對受檢者腸道準備質(zhì)量所產(chǎn)生的影響。結(jié)果:1.三組受檢者一般資料在性別、年齡、文化程度、結(jié)腸鏡檢查類型、首次進行腸道準備、預(yù)約與檢查的間隔天數(shù)、清腸劑服用類型、便秘、糖尿病、腹部或盆腔手術(shù)史方面相比,差異不具有統(tǒng)計學(xué)意義(P0.05),說明三組之間可以進行比較。2.結(jié)腸鏡受檢者腸道準備質(zhì)量現(xiàn)狀顯示:三組受檢者腸道準備質(zhì)量相比,差異具有統(tǒng)計學(xué)意義(P0.05)。對照組與電話組、對照組與微信組腸道準備質(zhì)量相比,差異均具有統(tǒng)計學(xué)意義(P0.0167),且電話組腸道準備質(zhì)量合格率高于對照組,微信組腸道準備質(zhì)量合格率高于對照組。3.結(jié)腸鏡受檢者對腸道準備指導(dǎo)內(nèi)容的依從性方面,統(tǒng)計結(jié)果顯示檢查前一天采用流質(zhì)半流質(zhì)飲食、清腸劑的稀釋程度準確、開始服用清腸劑的時間準確、清腸劑在規(guī)定時間內(nèi)喝完、末次服用清腸劑與檢查的間隔時間在規(guī)定范圍內(nèi)相比,差異均具有統(tǒng)計學(xué)意義(P0.05)。對照組與微信組、對照組與電話組在檢查前一天采用流質(zhì)半流質(zhì)飲食方面相比,差異均具有統(tǒng)計學(xué)意義(P0.0167),且電話組受檢者的依從率高于對照組,微信組受檢者的依從率高于對照組;對照組和微信組在清腸劑的稀釋程度準確方面相比,差異具有統(tǒng)計學(xué)意義(P0.0167),且微信組受檢者依從率高于對照組;對照組與微信組在開始服用清腸劑的時間準確方面相比,差異具有統(tǒng)計學(xué)意義(P0.0167),且微信組受檢者依從率高于對照組;對照組與微信組、對照組與電話組在清腸劑在規(guī)定時間內(nèi)喝完方面相比,差異均具有統(tǒng)計學(xué)意義(P0.0167),且微信組受檢者依從率高于對照組,電話組受檢者依從率高于對照組;對照組與微信組、對照組與電話組在末次服用清腸劑與檢查的間隔時間在規(guī)定范圍內(nèi)方面相比,差異均具有統(tǒng)計學(xué)意義(P0.0167),且微信組受檢者依從率高于對照組,電話組受檢者依從率高于對照組。4.三組結(jié)腸鏡受檢者腸道準備期間出現(xiàn)的不良反應(yīng)如惡心、嘔吐癥狀相比,差異具有統(tǒng)計學(xué)意義(P0.05)。對照組與微信組在腸道準備中出現(xiàn)的惡心癥狀相比,差異具有統(tǒng)計學(xué)意義(P0.0167),且對照組的發(fā)生率高于微信組;對照組與微信組在腸道準備中出現(xiàn)的嘔吐癥狀相比,差異具有統(tǒng)計學(xué)意義(P0.0167),且對照組的發(fā)生率高于微信組。5.對三組結(jié)腸鏡受檢者預(yù)約護理服務(wù)滿意度進行調(diào)查,結(jié)果顯示,在預(yù)約環(huán)境、服務(wù)態(tài)度、用藥指導(dǎo)、飲食指導(dǎo)、健康宣教、解答疑問、體諒心情、隱私保護、總體滿意度方面相比,差異均具有統(tǒng)計學(xué)意義(P0.05)。其中,對照組與電話組滿意度相比,差異具有統(tǒng)計學(xué)意義(P0.05),且電話組滿意度得分高于對照組;對照組與微信組相比,差異具有統(tǒng)計學(xué)意義(P0.05),且微信組得分高于對照組。6.對照組經(jīng)過logistic回歸分析顯示年齡、文化程度、腸道準備中出現(xiàn)的不良反應(yīng)進入了回歸模式,該模型預(yù)測正確率為78.1%。結(jié)論:1.通過本研究顯示,電話、微信兩種宣教方式對結(jié)腸鏡受檢者腸道準備質(zhì)量的實施效果優(yōu)于對照組,因此消化內(nèi)鏡中心相關(guān)護理人員可以考慮在傳統(tǒng)紙質(zhì)宣教的基礎(chǔ)上通過電話或微信等方式對結(jié)腸鏡受檢者腸道準備期間注意事項進行再次宣教,以便有效提高其腸道準備質(zhì)量,避免因重復(fù)檢查帶來的資金浪費,提高醫(yī)療資源使用率,提升患者滿意度。2.以電話、微信等方式對結(jié)腸鏡受檢者做腸道準備方面的宣教,有利于提高受檢者腸道準備質(zhì)量的合格率;能夠提高受檢者飲食、用藥流程方面的依從率;可以緩解受檢者的緊張情緒;可以降低受檢者用藥期間出現(xiàn)的惡心、嘔吐癥狀發(fā)生率;提升受檢者對消化內(nèi)鏡中心預(yù)約護理服務(wù)的滿意度。
[Abstract]:Objective: to divide the enteroscopy central colonoscopy in No.1 Hospital of Jilin University into the traditional paper Education Group (control group), the telephone group and the WeChat group three groups. Through the different teaching methods, the intestinal preparation quality, the intestinal preparation compliance and the adverse reaction of the colonoscopy were compared, and the satisfaction of the three groups to the reserved nursing service was understood. The factors affecting the quality of intestinal preparation in the three groups were compared, and the effects of different teaching methods on the influencing factors were discussed. Through the above methods, the nursing managers in the center of digestive endoscopy were recommended to improve the quality of bowel preparation in the colonoscopy subjects. Methods: the 1. studies will voluntarily sign the colon of the informed consent. The subjects were divided into two groups: the control group, the telephone group, the WeChat group three groups. The control group was scheduled to register in the digestive endoscopy center front line, while the nurses who were in charge of the reservation were used in the colon mirror diagnosis and treatment appointments by the digestive endoscopy center. The.2. researchers of the intestinal tract preparation for the subjects were prepared. On the basis of the traditional paper preaching of the subjects, the.3. researchers, on the basis of the traditional paper preaching of the WeChat group, are reformed on the basis of the traditional paper preaching of the examiner of the group, on the basis of the traditional paper preaching of the examiner. Secondary education, by sending words, phonetics, pictures, and other ways to make the subjects more objective understanding of the intestinal preparation required.4. three groups, the researchers were examined on the day of the examiner, a period before the colonoscopy started, through the self-made digestive endoscopy central colonoscopy examiner's intestinal preparation questionnaire, in the digestive mirror. The questionnaire on the satisfaction of the patients who had been accepted by the enteroscopy was investigated by the examinees who were eligible for inclusion and the exclusion criteria were examined by the.5. examiner, and the examiner's bowel preparation quality was scored on the spot of the Boston intestinal preparation evaluation scale on the spot, and the researchers took the.6. to compare the three groups of subjects on the spot. Quality qualification rate, compliance, incidence of adverse reaction and satisfaction of reserved nursing service were prepared, and the effects of different teaching methods on the quality of intestinal preparation were analyzed. Results: 1. the general data of three groups were in sex, age, educational level, type of enteroscopy, first bowel preparation, reservation and examination. There was no statistical difference between the interval days of the three groups, constipation, constipation, diabetes, the history of abdominal or pelvic surgery. The difference was statistically significant (P0.05), indicating that the intestinal preparation quality of the three groups could be compared