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Article(id=1322168543521657326, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168262247432815, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.05.019, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749484800000, receivedDateStr=2025-06-10, revisedDate=1768838400000, revisedDateStr=2026-01-20, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159145478, onlineDateStr=2026-10-28, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159145478, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159145478, creator=13701087609, updateTime=1793159145478, updator=13701087609, issue=Issue{id=1322168262247432815, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='5', pageStart='705', pageEnd='880', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159078418, creator='13701087609', updateTime=1793159078418, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=843, endPage=847, ext={EN=ArticleExt(id=1322168543714595311, articleId=1322168543521657326, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Effect of pre-sleep care communication checklist on improving sleep quality in urological surgery patients, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effect of the pre-sleep care communication checklist nursing intervention on sleep quality in urological surgery patients.

Methods

Using a random number table,120 patients were divided into the intervention group and the control group,with 60 patients in each group.The control group received routine care,while the intervention group received the pre-sleep care communication checklist intervention in addition to routine care.The checklist covered environmental management,pain management,psychological support,and sleep guidance.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Numerical Rating Scale(NRS) were used to assess patients' sleep quality,anxiety levels,and pain intensity,respectively.

Results

On the third postoperative day,the PSQI score in the intervention group was (6.5±1.2),lower than that in the control group (8.2±1.5);the SAS score was (52.1±6.0),lower than that in the control group(60.2±6.8);and the NRS scores at 24 and 48 hours postoperatively were (3.5±0.8) and (2.8±0.7),respectively,better than those in the control group[(4.2±0.9) and (3.6±0.8)].All differences were statistically significant(P<0.01).

Conclusions

The multi-dimensionally designed pre-sleep care communication checklist,through interventions such as optimizing the ward environment,standardizing pain management,providing psychological support,and offering scientific sleep guidance,can effectively improve sleep quality,alleviate anxiety,and reduce pain in urological surgery patients.

, authors=Haiyan TIAN1, Li LI1, Junping GAO1, Beibei WANG2, Yuting CHENG2, authorsList=Haiyan TIAN, Li LI, Junping GAO, Beibei WANG, Yuting CHENG, authorCompany=null, correspAuthors=Li LI, authorNote=null, correspAuthorsNote=
LI Li, E-mail:
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目的

探讨睡前关怀沟通清单护理干预对泌尿外科术后病人睡眠质量的影响。

方法

采用随机数字表法将120例泌尿外科术后病人分为干预组和对照组各60例，对照组接受常规护理，干预组在常规护理基础上实施睡前关怀沟通清单干预，清单内容涵盖环境调节、疼痛管理、心理支持和睡眠指导。采用匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、数字评定量表（NRS）分别评估病人睡眠质量、焦虑水平和疼痛程度。

结果

干预组术后第3天PSQI评分为（6.5±1.2）分，低于对照组［（8.2±1.5）分］，SAS评分为（52.1±6.0）分，低于对照组［（60.2±6.8）分］，术后24 h和48 h NRS评分分别为（3.5±0.8）分、（2.8±0.7）分，优于对照组［（4.2±0.9）分、（3.6±0.8）分］；差异均有统计学意义（P<0.01）。

