反转式教育模式在神经源性膀胱患者行清洁间歇导尿中的应用

陈琰琰; 刘晓莉; 陶爱萍; 贾曼; 潘森森; 王成贵

doi:10.16766/j.cnki.issn.1674-4152.004315

反转式教育模式在神经源性膀胱患者行清洁间歇导尿中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004315

温州医科大学附属第二医院骨关节康复科，浙江温州 325000

基金项目:

浙江省自然科学基金项目 LY23H060006

温州市基础性科研项目 Y20240486

详细信息

通讯作者:
贾曼，E-mail：jiajiamanman36@163.com

中图分类号: R473.6 R694.6
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- 文章访问数: 14
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出版历程
- 收稿日期: 2025-07-14
- 网络出版日期: 2026-03-13

The application of the teach-back education model in clean intermittent catheterization for patients with neurogenic bladder

Department of Bone and Joint Rehabilitation, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨反转式教育模式在神经源性膀胱患者行清洁间歇导尿中的应用效果，分析对脊髓损伤后神经源性膀胱患者膀胱功能、满意度及依从性的影响，为制定患者康复方案提供参考。方法采用便利抽样法，选取2023年6月—2025年6月温州医科大学附属第二医院收治的80例脊髓损伤并发神经源性膀胱患者为研究对象，按患者就诊顺序将患者进行排序编号，按随机数字表分为对照组和干预组，每组各40例。对照组给予常规清洁间歇导尿术(CIC)教育，干预组在常规护理基础上，开展基于智慧护理的反转式教育干预，比较2组患者膀胱功能、满意度及依从性。结果接受反转式教育模式干预的神经源性膀胱患者膀胱容量为(327.64±25.44)mL，高于对照组的(299.07±24.72)mL，膀胱残余尿量为(102.05±9.04)mL，低于对照组的(110.25±9.16)mL；尿路感染发生率(2.50%，1/40)低于对照组(15.00%, 6/40)，差异均有统计学意义(P＜0.05)；满意度总分及各维度得分均高于对照组，差异均有统计学意义(P＜0.05)；干预组依从性高于对照组，差异有统计学意义(P＜0.05)。结论反转式教育模式应用于神经源性膀胱患者行清洁间歇导尿能够有效提高患者膀胱功能，降低泌尿系统感染率，提高患者满意度及依从性，可以在临床上推广使用。
- 反转式教育模式 /
- 神经源性膀胱 /
- 清洁间歇导尿术 /
- 膀胱功能 /
- 满意度 /
- 依从性
Abstract: Objective To explore the application effect of the teach-back education model in clean intermittent catheterization for patients with neurogenic bladder. Analyzes its influence on bladder function, satisfaction, and compliance of patients with neurogenic bladder after spinal cord injury, and provides a reference for formulating rehabilitation plans for patients. Methods By using the convenience sampling method, 80 patients with neurogenic bladder after spinal cord injury in the Second Affiliated Hospital of Wenzhou Medical University from June 2023 to June 2025 were selected as the research subjects. The patients were ranked and numbered according to the order of their visit. The 80 patients were divided into the control group and the intervention group according to the random number table, with 40 patients in each group. The control group was given conventional CIC education, while the intervention group, on the basis of conventional care, carried out a teach-back educational intervention based on smart nursing. The bladder function, satisfaction, and compliance of the two groups of patients were compared. Results The bladder capacity of patients with neurogenic bladder who received the teach-back education model intervention was (327.64±25.44) mL, which was higher than that of the control group (299.07±24.72) mL, the residual urine volume of the bladder was (102.05±9.04) mL, which was lower than that of the control group (110.25±9.16) mL, and the incidence of urinary tract infection was 2.50% (1/40), which was lower than that of the control group (15.00%, 6/40). The differences were statistically significant (P < 0.05). The total score of satisfaction and the scores of each dimension were all higher than those of the control group, and the differences were statistically significant (P < 0.05). The compliance was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion The application of the teach-back education model in clean intermittent catheterization for patients with neurogenic bladder can effectively improve the bladder function of patients, reduce the infection rate of the urinary system, increase patient satisfaction and compliance, and can be promoted and used in clinical practice.
- Teach-back education model /
- Neurogenic bladder /
- Clean intermittent catheterization /
- Bladder function /
- Satisfaction /
- Compliance

