四手操作配合“知信行”健康宣教在根管治疗中的应用及效果评价

  目的  探讨四手操作配合“知信行”健康宣教在根管治疗中的应用及效果评价。  方法  选取2019年1月—2020年1月期间于新疆医科大学第一附属医院牙体牙髓科行根管治疗的100例患者作为研究对象，采用随机数字表法随机分为观察组(50例)和对照组(50例)。对照组采用传统操作护理配合+常规健康教育，观察组采用四手操作护理+“知信行”健康宣教。对比2组根管治疗时间、术后患牙疼痛视觉模拟评分(VAS)、肿胀发生率，以及干预前后的汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、自我护理能力测定量表(ESCA)评分以及随访情况。  结果  干预后，观察组的根管治疗时间(26.45±5.73)分、术后疼痛VAS评分(3.36±1.12)分和术后肿胀发生率4.00%、HAMA评分(13.13±2.46)分、HAMD评分(7.29±1.45)分均低于对照组的(34.69±6.24)分、(4.28±1.34)分、16.00%、(15.47±2.31)分、(8.53±2.06)分(均P＜0.05)；且观察组患者ESCA总分(125.82±6.53)分高于对照组的(112.03±7.55)分，差异有统计学意义(P＜0.05)。随访期间，观察组暂存物脱落发生率为8.00%，低于对照组的24.00%(P＜0.05)，按时复诊和全冠修复患者占比为92.00%和78.00%，明显高于对照组的74.00%、58.00%(均P＜0.05)。  结论  采用四手操作配合“知信行”健康宣教护理根管治疗患者能明显缩短手术治疗时间，改善患者心理状态，减轻患者术后疼痛感，并提高患者自我护理能力和按时复诊率。 

Application and effects of four-hand operation combined with knowledge-attitude-belief practice health education in root canal therapy

  Objective  To explore the application and effects of four-hand operation combined with knowledge-attitude-belief practice (KABP) health education in root canal therapy.  Methods  A total of 100 patients who underwent root canal therapy at the Endodontics Department of our hospital from January 2019 to January 2020 were enrolled as the research objects. They were divided into the observation group (n=50) and control group (n=50) by random number table method. The control group was given traditional operation nursing combined with routine health education, whereas observation group was given four-hand operation nursing combined with KABP health education for intervention. The time of root canal therapy, score of offending teeth visual analogue scale (VAS) after surgery, incidence of swelling, scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and exercise of self-care agency scale (ESCA) before and after intervention and follow-up situations were compared between the two groups.  Results  After intervention, root canal treatment therapy, score of postoperative VAS, incidence of postoperative swelling, and scores of HAMA and HAMD in the observation group were all lower than those in the control group(26.45±5.73) points, (3.36±1.12) points, 4.00%, (13.13±2.46) points, (7.29±1.45) points vs. (34.69±6.24) points, (4.28±1.34) points, 16.00%, (15.47±2.31) points, (8.53±2.06) points, all P < 0.05]. The total score of ESCA in the observation group was higher than that in the control group(125.82±6.53) points vs. (112.03±7.55) points, P < 0.05]. During follow-up, the incidence of temporary objects shedding in the observation group was lower than that in the control group (8.00% vs. 24.00%, P < 0.05), whereas the proportions of patients undergoing regular subsequent visit and full crown restoration were significantly higher than those in the control group (92.00%, 78.00% vs. 74.00%, 58.00%, all P < 0.05).  Conclusion  The application of four-hand operation combined with KABP health education for nursing intervention in patients undergoing root canal therapy can significantly shorten surgical treatment time, improve psychological status, alleviate postoperative pain and improve self-care ability and the incidence of regular subsequent visit.