妇科护士加速康复外科理念知信行现状的调查研究

doi:10.3761/j.issn.1672-9234.2024.06.012

摘要/Abstract

摘要：

目的了解妇科护士加速康复外科（enhanced recovery after surgery，ERAS）理念知信行现状。方法 2023年8月，采取便利抽样法和滚雪球抽样法，选取来自20个省份的1 553名妇科护士作为调查对象，采用一般资料调查表、妇科护士ERAS理念知信行问卷对其进行调查。结果共回收有效问卷1 470份，有效问卷回收率为94.66%。1 470名妇科护士ERAS理念知信行得分分别为（15.75±3.53）分、（23.57±2.62）分、（94.58±19.39）分。所在医院类别、所在科室床位数、ERAS实施时间、ERAS相关指南内容知晓情况、所在科室ERAS相关规章或流程拥有情况、成立ERAS小组情况、组织开展ERAS相关培训情况不同的妇科护士ERAS理念知信行得分比较，差异均有统计学意义（P<0.05）。结论妇科护士对ERAS的态度较为积极，但知识、行为水平仍有较大提升空间。护理管理者应注重对妇科护士ERAS理念知信行水平的评估，并基于妇科护士ERAS理念知信行水平特征对其进行针对性的干预，进而提高其ERAS理念知信行水平，保障ERAS在妇科手术围术期管理中的顺利实施，提升其实施效果。

关键词: 加速康复外科, 护理, 知信行, 现状调查

Abstract:

Objective To explore the current status of knowledge，attitude，and practice（KAP） related to enhanced recovery after surgery（ERAS） among gynecological nurses. Methods In August 2023，a convenience sampling method was used to select 1 553 gynecological nurses from 20 provinces as the survey participants. A general information questionnaire and a gynecological nurse ERAS KAP questionnaire were used to conduct the survey. Results A total of 1 470 valid questionnaires were collected，with a recovery rate of 94.66%. The scores of KAP related to ERAS among the 1 470 gynecological nurses were（15.75±3.53），（23.57±2.62），and（94.58±19.39），respectively. Comparisons of ERAS knowledge，attitudes，and practices among gynecological nurses who work in different types of hospitals，numbers of beds in their departments，implementation time of ERAS，awareness of ERAS-related guidelines，departments with differing availability of ERAS-related regulations or procedures，departments with varying statuses of ERAS team establishment，and departments with different levels of organization for ERAS-related training revealed statistically significant differences（P<0.05）. Conclusion Gynecological nurses have a positive attitude towards ERAS，but their knowledge and practice levels still need to be improved. Nursing managers should focus on assessing the KAP levels of gynecological nurses related to ERAS and implement targeted interventions based on their characteristics to improve their KAP levels and enhance the quality of gynecological ERAS nursing.

Key words: Enhanced recovery after surgery, Nursing, Knowledge, attitude and practice, Currency survey

龚晶晶, 白莲花, 魏小停, 付立, 李晓丹, 刘媛媛. 妇科护士加速康复外科理念知信行现状的调查研究[J]. 中华护理教育, 2024, 21(6): 711-717.

GONG Jingjing, BAI Lianhua, WEI Xiaoting, FU Li, LI Xiaodan, LIU Yuanyuan. The current status of knowledge，attitude，and practice of enhanced recovery after surgery among gynecological nurses[J]. Chinese Journal of Nursing Education, 2024, 21(6): 711-717.

