基于患者旅程地图的全程护理模式在血液病患者中的应用研究 [中文引用][英文引用]

目的  探讨基于患者旅程地图的全程护理模式在血液病患者中的应用效果。方法  采用便利抽样方法，选取2023 年 1 月— 12 月在天津市某三级甲等血液病专科医院住院的 268 例血液病患者作为调查对象。在患者入院 24h 内进行基线评估，并在住院期间结合常规护理，实施基于患者旅程地图的全程护理模式，围绕“就诊 - 诊断 - 治疗 - 康复 - 随访”5 个阶段进行干预。前 3 阶段分别实施一对一沟通、评估及指导 - 监督 - 管理，干预时间在 20~40min；居家康复及随访阶段，每 2w 专职随访护士通过线上平台对患者进行 1 次护理干预，时间 30min，直至患者第二次入院时结束。比较干预前后患者的营养风险、心理状态、睡眠质量和自我护理能力。结果  260 例血液病患者完成研究。血液病患者营养风险筛查评分、焦虑评分、抑郁评分、睡眠质量评分干预后低于干预前，自我护理能力评分干预后高于干预前，干预前后比较，差异具有统计学意义（均 P<0.01）。结论  基于患者旅程地图的全程护理可改善血液病患者睡眠质量，降低营养风险，提高自我护理能力水平，缓解负性情绪。

Objective To explore the impact of a Patient Journey Mapping（PJM）whole-course nursing model based on inpatients with haematological diseases. Methods Convenience sampling was used to recruit 268 patients with haematological diseases and hospitalised in a Tire-IIIA specialised haematological hospital in Tianjin from January to December 2023. Baseline assessments on patients were conducted within 24 hours after admission. During hospitalisation a patient journey map based on whole-courses nursing model was implemented in addition to routine nursing care，with interventions delivered across five stages:“seeing a doctor，diagnosis， treatment，recovery and outpatient follow-up”. One-to-one communication，assessment and guidance-supervision-management nursing interventions were implemented in the first three stages，with a duration of 20-40 minutes. Over the home-based rehabilitation and follow-up stages，nurses who were in charge of follow-up provided a 30-minute online nursing instructions to every patient at once a fortnight until re-admission of the patient. The nutritional risk，psychological state，sleep quality and self-care ability of the patients were compared before and after the intervention. Results A total of 260 patients completed the study. The mean scores of nutritional risk screening，anxiety，depression，sleep quality and self-care ability showed statistically significant differences between pre- and post- intervention（all P<0.01），where the mean scores of nutritional risk screening, anxiety，depression and sleep quality were lower post- intervention than those pre-intervention，self-care ability was higher. Conclusion The whole-course nursing model based journey map can improve sleep quality，reduce nutritional risk，enhance self-care ability and alleviate negative emotions in patients with haematological diseases.