between the three groups, and the difference between the three groups was statistically significant (P0.05). Compared with the WeChat group, the difference of intestinal preparation quality between the control group and the WeChat group had statistical significance (P0.0167), and the qualified rate of the intestinal preparation quality of the telephone group was higher than that of the control group. The compliance rate of the intestinal preparation quality of the WeChat group was higher than that of the control group. The statistical results showed that the compliance of the enteric preparation guidance content of the.3. colonoscopy group was examined. Before the examination, a fluid half fluid diet was used, the dilution of the bowel agent was accurate, the time of taking the bowel agent was accurate, the bowel agent was drunk in the prescribed time, the interval between the last use of the bowel agent and the examination interval were statistically significant (P0.05). The control group and the WeChat group, the control group and the telephone group were examined. The difference was statistically significant (P0.0167), and the compliance rate of the patients in the telephone group was higher than that of the control group. The compliance rate of the WeChat group was higher than that of the control group. Compared with the control group and the WeChat group, the difference was statistically significant (P0.0167), and the difference was significant (P0.0167), and the difference between the control group and the control group was statistically significant. The compliance rate of the letter group was higher than that of the control group. Compared with the WeChat group, the difference was statistically significant (P0.0167), and the compliance rate of the WeChat group was higher than that of the control group. The control group and the WeChat group, the control group and the telephone group were compared with the telephone group in the prescribed time during the prescribed time. There were statistical significance (P0.0167), and the compliance rate of the WeChat group was higher than that of the control group. The compliance rate of the telephone group was higher than that of the control group; the control group and the WeChat group, the control group and the telephone group were statistically significant (P0.0167), and the WeChat group received the statistical significance compared with the time interval between the last use of the bowel agent and the examination (P0.0167). The compliance rate of the examiner was higher than that of the control group. The compliance rate of the patients in the telephone group was higher than that of the control group.4. three groups, such as nausea and vomiting (P0.05). The difference between the control group and the WeChat group was statistically significant compared with the nausea symptoms in the intestinal preparation (P 0.0167) and the incidence of the control group was higher than that of the WeChat group; the control group and the WeChat group had a significant difference in the vomiting symptoms in the intestinal preparation (P0.0167), and the incidence of the control group was higher than that of the WeChat group.5.. The results showed that the reservation environment and the service state were found. The difference was statistically significant (P0.05) compared with the satisfaction of telephone group (P0.05), and the satisfaction score of the telephone group was higher than that of the control group; the control group was compared with the WeChat group, and the control group was higher than the control group, and the control group was compared with the control group. The difference was statistically significant (P0.05), and the score of WeChat group was higher than that of the control group.6. control group after logistic regression analysis showed that age, cultural degree, the adverse reaction in intestinal preparation entered the regression model, and the prediction accuracy of this model was 78.1%. conclusion: 1. through this study, the two types of propaganda by telephone and WeChat were shown to colonoscopy. The effect of intestinal preparation quality is better than that of the control group. Therefore, the nursing staff in the center of digestive endoscopy may consider the precautions of intestinal preparation during the bowel preparation by telephone or WeChat on the basis of traditional paper education, so as to effectively improve the quality of the bowel preparation and avoid the heavy weight. The waste of funds, the utilization rate of medical resources, and the improvement of patient satisfaction.2. by telephone, WeChat and other methods of bowel preparation for the examiner of colonoscopy are beneficial to improve the qualified rate of the intestinal preparation quality of the examiner, improve the compliance rate of the subjects' diet and the process of drug use, and relieve the subjects. Tension; can reduce the incidence of nausea and vomiting, and improve the degree of satisfaction of the subjects on the reservation care service of the digestive endoscopy center.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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