2019 年第 11 期 第 14 卷

基于信息-动机-行为技巧模型模式的干预对膀胱肿瘤术后膀胱灌注化疗依从性和效果的影响

Effect of information-motivation-behavioral skills model on patient compliance and effectiveness of intravesical chemotherapy after bladder tumor surgery

作者：钱丽萍傅巧美王良梅张青

英文作者：

单位：210008南京大学医学院附属鼓楼医院南京鼓楼医院泌尿外科

英文单位：

关键词：膀胱肿瘤；信息-动机-行为技巧模型模式；护理干预；膀胱灌注化疗；负性情绪；生存质量；并发症

英文关键词：

• 摘要：

• 【摘要】目的    探讨基于信息-动机-行为技巧模型（IMB）模式的干预对膀胱肿瘤术后膀胱灌注化疗依从性和效果的影响。方法    选择2017年1月至2018年1月南京大学医学院附属鼓楼医院收治的行常规护理的膀胱肿瘤术后膀胱灌注化疗患者49例作为对照组，另选择2018年2月至2019年2月本院收治的行IMB模式干预的膀胱肿瘤术后膀胱灌注化疗患者49例作为观察组。对比2组化疗依从性、干预前后负性情绪、生存质量变化及并发症发生率情况。结果    观察组化疗依从性高于对照组［98.0%（48/49）比81.6%（40/49）］，差异有统计学意义（χ2=7.127，P=0.008）。干预后观察组焦虑自评量表、抑郁自评量表评分低于对照组［（46±5）分比（50±5）分、（48±6）分比（54±6）分］，差异均有统计学意义（均P＜0.01）。干预后观察组躯体功能、认知功能、角色功能、情绪功能、社会功能、生存质量总评分均高于对照组［（74±5）分比（62±5）分、（67±7）分比（56±7）分、（73±5）分比（63±5）分、（70±8）分比（59±7）分、（73±6）分比（61±6）分、（71±5）分比（60±6）分］，差异均有统计学意义（均P＜0.01）。观察组总并发症发生率低于对照组［10.2%（5/49）比44.9%（22/49）］，差异有统计学意义（χ2=14.774，P<0.001）。结论    基于IMB模式的干预应用于膀胱肿瘤术后膀胱灌注化疗患者可提高化疗依从性，缓解负性情绪，改善生存质量，降低并发症发生率。

• 【Abstract】Objective    To investigate the effect of information-motivation-behavioral skills(IMB) model on patient compliance and effectiveness of intravesical chemotherapy after bladder tumor surgery. Methods    Forty-nine patients who had intravesical chemotherapy after bladder tumor surgery from January 2017 to January 2018 treated with routine nursing care in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were enrolled as control group; 49 patients treated with IMB-based intervention from February 2018 to February 2019 were enrolled as observation group. Compliance of patients, negative emotions, quality of life and incidence of complications were analyzed. Results    Compliance of patients in observation group was significantly better than that in control group［98.0%（48/49） vs 81.6%（40/49）］（χ2=7.127, P=0.008）. Scores of Self-rating Anxiety Scale and Self-rating Depressive Scale after intervention in observation group were significantly lower than those in control group［（46±5） vs （50±5）, （48±6） vs （54±6）］(both P<0.01). Scores of physical function, cognitive function, role function, emotional function, social function and the total quality of life score after intervention in observation group were significantly higher than those in control group［（74±5） vs （62±5）, （67±7） vs （56±7）， （73±5） vs （63±5）, （70±8） vs （59±7）, （73±6） vs （61±6）, （71±5） vs （60±6）］(all P<0.01). Incidence of complications in observation group was significantly lower than that in control group［10.2%（5/49） vs 44.9%（22/49）］（χ2=14.774，P<0.001）. Conclusion    IMB-based intervention in patients having intravesical chemotherapy after bladder tumor surgery can improve the compliance, relieve negative emotions, improve quality of life, and reduce the incidence of complications.