| Objective:In view of the problems such as the lack of systematic content of gynecological laparoscopic perioperative health education and the adverse impact of inadequate health education on postoperative rehabilitation of patients,this study established a set of health education programs suitable for gynecological laparoscopic perioperative patients based on evidence-based theory and AIDET communication mode.Through the preliminary clinical application,its feasibility in clinical nursing and its effectiveness in improving patients’self-care ability,improving patients’pain experience,negative emotions,promoting postoperative functional recovery and improving nursing service satisfaction were scientifically verified,so as to provide reference for nursing managers to improve the quality of clinical nursing.Methods:1.Systematically searched the guidelines,expert consensus and original literature related to gynecological laparoscopic perioperative nursing or health education,screened and evaluated the literature according to the exclusion standard,extracted items related to health education of gynecological laparoscopic perioperative patients,and conducted evidence integration and recommendation level evaluation to provide basis for program construction.2.Using phenomenological research methods,semi-structured interviews were conducted with gynecological patients who(planned)to undergo laparoscopic surgery to understand the main concerns and related needs of patients in the perioperative period,so as to provide support for the improvement of program content.3.Combined with evidence integration and interview results,and based on AIDET communication mode,preliminary formation of gynecological laparoscopic perioperative health education program in line with clinical practice;Sixteen experts with certain influence in the discipline were selected for Delphi expert letter consultation,the importance of the first,second and third indexes and item contents of the program was rated,and suggestions for modification were put forward.Combined with expert opinions,the draft of the program was improved according to the results of group discussion,and the final draft of the health education program for gynecological laparoscopic perioperative patients was formed.4.The convenience sampling method was used to select the patients who met the standard of natrexia in the department of Gynecology of a third Class A hospital in Shanxi Province for clinical control study to verify the effectiveness of the scheme.The patients in the intervention group were taught by the constructed health education program,and the patients in the control group were taught by the conventional health education method.The differences of self-care ability,anxiety,depression,pain experience,treatment compliance and nursing satisfaction after intervention were observed between the two groups.The count data were compared by chi-square test and Fisher’s exact test.The measurement data conforming to the normal distribution were compared by the t-test of two independent samples,while the Mann-Whitney rank sum test was used to compare the inconsistent and normal distribution.Results:1.Based on AIDET communication mode,evidence-based evidence integration and patient interview results,through Delphi expert letter consultation,scientific construction of gynecological laparoscopic perioperative health education program.Contents include care,communication,admission instructions,knowledge propaganda,hospitalization plan,operation plan,preoperative preparation,intraoperative cooperation,postoperative management,complications prevention,discharge guidance,thank 12aspects,a total of 51 items.2.Before intervention,the general data of the two groups were compared,and the results showed no statistical significance(P>0.05),indicating that the baseline data of the two groups were comparable.After intervention,the self-care ability(ESCA),anxiety(SAS),depression(SDS)and nursing satisfaction scores of the two groups met the normal distribution,and the two independent sample t-test was used to compare.Pain scores(NRS)did not conform to normal distribution and were compared by Mann-Whitney rank sum test.Treatment compliance was counted data,and chi-square test were used for comparison.The results showed that in ESCA scores,the scores of self-concept(t=6.683,P<0.001),sense of self-care(t=3.964,P<0.001),self-care skills(t=5.661,P<0.001)and health knowledge level(t=7.825,P<0.001)in the intervention group were significantly higher than those in the control group.In nursing satisfaction score,the intervention group was higher than the control group in three dimensions of nurse-patient communication(t=8.154,P<0.001),health education(t=80118,P<0.001),nursing skills(t=2.974,P=0.004),but the two groups of patients in the ward environment dimension(t=0.863,P=0.392)the difference was small and not statistically significant;As for anxiety and depression scores,SAS(t=-7.906,P<0.001)and SDS(t=-2.089,P=0.041)scores in the intervention group were significantly lower than those in the control group,and the difference was significant.In pain score,NRS score of intervention group(Z=05.668,P<0.001)was significantly lower than that of control group,and the difference was statistically significant.In terms of treatment compliance,the total compliance rate of patients in the intervention group was significantly higher than that in the control group(χ~2=7.035,P=0.033),and the difference was statistically significant.Conclusion:1.With AIDET communication model as theoretical guidance,health education program for gynecological laparoscopic perioperative patients was scientifically constructed by applying evidence-based resource integration,patient qualitative interview,Delphi expert consultation and other methods.2.The constructed scheme was preliminatively applied in clinical practice,and the results showed that the scheme had certain effects in improving patients’self-care ability,improving patients’anxiety and depression,relieving patients’postoperative pain,enhancing patients’treatment compliance,and improving patients’nursing satisfaction.3.Through empirical study,it is considered that the scheme is systematic,scientific,reliable and feasible,and can be further promoted and applied in clinical nursing work. |
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