熊秀梅 吴水梅 叶冬玲

[摘要]目的 探討Teach-back反馈护理模式在腹腔镜下胆囊切除患者护理宣教中的应用效果。方法 选取2017年4月～2019年1月于九江市柴桑区人民医院行腹腔镜下胆囊摘除的86例急性胆囊炎患者作为研究对象，按照随机数字表法将其分为对照组和实验组，每组各43例。对照组患者采用常规护理宣教模式，实验组患者采用Teach-back反馈护理模式。观察比较两组患者护理前后的胆囊炎知识、腹腔镜手术知识及医院焦虑抑郁（HADS）评分，比较两组患者的护理工作满意度。结果 两组患者护理后的胆囊炎知识、腹腔镜手术知识评分高于本组护理前，HADS评分低于本组护理前，差异有统计学意义（P<0.05）。实验组患者护理后的胆囊炎知识、腹腔镜手术知识评分高于对照组，HADS评分低于对照组，差异有统计学意义（P<0.05）。实验组患者的护理总满意度为97.67%，高于对照组的83.72%，差异有统计学意义（P<0.05）。结论 腹腔镜下胆囊切除术患者术后采用Teach-back反馈护理模式，可以为患者提供个性化的沟通及动态的效果评价，通过患者的反馈信息指导护理宣教工作，及时纠正偏差，提高了患者对疾病以及腹腔镜手术治疗的认识，值得临床进一步推广。

[关键词] Teach-back反馈护理模式;急性胆囊炎;腹腔镜;护理

[中图分类号] R473.5          [文献标识码] A          [文章编号] 1674-4721（2019）12（a）-0176-04

Application effect of Teach-back feedback nursing model in patients of laparoscopic cholecystectomy

XIONG Xiu-mei1   WU Shui-mei2   YE Dong-ling1   CHEN Wei-wei3

1. Department of Surgery， People′s Hospital in Chaisang District of Jiujiang City， Jiangxi Province， Jiujiang   332100， China; 2. Department of Nursing， People′s Hospital in Chaisang District of Jiujiang City， Jiangxi Province， Jiujiang   332100， China; 3. Intensive Care Unit， the Second Hospital of Tangshan City， Hebei Province， Tangshan   063000， China

[Abstract] Objective To explore the application of Teach-back feedback nursing model in patients of laparoscopic cholecystectomy. Methods From April 2017 to January 2019， 86 patients with acute cholecystitis who underwent laparoscopic cholecystectomy in People′s Hospital in Chaisang District of Jiujiang City were selected as the study objects， and divided into control group and experimental group according to random number table method， 43 cases in each group. The control group was treated with routine nursing education model， and the experimental group was treated with Teach-back feedback nursing education model. The scores of cholecystitis knowledge， laparoscopic surgery knowledge， hospital anxiety and depression scale （HADS） before and after nursing were observed and compared between the two groups， the nursing job satisfaction were compared between the two groups. Results The scores of cholecystitis knowledge and laparoscopic surgery knowledge after nursing in the two groups were higher than those before nursing， and the HADS scores in the two groups were lower than those before nursing， the differences were statistically significant （P<0.05）. The scores of cholecystitis knowledge and laparoscopic surgery knowledge in the experimental group were higher than those in the control group， and the HADS score was lower than that in the control group， the differences were statistically significant （P<0.05）. The total satisfaction rate of the patients was 97.67%， which was higher than 83.72% of the control group， the difference was statistically significant （P<0.05）. Conclusion Patients with laparoscopic cholecystectomy adopts Teach-back feedback nursing model， it can provide personalized communication and dynamic effect evaluation for patients， through the patients′ feedback information guidance nursing propaganda and education work， timely correct the deviation. It improves patients′ understanding of diseases and laparoscopic surgery， and is worthy of further clinical promotion.

[Key words] Teach-back feedback nursing model; Acute cholecystitis; Laparoscopy; Nursing

急性胆囊炎的主要治疗方法是将胆囊摘除，常用的方法包括传统开腹手术以及腹腔镜下手术[1]。与传统开腹手术相比，腹腔镜下胆囊摘除手术具有创伤小、切口美观、并发症少等优点，目前日益成为急性胆囊炎的首选治疗方法，同时这也对腹腔镜下胆囊摘除手术患者的护理工作提出了更高的要求。Teach-back反馈护理模式也称反馈教学、后教学等，是美国医疗保健与质量局国家论坛（National Quality Forum，NQF）所推荐的“全面预防措施”的重要方法，其精髓主要是采用反馈的方式，通过在护理宣教中引入评估机制，反馈出患者对疾病及手术的掌握程度，并由此指导进一步的护理工作[2-3]。目前该方法已在国外医疗、社区、诊所及健康管理中心大量广泛应用[3]。……