潘君玲

【摘要】 目的：探討基于保护动机理论（PMT）的预防对全麻介入手术患者压力性损伤发生率的影响。方法：采用便利抽样法，抽取2022年2月—2023年2月在东莞市滨海湾中心医院就诊的介入手术患者145例为研究对象。按照入组的时间顺序，将患者分为对照组和干预组，对照组72例，干预组73例。对照组采用常规护理干预措施，干预组采用PMT的护理措施。比较两组术中压力性损伤的发生率、护士对患者压力性损伤风险评估的准确率、皮肤规范交接执行率、护士手术中压力性损伤预防行为得分。结果：干预组术中压力性损伤的发生率明显低于对照组，干预组护士的压力性损伤风险评估准确率较对照组有所提高，干预组护士的皮肤规范交接执行率较干预前有所提高（P<0.05）。干预后，干预组护士的术中压力性损伤预防行为得分为（102.72±2.66）分，高于对照组的（86.38±3.92）分，差异均有统计学意义（P<0.05）。结论：基于PMT的预防可以有效降低介入手术患者术中压力性损伤发生率，提高护士的压力性损伤风险评估准确率和皮肤规范交接执行率，改善护士的术中压力性损伤预防行为。

【关键词】 压力性损伤 保护动机理论 围手术期护理 介入手术

Application of Protective Motivation Theory in the Prevention of Stress Injury in Patients with Interventional Surgery General Anesthesia/PAN Junling. //Medical Innovation of China， 2024， 21（08）： 0-097

[Abstract] Objective： To explore the effect of prevention based on protective motivation theory （PMT） on the incidence of stress injury in patients with interventional surgery general anesthesia. Method： A total of 145 patients undergoing interventional surgery in Dongguan Binhai Bay Central Hospital from February 2022 to February 2023 were selected by convenience sampling. According to the chronological order of enrollment， patients were divided into control group and intervention group， 72 cases in control group and 73 cases in intervention group. The control group adopted conventional nursing interventions， and the intervention group adopted nursing measures with PMT. The incidence of intraoperative stress injury， the accuracy of nurses' risk assessment of patients' stress injury， the implementation rate of skin standards， and the score of nurses' stress injury prevention behavior during surgery were compared between the two groups. Result： The incidence of intraoperative pressure injury in the intervention group was significantly lower than that in the control group， the risk assessment accuracy of pressure injury in the intervention group was improved compared with the control group， and the implementation rate of skin standard handover in the intervention group was improved compared with that before intervention （P<0.05）. After intervention， the intraoperative stress injury prevention behavior score of nurses in the intervention group was （102.72±2.66） points， higher than （86.38±3.92） points in the control group， the difference was statistically significant （P<0.05）. Conclusion： Prevention based on PMT can effectively reduce the incidence of intraoperative pressure injury in patients undergoing interventional surgery， improve the accuracy of risk assessment of pressure injury and the implementation rate of skin norms， and improve the prevention behavior of intraoperative pressure injury of nurses.

[Key words] Pressure injury Protection motivation theory Perioperative nursing Interventional surgery

First-author's address： Department of Intervention， Dongguan Binhai Bay Central Hospital， Dongguan 523900， China

doi：10.3969/j.issn.1674-4985.2024.08.021

压力性损伤是一项重要的护理质量敏感指标，也是重要的临床护理工作内容，其中术中获得性压力性损伤（intraoperative acquired pressure injury，IAPI）是指术后72 h内发生的组织损伤[1-2]。近年来，随着医学的发展，手术的复杂性越来越高、手术时间也逐渐增长，术中压力性损伤的发生率也在增高[3]。有研究报道，术中获得性压力性损伤的发生率为8.1%～54.8%[4]。有研究表明，年龄、术前禁食水时间、手术时长、术中体位、术后制动等是影响患者术中压力性损伤的危险因素[5]，因此，此类患者是术后压力性损伤发生的高危人群。术中获得性压力性损伤的发生不仅会导致医疗成本增高，同时会导致护士的工作量增大，还会给患者带来痛苦，延长患者住院时长，增加患者经济负担，甚至导致患者死亡[6-7]。……