A study on the application effect of standardized medical nursing service in the perioperative period of gynecologic oncology patients
规范医疗护理员服务的免陪照护模式在妇科肿瘤患者 围手术期的应用效果研究

摘要

目的 构建以规范医疗护理员服务为核心的免陪照护模式，探讨其对妇科肿瘤患者围手术期康复锻炼执行率及临床预后的影响，为临床护理实践提供循证依据。方法 采用类实验研究设计，选取某三级甲等医院2025年11月1日-2025年11月30日实施免陪照护的50例妇科肿瘤手术患者为干预组，回顾性纳入2025年10月1日-2025年10月31日传统家属陪护的50例患者为对照组。干预组实施“护理员专项培训+康复锻炼标准化流程+多学科督导”方案，对照组采用“家属陪护+常规护理指导”。比较两组康复锻炼执行率、术后恢复指标、并发症及不良事件发生率、优质护理满意度得分。结果 干预组康复锻炼频次达标率（96%）、质量达标率（92%）显著高于对照组康复锻炼频次达标率（64%）、质量达标率（66%）（均P＜0.05）；干预组术后首次下床时间18（16，20）h、首次肛门排气时间38.5（31.75，40）h、住院天数4.5（3.5，5.75）d，均短于对照组20（18，23）h、52.5（40，70）h、6（4.875，7.625）d（均P＜0.05）；干预组并发症发生率（0%）低于对照组（4%）、不良事件发生率（0%）低于对照组（2%），医疗护理员满意度干预组100（100，100）高于对照组100（90，100）（均P＜0.01）。结论 规范医疗护理员服务的免陪照护模式可提升妇科肿瘤患者围手术期康复锻炼执行率，加速术后恢复，降低风险，提高满意度，值得推广。

Abstract

Objective To construct a care model without family accompaniment centered on standardized medical care assistant services, and to explore its impact on the compliance rate of perioperative rehabilitation exercises and clinical prognosis in gynecological tumor patients, providing evidence-based support for clinical nursing practice.
Methods A quasi-experimental design was adopted. Fifty patients undergoing gynecological tumor surgery who received care without family accompaniment from November 1st to November 30th, 2025, in a tertiary grade-A hospital were selected as the intervention group. Fifty patients who received traditional family accompaniment care from October 1st to October 31st, 2025, were retrospectively included as the control group. The intervention group was provided with a program of “specialized training for care assistants + standardized rehabilitation exercise procedures + multidisciplinary supervision”, while the control group received “family accompaniment + routine nursing guidance”. The compliance rate of rehabilitation exercises, postoperative recovery indicators, incidence of complications and adverse events and high-quality care satisfaction scores were compared across the two groups.
Results In the intervention group, the compliance rates of rehabilitation exercise frequency (96%) and quality (92%) were markedly higher than those in the control group (64%, 66%), all P < 0.05. The time to first postoperative ambulation [18 (16, 20) hours], the time to first postoperative anal exhaust [38.5 (31.75, 40) hours], and the length of hospital stay [4.5 (3.5, 5.75) days] in the intervention group were shorter than those in the control group [20 (18, 23) hours, 52.5 (40, 70) hours, and 6 (4.875,7.625) days, respectively] (all P< 0.05). The incidence of complications (0%) and adverse events (0%) in the intervention group was lower than that in the control group (4% and 2%, respectively), and the satisfaction score of medical care assistants in the intervention group [100 (100, 100)] was higher than that in the control group [100 (90, 100)] (all P < 0.01).
Conclusion   The care model without family accompaniment based on standardized medical care assistant services can enhance the compliance rate of perioperative rehabilitation exercises in gynecological tumor patients, accelerate postoperative recovery, reduce risks, and improve satisfaction, making it worthy of promotion.