结论

基于多维度干预的睡前关怀沟通清单，通过优化病房环境、规范疼痛管理、提供心理支持和科学睡眠指导等多途径干预，可有效改善泌尿外科术后病人睡眠质量，缓解焦虑和疼痛。

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田海燕，副主任护师

, correspAuthorsNote=
李莉，E-mail：
LI Li, E-mail:
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WONG W H T, ROY T, journalName=Journal of Clinical Nursing, refType=null, unstructuredReference=SOH P Q P,WONG W H T,ROY T,et al.Effectiveness of non-pharmacological interventions in improving sleep quality after cardiac surgery:a systematic review and meta-analysis[J].Journal of Clinical Nursing,2024,33(6):2084-2098., articleTitle=Effectiveness of non-pharmacological interventions in improving sleep quality after cardiac surgery:a systematic review and meta-analysis, refAbstract=null), Reference(id=1322530201549001326, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, doi=null, pmid=null, pmcid=null, year=2025, volume=29, issue=8, pageStart=149, pageEnd=152, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=张记婷, journalName=基层医学论坛, refType=null, unstructuredReference=张记婷.疼痛护理干预在胆囊结石手术患者中的实施及对患者术后疼痛睡眠质量的影响[J].基层医学论坛,2025,29(8):149-152., articleTitle=疼痛护理干预在胆囊结石手术患者中的实施及对患者术后疼痛睡眠质量的影响, refAbstract=null), Reference(id=1322530201616110191, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, doi=null, pmid=null, pmcid=null, year=2025, volume=32, issue=1, pageStart=63, pageEnd=67, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=张晓燕, 胡彦霞, 闫美荣, journalName=当代护士(中旬刊), refType=null, unstructuredReference=张晓燕,胡彦霞,闫美荣.支持性心理干预联合疼痛管理对烧伤患者心理应激、睡眠质量的改善作用分析[J].当代护士(中旬刊),2025,32(1):63-67., articleTitle=支持性心理干预联合疼痛管理对烧伤患者心理应激、睡眠质量的改善作用分析, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322530193676292649, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, xref=1, ext=[AuthorCompanyExt(id=1322530193705652778, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193676292649, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1First Hospital of Shanxi Medical University, Shanxi 030001 China), AuthorCompanyExt(id=1322530193735012907, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193676292649, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1山西医科大学第一医院，山西 030001)]), AuthorCompany(id=1322530193852453420, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, xref=2, ext=[AuthorCompanyExt(id=1322530193881813549, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193852453420, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Shanxi Medical University), AuthorCompanyExt(id=1322530193911173678, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193852453420, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2山西医科大学)])], figs=[ArticleFig(id=1322530197795099218, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=EN, label=Table 1, caption=

Comparison of baseline data between the two groups of patients

, figureFileSmall=null, figureFileBig=null, tableContent=
项目干预组(n=60)对照组(n=60)统计值P
年龄（岁）58.2±6.557.8±7.2t=0.3450.731
性别[例（%）]男38(63.3)40(66.7)χ²=0.1380.711
女22(36.7)20(33.3)
手术类型[例（%）]前列腺切除术25(41.7)23(38.3)χ²=0.2220.895
肾结石手术18(30.0)20(33.3)
膀胱肿瘤切除术17(28.3)17(28.3)
病程（年）3.2±1.53.5±1.3t=-1.0780.284
), ArticleFig(id=1322530197870596691, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=CN, label=表1, caption=

两组病人基线资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目干预组(n=60)对照组(n=60)统计值P
年龄（岁）58.2±6.557.8±7.2t=0.3450.731
性别[例（%）]男38(63.3)40(66.7)χ²=0.1380.711
女22(36.7)20(33.3)
手术类型[例（%）]前列腺切除术25(41.7)23(38.3)χ²=0.2220.895
肾结石手术18(30.0)20(33.3)
膀胱肿瘤切除术17(28.3)17(28.3)
病程（年）3.2±1.53.5±1.3t=-1.0780.284
), ArticleFig(id=1322530197941899860, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=EN, label=Table 2, caption=

Comparison of PSQI scores between two groups before and after intervention（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数术前1 d术后第3天
干预组604.2±0.86.5±1.2
对照组604.3±0.98.2±1.5
t值-0.673-6.892
P0.502<0.001
), ArticleFig(id=1322530198017397333, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=CN, label=表2, caption=

两组病人干预前后PSQI评分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数术前1 d术后第3天
干预组604.2±0.86.5±1.2
对照组604.3±0.98.2±1.5
t值-0.673-6.892
P0.502<0.001
), ArticleFig(id=1322530198080311894, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=EN, label=Table 3, caption=

Comparison of PSQI dimension scores between two groups on the 3rd postoperative day（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数睡眠质量入睡时间睡眠时间睡眠效率睡眠障碍催眠药物日间功能障碍
干预组601.2±0.41.0±0.30.8±0.30.7±0.21.1±0.301.7±0.5
对照组601.8±0.51.5±0.41.2±0.41.1±0.31.6±0.402.0±0.6
t 值-4.321-3.987-3.456-4.102-4.876-2.345
P<0.001<0.0010.001<0.001<0.0010.021
), ArticleFig(id=1322530198160003671, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=CN, label=表3, caption=

