Construction And Application Of TPB Nursing Model For Patients With Lumbar Disc Herniation

BackgroundLumbar disc herniation(LDH)has risen to become the most common chronic disease among non-fatal diseases in recent years.Because of the characteristics of pain,easy to relapse and chronic delay,it brings serious psychological pressure to patients,causes serious negative emotions in patients and affects the quality of life of patients and their families.The Theory of Planned Behavior(TPB)may motivate patients to have positive behavior attitude,increase relatives’and friends’ motivation,assistance,and support.And increase the patient’s inner confidence level,reducing discomfort and aiding disease recovery.ObjectiveBased on the theory of planned behavior,this study constructed the nursing model of conservative treatment for LDH patients.Through the application of this nursing mode,we can provide more effective nursing services for LDH patients and improve the quality of life of patients.Methods1.A semi-structured interview outline was developed using the literature review process,the formation of a research team,and the guidance of TPB’s theoretical framework,and 13 medical staff working in spinal surgery were interviewed.The study team compiled,analyzed,and sorted the interview findings into a preliminary index system called primary,Secondary and Tertiary Nursing Index System.Expert inspection method:15 long-term nursing experts engaged in spinal surgery were selected to conduct two rounds of expert investigation on the initially formed primary,secondary and third level index system to form the final nursing model.2.A total of 110 patients with LDH conservative treatment who were hospitalized in the spinal surgery department of a third-class A military hospital in Zhengzhou from July 2019 to June 2020 were selected as the research objects.The patients were divided into groups according to the random sampling method.The control group(55 cases)were given conventional nursing measures,while the experimental group(55 cases)were given TPB nursing mode on the basis of conventional nursing.At admission,discharge,1 month after discharge,3 months after discharge,and 6 months after discharge,the Morisky compatible behavior scale,self-rating anxiety scale(SAS),visual analogue scale(VAS),and Oswestry disability index(ODI)were used to evaluate compliance behavior,anxiety,lumbar pain and disability of patients in the two groups,and the number of repeated visits was compared between the two groups.3.Statistical methods:the collected data is entered and plotted into excel 2016,and spss23.0 statistical software was also used to process and analyze the data.The measurement data were displayed by means and standard deviation,while the frequency and rate showed the counting data.Test methods such as single-sample t-test and independent-sample t-test showed specific statistical significance.Results1.semi-structured interview results:the overall cognitive level of LHD patients is poor,and there are significant differences in the cognitive level of occupational characteristics and educational level;LHD patients need more encouragement and support from relatives,doctors and patients,but less encouragement and support from daily treatment,rehabilitation and life;LHD patients generally have poor ability to control their own behavior,and the consciousness level of active cooperation in treatment,nursing or rehabilitation is general.There are significant differences in the ability of controlling their own behavior among age,education level and residence.2.Delphi expert inquiry results:there were 15 experts participating in the two rounds,the positive coefficient of experts was 100%,the authority coefficient of experts was 0.88.In the first round of inquiry,8 indicators were deleted,4 indicators were modified and 5 indicators were added.The Kendall harmony coefficient of the first,second and third level indicators were 0.00,0.20 and 0.05 respectively;The first,second and third level indexes of Kendall’s harmony coefficient of the second round of experts consultation were 0.00,0.20 and 0.45 respectively,and the coordination of experts is good.The final nursing model was formed after group discussion.3.The clinical application of TPB nursing mode showed:there was no significant difference in general data between the two groups(P>0.05)after developing a TPB-based nursing model and carrying out clinical applications.Before intervention,there were no significant differences in Morisky compliance behavior scale,SAS,VAS and ODI scores between two groups(P>0.05).At 1 month,3 months and 6 months after discharge,the scores of Morisky compliance behavior scale in the experimental group were significantly higher than those in the control group(P<0.05).The scores of SAS in the experimental group were significantly lower than those in the control group(P 0.05).The scores of vas and ODI in the experimental group were significantly lower than those in the control group(P 0.05),The difference was statistically significant(P<0.05).ConclusionThe TPB nursing mode on the nursing problems of the experimental group patients effectively improved the compliance of patients with lumbar disc herniation,alleviated anxiety and waist pain,reduced the dysfunction,reduced the rate of patient outpatient visit,and improved the quality of life.