| Objective:Based on the guidance of Peplau's interpersonal relationship theory,the CICARE communication model was used to complete the communication of patients with ectopic pregnancy under the scenes of admission and discharged education,treatment plan introduction,preoperative preparation,postoperative propaganda,as well as basic nursing and auxiliary examination and so on.To explore the impact of this intervention model compared with“responding to the scene”nurse-patient communication on disease uncertainty,state anxiety and satisfaction in patients with ectopic pregnancy.Methods:This study is divided into two parts.The first part of this study based on the literature review and discussion of the research group initially formed the CICARE communication model template for ectopic pregnancy patients in different scenarios,and then was refined and modified by the Delphi expert consultation method to construct the final CICARE communication model template for ectopic pregnancy patients.The second part of this study used randomized controlled trial.From December 2018 to August 2019,104 subjects who met the inclusion criteria were selected in the gynecology department of The Fifth Affiliated Hospital of the Zunyi Medical University.They were randomly divided into a control group and an intervention group,each with 52 participants.Both groups received the same treatment plan and nursing measures during their hospitalization.The patients in the control group adopted the“responding to the scene”nurse-patient communication.Based on the guidance of Peplau's interpersonal relationship theory,patients in the intervention group adopted the established CICARE communication template to conduct nurse-patient communication.Data on general demographic characteristics,disease related data,disease uncertainty level and state anxiety level were collected and evaluated on the day of admission.After all interventions were completed on the day of discharge,the patient's disease uncertainty level,state anxiety level and satisfaction with nursing work were evaluated again.SPSS22.0 software was used to analyze the data of the first part and second part of this study.Results:(1)The first part of this study based on the literature review and discussion of the research group,12 communication scenarios and a total of 49 communication contents under each communication scenario were preliminarily formulated.A total of 20 experts from nine third-level general hospitals and women and children's special hospitals in Guangdong,Hunan,and Sichuan participated in the Delphi expert consultation in this study.The recovery rates of the first and second round of expert consultation questionnaires were 100%and 90%respectively,and the expert authority coefficient was0.88.After two rounds of expert consultation,the CICARE communication model template for patients with ectopic pregnancy was constructed,which contains 17 communication scenarios and a total of 68 communication contents under each communication scenario.By Kendall W test,the coordination coefficients of the first and second indexes were0.32(?~2=93.13,P<0.05)and 0.30(?~2=353.30,P<0.05),respectively.(2)A total of 104subjects participated in the second study,5 patients lost to follow-up in the trial.There was no difference in the characteristics of general demographic data,disease-related data,disease uncertainty score,and state anxiety score between the two groups of patients before intervention(P>0.05).(3)Two independent sample t tests were used to compare the level of disease uncertainty after intervention between the two groups of patients.The results showed that the total score of disease uncertainty(t=8.57,P<0.05),complexity dimension(t=4.17,P<0.05)and uncertainty dimension(t=7.55,P<0.05)of the intervention group were lower than those of the control group,and the difference was statistically significant.Paired sample t test was used to compare the changes in the level of disease uncertainty before and after intervention in the two groups respectively.The results showed that after intervention,the total score of disease uncertainty(the control group:t=24.21,P<0.05;the intervention group:t=38.92,P<0.05),complexity dimension(the control group:t=19.82,P<0.05;the intervention group:t=26.50,P<0.05)and uncertainty dimension(the control group:t=23.69,P<0.05;the intervention group:t=37.70,P<0.05)of the two groups were all lower than those before,and the difference was statistically significant.(4)Two independent sample t test was used to compare the state anxiety level of the two groups after intervention.The results showed that the state anxiety score of the intervention group was lower than that of the control group,and the difference was statistically significant(t=3.77,P<0.05).Paired sample t test was used to compare the changes of state anxiety before and after intervention in the two groups respectively.The results showed that after intervention,the score of state anxiety of the two groups were lower than those before,and the difference was statistically significant(the control group:t=13.83,P<0.05;the intervention group:t=18.67,P<0.05).(5)Two independent samples t test and two independent samples non-parametric Mann-Whieney U test were used to compare the satisfaction differences between the two groups of patients.Patients in the intervention group had higher overall satisfaction scores(t=-6.37,P<0.05),nursing services(t=-2.82,P<0.05),and nurse-patient communication(t=-8.11,P<0.05)dimensions than the control group,with significant differences.There was no difference between the two groups in the dimensions of nursing system(t=-1.60,P>0.05)and nursing environment(z=-0.28,P>0.05).Conclusion:(1)In the Delphi Expert Consultation for this study,experts had a high degree of coordination and recognition of the CICARE communication template,which can provide a reference for gynaecological nurses to complete admission and discharged education,treatment plan introduction,preoperative preparation,postoperative propaganda,basic nursing,auxiliary examination and so on.(2)Based on the guidance of Peplau's interpersonal relationship theory,CICARE communication template can reduce the disease uncertainty and the state anxiety of patients with ectopic pregnancy during hospitalization.It can improve the nursing satisfaction of patients with ectopic pregnancy,and improve the communication efficiency and the quality of nursing service. |
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