两组病人术后第3天PSQI各维度得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数睡眠质量入睡时间睡眠时间睡眠效率睡眠障碍催眠药物日间功能障碍
干预组601.2±0.41.0±0.30.8±0.30.7±0.21.1±0.301.7±0.5
对照组601.8±0.51.5±0.41.2±0.41.1±0.31.6±0.402.0±0.6
t 值-4.321-3.987-3.456-4.102-4.876-2.345
P<0.001<0.0010.001<0.001<0.0010.021
), ArticleFig(id=1322530198231306840, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=EN, label=Table 4, caption=

Comparison of SAS scores between two groups of patients before and after intervention（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数术前1 d术后第3天
干预组6045.6±5.252.1±6.0
对照组6046.3±5.560.2±6.8
t值-0.789-6.231
P0.432<0.001
), ArticleFig(id=1322530198294221401, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=CN, label=表4, caption=

两组病人干预前后SAS评分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数术前1 d术后第3天
干预组6045.6±5.252.1±6.0
对照组6046.3±5.560.2±6.8
t值-0.789-6.231
P0.432<0.001
), ArticleFig(id=1322530198365524570, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=EN, label=Table 5, caption=

Comparison of NRS scores between the two groups of patients before and after intervention（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间例数术后6 h术后12 h术后24 h术后48 h
干预组604.8±1.04.2±0.93.5±0.82.8±0.7
对照组604.9±1.14.3±1.04.2±0.93.6±0.8
t值-0.476-0.523-4.567-5.342
P0.6350.602<0.001<0.001
), ArticleFig(id=1322530198466187867, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, language=CN, label=表5, caption=

两组病人干预前后NRS评分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间例数术后6 h术后12 h术后24 h术后48 h
干预组604.8±1.04.2±0.93.5±0.82.8±0.7
对照组604.9±1.14.3±1.04.2±0.93.6±0.8
t值-0.476-0.523-4.567-5.342
P0.6350.602<0.001<0.001
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睡前关怀沟通清单提升泌尿外科术后病人睡眠质量的效果
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田海燕 1 , 李莉 1, *, * , 高俊平 1 , 王蓓蓓 2 , 成雨婷 2
护理研究 | 综合研究 2026,40(5): 843-847
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护理研究 |综合研究 2026 , 40 (5) : 843 -847
睡前关怀沟通清单提升泌尿外科术后病人睡眠质量的效果
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articleId=1322168543521657326, authorId=1322530196704580164, language=CN, stringName=成雨婷, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, address=2山西医科大学, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322530193852453420, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, xref=2, ext=[AuthorCompanyExt(id=1322530193881813549, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193852453420, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Shanxi Medical University), AuthorCompanyExt(id=1322530193911173678, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168543521657326, companyId=1322530193852453420, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2山西医科大学)])])]
田海燕1, 李莉1, *, * , 高俊平1, 王蓓蓓2, 成雨婷2
作者信息
  • 1山西医科大学第一医院，山西 030001
  • 2山西医科大学
通讯作者:
李莉，E-mail：
LI Li, E-mail:
作者简介:

田海燕，副主任护师

Effect of pre-sleep care communication checklist on improving sleep quality in urological surgery patients
Haiyan TIAN1, Li LI1 , Junping GAO1, Beibei WANG2, Yuting CHENG2
Affiliations
  • 1First Hospital of Shanxi Medical University, Shanxi 030001 China
  • 2Shanxi Medical University
    • Corresponding Author:
    LI Li, E-mail:
出版时间: 2026-03-10 doi: 10.12102/j.issn.1009-6493.2026.05.019
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摘要
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目的

探讨睡前关怀沟通清单护理干预对泌尿外科术后病人睡眠质量的影响。

方法

采用随机数字表法将120例泌尿外科术后病人分为干预组和对照组各60例，对照组接受常规护理，干预组在常规护理基础上实施睡前关怀沟通清单干预，清单内容涵盖环境调节、疼痛管理、心理支持和睡眠指导。采用匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、数字评定量表（NRS）分别评估病人睡眠质量、焦虑水平和疼痛程度。

结果

干预组术后第3天PSQI评分为（6.5±1.2）分，低于对照组［（8.2±1.5）分］，SAS评分为（52.1±6.0）分，低于对照组［（60.2±6.8）分］，术后24 h和48 h NRS评分分别为（3.5±0.8）分、（2.8±0.7）分，优于对照组［（4.2±0.9）分、（3.6±0.8）分］；差异均有统计学意义（P<0.01）。

