微信在妇科腔镜术后患者随访中的应用

doi:10.3969/j.issn.1006-9771.2020.09.020

摘要/Abstract

摘要：

目的探讨微信平台对妇科腔镜手术后患者出院后随访中的应用价值。
方法 2018年10月至2019年9月期间接受妇科腔镜手术的患者84例,分为对照组和微信组,各42例。出院后,两组均进行相同内容的健康教育,包括伤口护理、院后康复训练指导等,对照组发放纸质材料,常规电话随访;微信组通过微信发放材料及随访,与患者沟通时可上传文本、语音、视频等资料。每周2次,至术后3~4周,最后一次为门诊面对面方式。出院当日和随访结束时采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和情感量表-2进行调查,并进行满意度调查。
结果对照组失访7例。微信组满意度优于对照组(χ ² > 4.614, P < 0.05)。末次随访时,微信组SAS、SDS和情感量表-2评分均显著改善(| t| > 16.255, P < 0.001),且显著优于对照组(| t| > 10.293, P < 0.001);对照组在干预前后各量表评分变化不明显(| t| < 1.950, P > 0.05)。
结论基于微信平台的随访对妇科腔镜术后患者的心理康复有积极影响。

关键词: 妇科腔镜术, 延续康复, 微信, 心理, 满意度, 护理

Abstract:

Objective To apply WeChat platform for discharged patients after gynecological laparoscopic surgery.
Methods From October, 2018 to February, 2019, 84 patients accepted gynecological laparoscopic surgery were followed up with telephone (control group,n = 42) or WeChat (WeChat group, n = 42) from discharge to three to four weeks after surgery. They were assessed with Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Affectometer 2 on the day of discharge and the last day of follow-up.
Results Seven cases lost in the control group. The comprehensive satisfaction and satisfaction to recovery were better in WeChat group than in the control group (χ ² > 4.614, P < 0.05). The scores of SAS, SDS and Affectometer 2 improved in WeChat group (| t| > 16.255, P < 0.001), and were better than those in the control group (| t| > 10.293, P < 0.001). There were no significant improvement in the control group (| t| < 1.950, P > 0.05).
Conclusion Follow-up based on WeChat platform is effective on psychological recovery and satisfaction after gynecological laparoscopic surgery.

Key words: gynecological endoscopic surgery, continuous rehabilitation, WeChat, psychology, satisfaction, nursing

于飞,侯坤,曹京红,翟建军,孙凤梅,龙志华. 微信在妇科腔镜术后患者随访中的应用[J]. 《中国康复理论与实践》, 2020, 26(9): 1107-1111.

YU Fei,HOU Kun,CAO Jing-hong,ZHAI Jian-jun,SUN Feng-mei,LONG Zhi-hua. Application of WeChat in Following-up after Gynecological Laparoscopic Surgery[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(9): 1107-1111.

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项目		对照组(n = 35)	微信组(n = 42)	χ²值	P值
年龄	20~40岁	20	27	0.164	0.685
	41~60岁	15	15
婚姻状况	单身	0	2	0.298	0.226
	已婚	33	39
	离异及丧偶	2	1
工作种类	事业单位	19	25	0.765	0.858
	公司企业	13	12
	农民	1	2
	其他	2	3
医保类型	医保	35	42	< 0.001	1.000
	自费	0	0
家庭月收入	≤ 5000元	2	2	< 0.001	1.000
	> 5000元	33	40
腔镜手术	子宫肌瘤切除	11	13	0.019	0.999
	单侧卵巢良性肿瘤切除	8	10
	双侧卵巢良性肿瘤切除	9	11
	全子宫切除术	7	8

时间	方式	内容
第1周	PPT讲解锻炼操视频放松训练及音乐治疗视频	结合出院时发放的纸质资料,PPT讲解切口保护、切口常见并发症处理、术后切口疼痛管理;腹腔镜手术后排便管理与饮食推荐;腹腔镜手术后心理康复指导推荐意见;腹腔镜手术后康复及运动训练指导;放松训练及音乐治疗视频
第2周	讲解与演示放松训练及音乐治疗视频	术后切口保护与洗浴要求;腹腔镜术后康复及盆底康复运动训练;腹腔镜术后心理康复指导;腹腔镜术后复查要求;常见妇产科疾病基本知识;放松训练及音乐康复指导
第3周	PPT讲解	腹腔镜术后康复及运动训练;盆底康复训练;家庭康复训练;腹腔镜术后心理康复指导;腹腔镜手术后复查要求与提醒;放松训练及音乐治疗;性生活答疑与后续综合治疗答疑

组别	n	出院时	末次随访	t值	P值
对照组	35	59.02±10.53	58.68±8.78	0.678	0.502
微信组	42	56.78±11.16	36.66±5.19	19.979	< 0.001
t值		-0.900	-13.051
P值		0.371	< 0.001

组别	n	出院时	末次随访	t值	P值
对照组	35	57.31±10.22	56.82±8.92	0.973	0.338
微信组	42	57.45±10.13	38.45±6.18	23.270	< 0.001
t值		0.059	-10.293
P值		0.953	< 0.001

组别	n	出院时	末次随访	t值	P值
对照组	35	13.40±2.98	14.14±3.27	-1.950	0.059
微信组	42	14.42±3.83	23.61±4.19	-16.255	< 0.001
t值		1.293	10.880
P值		0.200	< 0.001