不同宣教方式对结肠镜受检者肠道准备质量的效果研究

发布时间：2018-06-30 08:03

本文选题：结肠镜检查 + 宣教方式　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:将吉林大学第一医院消化内镜中心结肠镜受检者分为传统纸质宣教组(对照组)、电话组、微信组三组,通过不同宣教方式,比较结肠镜受检者肠道准备质量、肠道准备依从性及其不良反应;了解三组受检者对预约护理服务的满意度;比较三组受检者肠道准备质量的影响因素,并探讨不同宣教方式对其影响因素的作用。通过以上方式,为消化内镜中心护理管理人员推荐有利于提高结肠镜受检者肠道准备质量的宣教方式。方法:1.本研究将自愿签署知情同意书的结肠镜受检者分为对照组、电话组、微信组三组。对照组受检者按照先后顺序在消化内镜中心前台排队预约登记,同时负责预约的护士利用消化内镜中心统一设计的结肠镜诊疗预约单对受检者进行肠道准备相关知识纸质宣教。2.研究者在电话组受检者传统纸质宣教的基础上,通过电话宣教方式于受检者检查的前一天再次告知肠道准备期间相关事宜。3.研究者在微信组受检者传统纸质宣教的基础上,通过微信宣教方式于受检者检查的前一天对其肠道准备注意事项进行再次宣教,通过发送文字、语音、图片等方式让受检者更加客观的理解肠道准备要求。4.三组实施完毕,研究者于受检者检查当天、结肠镜开始检查之前的一段时间,通过自制的消化内镜中心结肠镜受检者肠道准备状况调查问卷、消化内镜中心结肠镜受检者预约护理服务满意度调查问卷,对符合纳入、排除标准的受检者进行调查。5.受检者检查完毕,由检查医师通过波士顿肠道准备评价量表当场对受检者的肠道准备质量进行评分,并由研究者当场收回。6.比较三组受检者肠道准备质量合格率、依从性、不良反应发生率以及对预约护理服务的满意度,并分析不同宣教方式对受检者肠道准备质量所产生的影响。结果:1.三组受检者一般资料在性别、年龄、文化程度、结肠镜检查类型、首次进行肠道准备、预约与检查的间隔天数、清肠剂服用类型、便秘、糖尿病、腹部或盆腔手术史方面相比,差异不具有统计学意义(P0.05),说明三组之间可以进行比较。2.结肠镜受检者肠道准备质量现状显示:三组受检者肠道准备质量相比,差异具有统计学意义(P0.05)。对照组与电话组、对照组与微信组肠道准备质量相比,差异均具有统计学意义(P0.0167),且电话组肠道准备质量合格率高于对照组,微信组肠道准备质量合格率高于对照组。3.结肠镜受检者对肠道准备指导内容的依从性方面,统计结果显示检查前一天采用流质半流质饮食、清肠剂的稀释程度准确、开始服用清肠剂的时间准确、清肠剂在规定时间内喝完、末次服用清肠剂与检查的间隔时间在规定范围内相比,差异均具有统计学意义(P0.05)。对照组与微信组、对照组与电话组在检查前一天采用流质半流质饮食方面相比,差异均具有统计学意义(P0.0167),且电话组受检者的依从率高于对照组,微信组受检者的依从率高于对照组;对照组和微信组在清肠剂的稀释程度准确方面相比,差异具有统计学意义(P0.0167),且微信组受检者依从率高于对照组;对照组与微信组在开始服用清肠剂的时间准确方面相比,差异具有统计学意义(P0.0167),且微信组受检者依从率高于对照组;对照组与微信组、对照组与电话组在清肠剂在规定时间内喝完方面相比,差异均具有统计学意义(P0.0167),且微信组受检者依从率高于对照组,电话组受检者依从率高于对照组;对照组与微信组、对照组与电话组在末次服用清肠剂与检查的间隔时间在规定范围内方面相比,差异均具有统计学意义(P0.0167),且微信组受检者依从率高于对照组,电话组受检者依从率高于对照组。4.三组结肠镜受检者肠道准备期间出现的不良反应如恶心、呕吐症状相比,差异具有统计学意义(P0.05)。对照组与微信组在肠道准备中出现的恶心症状相比,差异具有统计学意义(P0.0167),且对照组的发生率高于微信组;对照组与微信组在肠道准备中出现的呕吐症状相比,差异具有统计学意义(P0.0167),且对照组的发生率高于微信组。5.对三组结肠镜受检者预约护理服务满意度进行调查,结果显示,在预约环境、服务态度、用药指导、饮食指导、健康宣教、解答疑问、体谅心情、隐私保护、总体满意度方面相比,差异均具有统计学意义(P0.05)。其中,对照组与电话组满意度相比,差异具有统计学意义(P0.05),且电话组满意度得分高于对照组;对照组与微信组相比,差异具有统计学意义(P0.05),且微信组得分高于对照组。6.对照组经过logistic回归分析显示年龄、文化程度、肠道准备中出现的不良反应进入了回归模式,该模型预测正确率为78.1%。结论:1.通过本研究显示,电话、微信两种宣教方式对结肠镜受检者肠道准备质量的实施效果优于对照组,因此消化内镜中心相关护理人员可以考虑在传统纸质宣教的基础上通过电话或微信等方式对结肠镜受检者肠道准备期间注意事项进行再次宣教,以便有效提高其肠道准备质量,避免因重复检查带来的资金浪费,提高医疗资源使用率,提升患者满意度。2.以电话、微信等方式对结肠镜受检者做肠道准备方面的宣教,有利于提高受检者肠道准备质量的合格率;能够提高受检者饮食、用药流程方面的依从率;可以缓解受检者的紧张情绪;可以降低受检者用药期间出现的恶心、呕吐症状发生率;提升受检者对消化内镜中心预约护理服务的满意度。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

【相似文献】