结论

基于多维度干预的睡前关怀沟通清单，通过优化病房环境、规范疼痛管理、提供心理支持和科学睡眠指导等多途径干预，可有效改善泌尿外科术后病人睡眠质量，缓解焦虑和疼痛。

睡前关怀沟通清单  /  泌尿外科  /  睡眠质量  /  焦虑  /  疼痛
Objective

To explore the effect of the pre-sleep care communication checklist nursing intervention on sleep quality in urological surgery patients.

Methods

Using a random number table,120 patients were divided into the intervention group and the control group,with 60 patients in each group.The control group received routine care,while the intervention group received the pre-sleep care communication checklist intervention in addition to routine care.The checklist covered environmental management,pain management,psychological support,and sleep guidance.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Numerical Rating Scale(NRS) were used to assess patients' sleep quality,anxiety levels,and pain intensity,respectively.

Results

On the third postoperative day,the PSQI score in the intervention group was (6.5±1.2),lower than that in the control group (8.2±1.5);the SAS score was (52.1±6.0),lower than that in the control group(60.2±6.8);and the NRS scores at 24 and 48 hours postoperatively were (3.5±0.8) and (2.8±0.7),respectively,better than those in the control group[(4.2±0.9) and (3.6±0.8)].All differences were statistically significant(P<0.01).

Conclusions

The multi-dimensionally designed pre-sleep care communication checklist,through interventions such as optimizing the ward environment,standardizing pain management,providing psychological support,and offering scientific sleep guidance,can effectively improve sleep quality,alleviate anxiety,and reduce pain in urological surgery patients.