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参考文献 18

[1]	Agarwal R, Rajanbabu A, P V N 5th, et al. A prospective study evaluating the impact of implementing the ERAS protocol on patients undergoing surgery for advanced ovarian cancer[J]. Int J Gynecol Cancer, 2019, 29(3):605-612. doi: 10.1136/ijgc-2018-000043 pmid: 30833445
[2]	Meyer LA, Shi QL, Lasala J, et al. Comparison of patient reported symptom burden on an enhanced recovery after surgery(ERAS) care pathway in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery[J]. Gynecol Oncol, 2019, 152(3):501-508.
[3]	Silva Filho ALD, Santiago AE, Derchain SFM, et al. Enhanced recovery after surgery(ERAS):new concepts in the periopera-tive management of gynecologic surgery[J]. Rev Bras Ginecol Obstet, 2018, 40(8):433-436.
[4]	Møller C, Kehlet H, Friland SG, et al. Fast track hysterectomy[J]. Eur J Obstet Gynecol Reprod Biol, 2001, 98(1):18-22. pmid: 11516794
[5]	Nelson G, Altman AD, Nick A, et al. Guidelines for postopera-tive care in gynecologic/oncology surgery:Enhanced Recovery After Surgery(ERAS^®) Society recommendations:part Ⅱ[J]. Gynecol Oncol, 2016, 140(2):323-332. doi: 10.1016/j.ygyno.2015.12.019 pmid: 26757238
[6]	Nelson G, Altman AD, Nick A, et al. Guidelines for pre-and intra-operative care in gynecologic/oncology surgery:enhanced Recovery After Surgery(ERAS) Society recommendations:part I[J]. Gynecol Oncol, 2016, 140(2):313-322. doi: 10.1016/j.ygyno.2015.11.015 pmid: 26603969
[7]	中华医学会妇产科学分会加速康复外科协作组. 妇科手术加速康复的中国专家共识[J]. 中华妇产科杂志, 2019, 54(2):73-79.
[8]	龚晶晶, 付立, 白莲花, 等. 加速康复外科理念在妇科肿瘤临床应用中障碍因素的质性研究[J]. 中国护理管理, 2023, 23(11):1610-1615.
	Gong JJ, Fu L, Bai LH, et al. Obstacles to clinical practice of Enhanced Recovery After Surgery in gynecologic oncology:a qualitative study[J]. Chin Nurs Manag, 2023, 23(11):1610-1615.
[9]	孙政, 古维立, 曹杰. 加速康复外科应用的现状及展望[J]. 广东医学, 2016, 37(18):2699-2701.
[10]	朱斌, 黄建宏. 加速康复外科在我国发展现状、挑战与对策[J]. 中国实用外科杂志, 2017, 37(1):26-29.
	Zhu B, Huang JH. The development,challenges and strategies of enhanced recovery after surgery in China[J]. Chin J Pract Surg, 2017, 37(1):26-29.
[11]	欧阳振波, 尹倩, 吴嘉雯, 等. 国际ERAS协会妇科/妇科肿瘤围手术期指南2019年更新解读[J]. 现代妇产科进展, 2020, 29(3):226-229.
[12]	王丹. 外科医护人员对加速康复外科知信行现状的调查研究[D]. 济南: 山东大学, 2018.
	Wang D. The study on the knowledge,attitude and practice (KAP) of surgical staff on enhanced recovery after surgery (ERAS)[D]. Jinan: Shandong University, 2018.
[13]	罗颖, 汪晖, 范婷, 等. 护士对加速康复外科认知、参与状况及提升策略的研究进展[J]. 中国护理管理, 2020, 20(8):1262-1265.
	Luo Y, Wang H, Fan T, et al. Research progress on nurses’ cognition,participation and promotion strategies of Enhanced Recovery After Surgery[J]. Chin Nurs Manag, 2020, 20(8):1262-1265.
[14]	朱晓红, 张丽晓, 张艳. 普外科护士结直肠手术快速康复外科护理知识的调查研究[J]. 护理研究, 2015, 29(21):2651-2653.
	Zhu XH, Zhang LX, Zhang Y. Investigation on fast-track surgery nursing knowledge of nurses in department of general surgery on colorectal operation[J]. Chin Nurs Res, 2015, 29(21):2651-2653.
[15]	赵文文, 杨涵琳, 任小玉, 等. 贵阳市某三甲医院妇产科医护人员加速康复外科知信行现状及讲座的干预效果[J]. 贵州医科大学学报, 2024, 49(1):115-120.
	Zhao WW, Yang HL, Ren XY, et al. Status quo of accelerated rehabilitation surgery knowledge-attitude-practice and effect of lecture intervention from medical staff of obstetrics and gynecology in grade A tertiary hospital of Guiyang[J]. J Guizhou Med Univ, 2024, 49(1):115-120.
[16]	张馨予, 宁宁, 李佩芳, 等. 外科医护人员对加速康复外科知信行现状的调查研究[J]. 中华现代护理杂志, 2016, 22(33):4790-4795.
	Zhang XY, Ning N, Li PF, et al. Study on the status of knowledge,attitude and practice in ERAS among surgical medical staff and its influencing factors[J]. Chin J Mod Nurs, 2016, 22(33):4790-4795.
[17]	许晨丽, 王翠玲. 医护人员加速康复外科理念知信行的研究进展[J]. 中华现代护理杂志, 2019, 25(2):133-136.
	Xu CL, Wang CL. Research progress on knowledge-attitude-practice of enhanced recovery after surgery among health care provider[J]. Chin J Mod Nurs, 2019, 25(2):133-136.
[18]	程黎阳. 快速康复外科的现状分析与前景展望[J]. 实用医学杂志, 2012, 28(1):1-4.