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表 1 2组脊髓损伤后NB患者一般资料比较

Table 1. Comparison of general data between the two groups of NB patients after spinal cord injury

项目	干预组(n=40)	对照组(n=40)	统计量	P值
年龄(x±s，岁)	48.74±6.92	49.26±7.08	0.332^a	0.741
性别[例(%)]			0.205^b	0.651
男性	24(60.00)	22(55.00)
女性	16(40.00)	18(45.00)
婚姻状况[例(%)]			0.267^b	0.606
在婚	31(77.50)	29(72.50)
未婚、离异或丧偶	9(22.50)	11(27.50)
文化程度[例(%)]			0.207^b	0.902
高中及以下	14(35.00)	13(32.50)
大专	9(22.50)	8(20.00)
本科及以上	17(42.50)	19(47.50)
损伤部位[例(%)]			0.228^b	0.892
颈髓	5(12.50)	6(15.00)
胸髓	20(50.00)	18(45.00)
腰髓	15(37.50)	16(40.00)
病程(x±s，d)	41.09±9.82	41.95±9.77	0.393^a	0.696
注：^a为t值，^b为χ²值。

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表 2 2组脊髓损伤后NB患者干预前后膀胱功能及尿路感染发生率比较

Table 2. Comparison of bladder function and incidence of urinary tract infection before and after intervention between the two groups of NB patients after spinal cord injury

组别	例数	膀胱容量(x±s，mL)		膀胱残余尿量(x±s，mL)		发生尿路感染[例(%)]
组别	例数	干预前	干预后	干预前	干预后	发生尿路感染[例(%)]
干预组	40	240.25±20.09	327.64±25.44^b	171.05±14.16	102.05±9.04^b	1(2.50)
对照组	40	239.73±19.95	299.07±24.72^b	170.58±13.94	110.25±9.16^b	6(15.00)
统计量		0.116^a	76.086^c	0.150^a	82.882^c	3.914^d
P值		0.908	＜0.001	0.881	＜0.001	0.048
注：^a为t值，^c为F值，^d为χ²值；与同组干预前比较，^bP＜0.05。

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表 3 2组脊髓损伤后NB患者干预前后满意度评分比较(x±s，分)

Table 3. Comparison of satisfaction scores before and after intervention between the two groups of NB patients after spinal cord injury (x±s, points)

组别	例数	有形性		可靠性		响应性
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
干预组	40	11.19±2.63	13.59±2.72^b	13.59±2.83	16.88±3.37^b	11.16±2.54	13.06±2.68^b
对照组	40	11.13±2.44	11.85±2.60	13.68±3.04	14.34±3.21	11.01±2.58	11.71±2.62
统计量		0.106^a	11.913^c	0.137^a	13.352^c	0.262^a	4.311^c
P值		0.916	0.001	0.891	＜0.001	0.794	0.041

组别	例数	保证性		移情性		满意度总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
干预组	40	11.05±2.51	12.91±2.62^b	13.45±2.96	16.24±3.29^b	60.44±14.29	72.68±15.26^b
对照组	40	10.98±2.55	11.52±2.47	13.13±2.75	14.05±3.13	59.93±14.13	63.47±15.02
统计量		0.124^a	4.893^c	0.501^a	10.693^c	0.161^a	7.881^c
P值		0.902	0.030	0.618	0.002	0.873	0.006
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 4 2组脊髓损伤后NB患者依从性比较[例(%)]

Table 4. Comparison of patient compliance between the two groups of NB patients after spinal cord injury [cases (%)]

组别	例数	依从性很高	依从性一般	依从性很低
干预组	40	25(62.50)	12(30.00)	3(7.50)
对照组	40	12(30.00)	23(57.50)	5(12.50)
注：2组依从性比较，Z=2.721, P=0.007。

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