The Application And Effect Of Seamless Nursing Management Model On Health Education In Surgery Patients Of Otolaryngological Department

Research backgroundThe disease of otolaryngology is complicated and repetitive,it's easy to appear the physical,psychological and social changes,which leads to negative emotions such as anxiety and depression,disease symptoms such as functional aphonia and interpersonal disorder,which is affected the patients' physical and mental health and the quality of life severely.Surgical treatment is the primary treatment of otolaryngology,at present,the otolaryngology nursing practice is still focus on the conventional knowledge and behavior intervention,also the care of patients during the hospitalization,lack of systemic health education from admission to discharge,meanwhile,most of the patients in the primary hospital are less educated which is lack of diseases knowledge,self-management and healthy behavior,the ability to accept the knowledge and health behaviors of the otolaryngology is poor which affects the effect of health education,therefore,the otolaryngology patients have a higher nursing and health education needs.The seamless nursing management model is a seamless and omnidirectional new nursing management model,which is in the process of providing nursing care to patients,aiming at the problems occurring in the nursing work,the model reflects the spirit of patient-oriented,personalized service,quick response and efficiency,which emphasized the whole process from admission to discharge,ensured the continuity and integrity of the nursing service,as well as showed the connotation of holistic nursing.At present,the application of the seamless nursing management model on health education in surgery patients of otolaryngological department has not been reported in the literature,this study use seamless nursing management model applied the ENT surgery patients and evaluated the effect in primary hospital,to provide scientific basis for clinical nursing work in primary hospital.Objective1.Based on seamless nursing management model,combined with the characteristics of hospital medical and nursing in primary hospital,provided seamless nursing management model on health education in surgery patients of otolaryngological department,to explore suitable seamless nursing management model for surgery patients.2.To carry out the effects of seamless nursing management model on health education,to explore the effects of health education on cognitive level of disease,healthy attitudes and behaviors,anxiety status,the routine nursing quality of care and nursing satisfaction in surgery patients of otolaryngological department,to provide scientific basis for clinical nursing work.Methods1.This study used nonsynchronous control methods,by convenience sampling method,274 surgery patients from Jiangyin people's Hospital between November 2015 and February 2016 were enrolled.According to the admission time,patients were divided into the observation group and the control group,137 cases in each group.The control group was given the routine surgical treatment,traditional nursing and routine health education,while the observation group was given the seamless nursing management model on health education,which was carried out by the operating room nurse,ward nurse and patient service center nurse formed the health education cooperation group.2.Patients characteristics(gender,age,education level,occupation,marital status,clinical diagnosis and anesthesia method)were collected.The otolaryngological department health education records were used to record the health education status,the otolaryngological department health knowledge,attitude and behavior questionnaire was used to evaluate the level of knowledge,attitude and behavior,the self-rating anxiety scale was used to evaluate the patients' anxiety,the nursing quality scale was used to evaluate the routine nursing quality of care,the psychological comfort and nursing satisfaction of patients.A comparative analysis was conducted on the preoperative hospitalization,hospitalization expenses,hospitalization time,complication and non-planned readmission rate in two groups of patients.Results1.There is no statistical difference in the aspect of age,gender,education level,occupation,marital status,clinical diagnosis and anesthesia method between the two groups(P>0.05).2.The rate of the related knowledge of otolaryngology:after intervention,the knowledge of otolaryngology of the two groups had improved,the knowledge of the complications(70.1%),the importance of surgical treatment(78.1%),preoperative examination(76.6%),preoperative preparation(70.8%),personal hygiene preparation(79.6%),the drug therapy(71.5%),postoperative rehabilitation(73.7%),preoperative analgesia(68.6%),postoperative diet(73.7%),the importance of psychological factors(70.1%),the importance of regular reexamination(83.9%)of the observation group were higher than the control group and before intervention(P<0.05 or P<0.01).3.The patients' health attitude of otolaryngology:after intervention,the attitude of express feeling(92.0%),the confidence in surgery and treatment(70.1%),compliance behavior(97.1%),the postoperative rehabilitation exercise(94.9%),looking for postoperative rehabilitation(97.8%),the trust in community care(78.3%)of the observation group were significantly higher than the control group(P<0.05 or P<0.01).4.The patients'health behavior of otolaryngology:after intervention,the behavior of participate in the formulation of postoperative rehabilitation(79.6%),surgical site self-nursing(85.4%),postoperative activity way(83.9%),seeking the control postoperative pain methods(74.5%),cough regularly(76.6%),keeping the oral hygiene clean(85.4%),drug compliance(89.8%),selecting the appropriate nutritional intake(86.9%),rehabilitation and functional exercise(83.9%),regular reexamination(86.9%)of the observation group were significantly higher than the control group(P<0.05 or P<0.01).5.The patients' anxiety:the percent of no anxiety(29.9%)and mild anxiety(43.8%)in observation group was higher than the control group,the percent of moderate anxiety(19.7%)and severe anxiety(6.6%)in observation group was lower than the control group,which is statistical difference(x2=14.085,P-0.003).6.The nursing quality of care:besides the rate of surgical wound bleeding treatment and the accuracy of nursing paperwork,the rate of hospitalization assessment in time(93.4%),observation of vital signs timely(95.6%),preoperative preparation(97.1%),treatment of complications(97.1%),pain assessment(93.4%)in the observation group was higher than the control group(P<0.05).7.The nursing satisfaction:There was no significant difference in the satisfaction of the medical environment(P>0.05),patients satisfaction was increased in the nurses' specialist skills(95.6%),nursing staff service attitude(94.2%),quality of basic nursing services(93.4%),health education(92.0%),mental invention(89.8%),overall satisfaction of nursing service quality(92.7%)in the observation group which is higher than the control group(P<0.05).8.The hospital-related index:there is no difference on the preoperative hospitalization(2.62±1.27)day,the hospitalization time(9.14±2.49)and the total hospitalization expenses(9891.64±2907.94)yuan between the observation group and the control group(P>0.05).9.The occurrence of complication and non-planned readmission:the rate of complication(2.2%)and non-planned readmission(0.7%)in the observation group was lower than the control group(P<0.05).ConclusionsThe seamless nursing management model on health education can improve the cognitive level of otolaryngology,positive attitude,health behavior,the nursing quality of care,as well as the patients' psychological comfort and nursing satisfaction,reduce patients' anxiety,as well as the complication rate and non-planned readmission,which is worth promoting application in clinical nursing work.