pre-sleep care communication checklist  /  urology  /  sleep quality  /  anxiety  /  pain
田海燕, 李莉, 高俊平, 王蓓蓓, 成雨婷. 睡前关怀沟通清单提升泌尿外科术后病人睡眠质量的效果. 护理研究, 2026 , 40 (5) : 843 -847 . DOI: 10.12102/j.issn.1009-6493.2026.05.019
Haiyan TIAN, Li LI, Junping GAO, Beibei WANG, Yuting CHENG. Effect of pre-sleep care communication checklist on improving sleep quality in urological surgery patients[J]. Chinese Nursing Research, 2026 , 40 (5) : 843 -847 . DOI: 10.12102/j.issn.1009-6493.2026.05.019
正文
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有研究表明，外科术后病人睡眠障碍发生率为60%~75%[1]。泌尿外科手术因手术部位特殊、术后留置导尿管及切口疼痛等因素可导致病人术后睡眠障碍。术后睡眠质量下降不仅会延缓伤口愈合、延长住院时间[2]，还可能诱发焦虑、抑郁情绪，增加术后并发症发生风险[3]。尽管常规护理措施能在一定程度上改善病人睡眠状况，但其效果往往有限[4]。近年来，以病人为中心的结构化护理干预逐渐受到重视。研究显示，整合环境调节、疼痛管理和心理支持的多维度干预可提升术后病人睡眠质量。清单式管理作为一种结构化护理工具，已在重症监护室（ICU）病人家属沟通、护理交接等领域取得显著成效[5-7]，但其在术后睡眠护理中的应用仍缺乏高质量证据支持。基于此，本研究构建睡前关怀沟通清单干预方案，通过整合环境调节、疼痛管理、心理支持和睡眠指导等多维度干预措施，旨在建立一套科学、规范的泌尿外科术后睡眠护理方案，旨在为改善病人睡眠质量、优化术后护理流程提供依据，同时也为清单式管理在专科护理中的应用拓展方向。
1　对象与方法
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1.1　研究对象
于2024年5月—12月选取山西省某三级甲等医院泌尿外科的手术病人120例为研究对象。纳入标准：1）18~65岁；2）首次接受泌尿外科手术；3）意识清楚并能有效沟通，简易精神状态检查量表(MMSE)评分≥27分；4）自愿参与并签署知情同意书。排除标准：1）合并严重心、肝、肾功能不全；2）有精神疾病史或认知障碍；3）术前匹兹堡睡眠质量指数（PSQI）>7分；4）长期服用镇静催眠类药物。采用计算机生成的随机数字表将120例病人分为干预组和对照组各60例。本研究已通过山西医科大学第一医院伦理委员会批准（审批号：2024KY09）。
1.2　方法
1.2.1　干预方法
1.2.1.1　对照组
实施泌尿外科术后常规护理，包括生命体征监测、管路（引流管、尿管、鼻导管）护理、疼痛评估、健康教育（口头宣教术后饮食与活动注意事项）。
1.2.1.2　干预组
在常规护理基础上给予睡前关怀沟通清单干预。该清单基于Kolcaba舒适理论框架，通过德尔菲专家咨询法构建[8]。1)环境调节（19:00~19:15）：物理环境方面，维持室温22~24 ℃，湿度50%~60%，噪声<40 dB；光线管理方面，关闭顶灯（照度<50 lux）、开启地灯（100 lux）。2)疼痛管理（19:15~19:25）：采用数字等级评定量表（NRS）评估病人疼痛感受，疼痛评分>4分时立即告知医师并配合处理；指导病人腹式呼吸、采用音乐疗法帮助病人改善疼痛情况。3)心理支持（19:25~19:35）：通过主动开放式提问引导病人倾诉顾虑，以专注倾听和共情回应建立信任关系；依据病人心理状态差异开展分层干预，对焦虑病人用正向激励强化康复信念，对自我效能感不足者分享成功案例增强信心，助力病人形成积极治疗心态。4)睡眠指导（19:35~19:45）：体位调整至30°半卧位，导尿管固定于大腿内侧，渐进性肌肉放松训练（PMR），并避免睡前2 h使用电子设备。
1.2.2　评价指标
1）睡眠质量：以PSQI测评，该量表从睡眠质量、入睡时长、睡眠干扰、助眠药物使用、睡眠持续时间、睡眠效率、日间功能状态7个维度评估，各维度评分0~3分，量表总分0~21分，得分越高睡眠质量越差[9]。于术前1 d和术后第3天对病人进行评估。2）焦虑情绪：采用由20个测评项目构成、4级评分的焦虑自评量表（SAS）评估，将各项目原始得分汇总乘以1.25换算成标准分，分值越高病人焦虑程度越明显。于术前1 d和术后第3天采集数据。3）疼痛程度：运用NRS进行疼痛评估，指导病人从0~10分的数字区间选择对应分值描述自己的疼痛感受，其中0分代表无痛状态，10分表示难以忍受的剧痛，分别在术后6、12、24、48 h进行评估。4）病人满意度：采用自行编制的护理满意度问卷从服务态度、护患沟通成效、护理措施执行情况等维度综合评价，问卷设非常满意、满意、一般、不满意4个等级，病人满意度=（非常满意例数+满意例数）/总例数×100%。
1.2.3　数据收集
本研究所有资料收集均由经统一培训并经过考核的护理人员完成，采用面对面询问的方式分别对两组病人进行PSQI、SAS和NRS评估，并发放病人满意度调查问卷进行数据收集。所有收集的资料经双人核查后录入电脑。
1.2.4　统计学方法
