CAJ | 학술논문

目的运用临床路径的方法规范大内科患者健康教育管理,使患者健康教育系统、动态、连续、有针对性,减少健康教育中的随意性和盲目性,提高健康教育质量和患者满意度.方法在大内科16个专业科室和病区中,针对48个病种的住院患者采用健康教育路径表进行患者健康教育,1年后对实施效果进行分析评价.比较实施前后患者对疾病相关知识知晓情况,患者或家属、护士、护士长的满意度,患者健康教育质量、平均住院天数及平均住院费用.结果实施1年后大内科患者疾病基本知识、饮食相关知识、运动相关知识、口服药物使用、标本留取方法及特殊诊疗注意事项得分分别为(82.48±0.50),(85.51±0.52),(83.54±0.50),(92.31±0.47),(90.26±0.50),(93.43±0.51)分,均高于实施前的(78.91±0.55),(80.72±0.56),(77.89±0.62),(88.76±0.59),(85.13±0.54),(89.06±0.48)分,差异均有统计学意义(t分别为-7.731,-10.368,-7.900,-7.168,-2.313,-5.459;P＜ 0.05).健康教育路径表实施后患者或家属、护士、护士长的满意度分别为96％,91％,94％,均高于实施前的89％,85％,82％,差异均有统计学意义(x2分别为6.20,3.95,5.02;P ＜0.05).实施后患者平均住院天数为(10.9±1.10)d,少于实施前的(13.3±2.31)d,差异有统计学意义(t=2.23,P＜0.05)；实施后患者平均住院费用比较,差异无统计学意义(P＞0.05).结论健康教育路径是对住院患者实施健康教育的有效方法,有助于提高护理质量和患者满意度,同时做到了在内科系统中的资源共享.
목적 운용림상로경적방법규범대내과환자건강교육관리,사환자건강교육계통、동태、련속、유침대성,감소건강교육중적수의성화맹목성,제고건강교육질량화환자만의도.방법 재대내과16개전업과실화병구중,침대48개병충적주원환자채용건강교육로경표진행환자건강교육,1년후대실시효과진행분석평개.비교실시전후환자대질병상관지식지효정황,환자혹가속、호사、호사장적만의도,환자건강교육질량、평균주원천수급평균주원비용.결과 실시1년후대내과환자질병기본지식、음식상관지식、운동상관지식、구복약물사용、표본류취방법급특수진료주의사항득분분별위(82.48±0.50),(85.51±0.52),(83.54±0.50),(92.31±0.47),(90.26±0.50),(93.43±0.51)분,균고우실시전적(78.91±0.55),(80.72±0.56),(77.89±0.62),(88.76±0.59),(85.13±0.54),(89.06±0.48)분,차이균유통계학의의(t분별위-7.731,-10.368,-7.900,-7.168,-2.313,-5.459;P＜ 0.05).건강교육로경표실시후환자혹가속、호사、호사장적만의도분별위96％,91％,94％,균고우실시전적89％,85％,82％,차이균유통계학의의(x2분별위6.20,3.95,5.02;P ＜0.05).실시후환자평균주원천수위(10.9±1.10)d,소우실시전적(13.3±2.31)d,차이유통계학의의(t=2.23,P＜0.05)；실시후환자평균주원비용비교,차이무통계학의의(P＞0.05).결론 건강교육로경시대주원환자실시건강교육적유효방법,유조우제고호리질량화환자만의도,동시주도료재내과계통중적자원공향.
Objective To apply clinical pathway in health education for patients in Department of internal medicine,in order to make their health education systemic,dynamic,continuous and well targeted,reduce its randomness and blindness,and improve its quality and patients' satisfaction.Methods Totals of 48 inpatients in 16 professional departments and wards of Department of internal medicine were intervened with health education pathway,and the effect was evaluated a year after.Patients' knowledge of the disease,satisfaction of patients or families,nurses and charge nurses,quality of health education,average days and expense of hospitalization were compared before and the intervention.Results One year after the clinical pathway,the scores of patients' basic knowledge of the disease,diet related knowledge,exercise related knowledge,oral drugs use,collecting methods of the sample and matters need attention of special treatment were respectively (82.48 ±0.50),(85.51 ±0.52),(83.54 ±0.50),(92.31 ±0.47),(90.26 ±0.50) and (93.43 ± 0.51),all of which were higher than (78.91 ± 0.55),(80.72 ± 0.56),(77.89 ± 0.62),(88.76 ± 0.59),(85.13 ± 0.54) and (89.06 ± 0.48) before the clinical pathway,and the differences were statistically significant (t =-7.731,-10.368,-7.900,-7.168,-2.313,-5.459,respectively; P ＜ 0.05).The satisfaction rates of patients or families,nurses and charge nurses were respectively 96％,91％ and 94％ after health education pathway,higher than 89％,85％ and 82％ before,and the differences were statistically significant (x2 =6.20,3.95,5.02,respectively ; P ＜ 0.05).The average days of hospitalization were (10.9 ± 1.10) d after and (13.3 ± 2.31) d before,with statistically significant difference (t =2.23,P ＜ 0.05).And there was no statistically significant difference of average expense of hospitalization before and after (P ＞ 0.05).Conclusions Health education pathway is an effective method which can improve the quality of nursing and patients' satisfaction,as well as share the recourses in the Department of internal medicine.