使用SPSS 26.0统计软件处理数据。对服从正态分布的定量资料采用均数±标准差（x±s）描述，两组间比较采用两独立样本t检验，多个时间比较用重复测量方差分析；定性资料采用例数、百分比（%）描述，组间比较采用χ2检验或Fisher确切概率法。以P<0.05为差异有统计学意义。
2　结果
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2.1　两组病人一般资料比较（见表1）
2.2　两组病人干预前后PSQI评分比较
术前1 d，两组病人PSQI总分及各维度评分比较，差异无统计学意义（P>0.05）；术后第3天，干预组病人PSQI总分及各维度评分低于对照组，差异有统计学意义（P<0.05）。具体见表2、表3。
2.3　两组病人干预前后 SAS 评分比较（见表4）
2.4　两组病人干预前后NRS评分比较（见表5）
2.5　两组病人满意度比较
实施清单护理干预后，干预组病人满意度为 95.00%（57/60），高于对照组的81.67%（49/60），差异有统计学意义（χ²=5.16，P<0.05）。
3　讨论
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3.1　睡前关怀沟通清单护理干预可有效提升泌尿外科病人的术后睡眠质量
本研究结果显示，睡前关怀沟通清单干预可降低泌尿外科术后病人PSQI评分，病人睡眠质量改善效果较好。睡前关怀沟通清单干预通过以下多通路机制发挥作用：通过标准化环境调节，对病房温湿度、光照及噪声进行控制[10-11]，病人睡眠障碍减轻；通过指导病人腹式呼吸以及采用音乐疗法放松病人身心进行疼痛管理，病人术后疼痛减轻，多重干预对病人术后睡眠质量产生积极影响[12]；通过与病人友好交流缓解其焦虑紧张等不良情绪，针对性心理干预疏导负面情绪，帮助病人改善心理生理状态，提高病人睡眠质量[13-14]；通过体位调整、导管固定和睡前2 h避免使用电子设备等多方面睡眠指导，为病人提供科学睡眠方法，以满足病人身心需求进一步提升睡眠质量。
3.2　睡前关怀沟通清单可有效缓解泌尿外科术后病人的焦虑情绪
本研究结果显示，干预组病人术后第3天SAS评分低于对照组，表明该清单干预能有效缓解病人的焦虑情绪。该清单通过构建结构化沟通框架使护理人员全面关注病人生理心理需求，联合放松训练、音乐疗法等心理支持，减少泌尿外科手术病人的焦虑情绪[15]，将人文关怀贯穿于护理过程中。护理人员主动倾听病人心声，运用共情技巧进行心理疏导，拉近护患距离，这种护理体系能够增强病人对护理团队的信任，提高病人治疗依从性与护理服务满意度[16]。
3.3　睡前关怀沟通清单有助于缓解泌尿外科术后病人的疼痛
本研究结果显示，睡前关怀沟通清单干预能降低病人术后疼痛程度，干预组术后24 h和48 h NRS评分低于对照组。其疼痛缓解机制主要体现在以下方面：首先，医护协作进行疼痛管理，向病人解释疼痛原因并指导缓解方法，帮助病人正确认识疼痛，减少因恐惧和未知产生的心理压力，降低疼痛感受，提升睡眠质量[17]；其次，采用标准化的非药物镇痛技术（体位调整、腹式呼吸训练、音乐疗法等[18]），形成一套可量化的疼痛缓解方案；第三，通过改善病人心理状态和睡眠质量，建立了良性循环[19]。护理人员在疼痛管理的同时，给予心理关怀和睡眠质量指导，有助于提升病人疼痛管理能力，进一步减轻疼痛[20]。
3.4　本研究的局限性
本研究虽证实了睡前关怀沟通清单的短期干预效果，但仍存在一定局限性。首先，本研究为单中心研究，且样本量较少，其结果在基层医院或不同地区医疗机构的适用性仍需验证；其次，主要采用PSQI、SAS等主观量表评估，虽辅以NRS疼痛评分，但缺乏多导睡眠图（PSG）等客观监测数据支持；第三，干预效果仅评估至术后第3天，缺乏对病人出院后睡眠质量（如术后1个月、3个月）的长期随访数据。后续研究可重点探索开展多中心随机对照试验，将认知行为疗法（CBT-I）与现有清单结合，形成技术+人文的复合干预方案，进一步探讨更有效的干预方案。
4　小结
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睡前关怀沟通清单作为标准化护理干预工具，有助于改善泌尿外科术后病人的睡眠质量，有效缓解围术期的焦虑情绪，并通过多维度疼痛管理策略加速术后康复进程。该清单以简洁的操作流程、良好的临床适用性及高度可复制性，为优化泌尿外科术后护理流程提供了解决方案。未来建议启动动态质量改进机制持续优化清单内容与实施路径，实现护理服务质量的持续提升，切实促进病人的身心康复，并可聚焦该干预模式对病人长期康复结局的影响，通过大样本、多中心的追踪研究，进一步完善循证医学证据体系，为临床护理实践提供更科学、全面的实践指导。

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2026年第40卷第5期
25
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doi: 10.12102/j.issn.1009-6493.2026.05.019
  • 接收时间：2025-06-10
  • 首发时间：2026-10-28
  • 出版时间：2026-03-10
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  • 收稿日期：2025-06-10
  • 修回日期：2026-01-20
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    2山西医科大学

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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