基于吉布斯反思循环模式的迷你临床演练评估在ICU废用综合征护理培训中的应用

樊巧玲; 顾佳欢

doi:10.16766/j.cnki.issn.1674-4152.004466

基于吉布斯反思循环模式的迷你临床演练评估在ICU废用综合征护理培训中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004466

樊巧玲^,,
顾佳欢

绍兴市人民医院重症医学科, 浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2025KY1672

详细信息

通讯作者:
樊巧玲，E-mail：fanqiaoling222@163.com

中图分类号: R473 R192
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出版历程
- 收稿日期: 2025-11-09

The application of mini clinical practice assessment based on Gibbs reflective cycle model in the nursing training of ICU disuse syndrome

FAN Qiaoling^,,
GU Jiahuan

Department of Critical Care Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的构建基于吉布斯反思循环模式的迷你临床演练评估护理培训方案，旨在提升ICU废用综合征患者护理质量。方法选取2022年10月—2025年5月绍兴市人民医院ICU护士52名，按照随机数字表法分为2组，A组26名采用传统教学法进行ICU废用综合征护理培训，B组26名采用基于吉布斯反思循环模式的迷你临床演练评估教学法进行ICU废用综合征护理培训，为期4周。培训结束后选取同期ICU废用综合征患者120例，按照随机数字表法进行分组，a组60例由A组护士护理；b组60例由B组护士护理，护理4周。比较AB两组培训前、后自我导向学习评定量表(SRSSDL)评分、理论知识和实操技能掌握情况；比较ab两组护理前、后徒手肌力检查(MMT)量表评分、日常生活活动能力及心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]。结果 B组培训后SRSSDL评分高于A组(P＜0.05)，理论知识[(90.12±6.26)分vs.(79.23±8.45)分]和实操技能[(90.45±8.37) 分vs.(80.05±9.24)分]考试分数高于A组(P＜0.05)。b组护理后MMT评分[(3.67±0.66)分vs.(3.10±0.51)分]、改良Barthel指数[(65.89±7.11) 分vs.(58.78±6.05)分]高于a组(P＜0.05)，SAS和SDS评分低于a组(F=20.871、18.973，P＜0.001、＜0.001)。结论基于吉布斯反思循环模式的迷你临床演练评估既能提升ICU护士自我导向学习和专业能力，又能改善ICU废用综合征患者肌力与日常生活能力，缓解焦虑抑郁。
- ICU废用综合征 /
- 护理教学 /
- 迷你临床演练评估 /
- 吉布斯反思循环模式 /
- 护理质量
Abstract: Objective To construct a mini-clinical exercise assessment nursing training program based on the Gibbs reflective cycle model, aiming to improve the quality of care for patients with disuse syndrome in the ICU. Methods Fifty-two ICU nurses from Shaoxing People ' s Hospital from October 2022 to May 2025 were selected and divided into two groups according to the random number table method. Group A, 26 nurses, received nursing training for ICU disuse syndrome using the traditional teaching method, while Group B, 26 nurses, received nursing training for ICU disuse syndrome using the mini clinical exercise assessment teaching method based on the Gibbs reflection cycle model. It lasted for four weeks. After the training, 120 patients with ICU disuse syndrome during the same period were selected and grouped according to the random number table method. Sixty cases in Group A were cared for by nurses in Group A. Sixty cases in Group B were cared for by nurses in Group B for 4 weeks. The scores of the Self-Directed Learning Assessment Scale (SRSSDL), the mastery of theoretical knowledge and practical skills of Group A and Group B before and after the training were compared. The scores of the manual muscle strength Test (MMT) scale, activities of daily living, and psychological states [Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores] of Group A and Group B before and after nursing. Results After training, the SRSSDL score of group B was higher than that of group A (P < 0.05), and the examination scores of theoretical knowledge[(90.12±6.26) vs.(79.23±8.45) points] and practical skills [(90.45±8.37) vs.(80.05±9.24) points] were higher than those of Group A (P < 0.05). After nursing, the MMT score [(3.67±0.66) vs.(3.10±0.51) points] and the modified Barthel index [(65.89±7.11) vs.(58.78±6.05) points] in group B were higher than those in group A (P < 0.05), while the SAS and SDS scores were lower than those in group A (F=20.871, 18.973; P < 0.001, < 0.001). Conclusion The mini clinical practice assessment based on the Gibbs reflective cycle model can not only enhance the self-directed learning and professional ability of ICU nurses, but also improve the muscle strength and daily living ability of patients with ICU disuse syndrome, and alleviate their anxiety and depression.
- ICU disuse syndrome /
- Nursing teaching /
- Mini clinical drill assessment /
- Gibbs reflects on the cyclical pattern /
- Nursing quality
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表 1 2组ICU护士培训前后SRSSDL评分比较(x ±s，分)

Table 1. Comparison of SRSSDL scores before and after training between two groups of ICU nurses (x ±s, points)

组别	人数	学习意识		学习评价		学习行为
组别	人数	培训前	培训后	培训前	培训后	培训前	培训后
A组	26	30.98±4.56	37.09±6.23^b	29.87±5.21	35.25±6.31^b	32.45±5.26	36.77±6.81^b
B组	26	31.34±5.77	43.50±7.24^b	30.17±6.34	40.88±6.27^b	32.59±6.84	41.23±7.20^b
统计量		0.250^a	19.245^c	0.186^a	23.454^c	0.083^a	18.509^c
P值		0.804	＜0.001	0.853	＜0.001	0.934	＜0.001

组别	人数	学习策略		人际关系技能		总分
组别	人数	培训前	培训后	培训前	培训后	培训前	培训后
A组	26	30.28±5.47	36.53±6.31^b	32.99±5.67	38.67±7.82^b	156.57±20.34	184.31±15.73^b
B组	26	30.56±6.31	41.09±5.47^b	33.17±6.24	42.35±8.09^b	157.83±12.22	209.05±20.76^b
统计量		0.171^a	18.341^c	0.109^a	14.561^c	0.271^a	33.207^c
P值		0.865	＜0.001	0.914	＜0.001	0.788	＜0.001
注：^a为t值，^c为F值; 与同组培训前比较，^bP＜0.05。

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表 2 2组护士培训前后理论知识和实操技能考试成绩比较(x ±s，分)

Table 2. Comparison of theoretical knowledge and practical skill examination scores before and after training between two groups of nurses (x ±s, points)

组别	人数	理论知识		实操技能
组别	人数	培训前	培训后	培训前	培训后
A组	26	69.33±5.12	79.23±8.45^b	68.88±6.23	80.05±9.24^b
B组	26	70.09±6.24	90.12±6.26^b	68.31±7.51	90.45±8.37^b
统计量		0.480^a	25.467^c	0.298^a	23.121^c
P值		0.633	＜0.001	0.767	＜0.001
注：^a为t值，^c为F值; 与同组培训前比较，^bP＜0.05。

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表 3 2组废用综合征患者护理前后肌力和日常生活能力比较(x ±s，分)

Table 3. Comparison of muscle strength and activities of daily living before and after nursing care between two groups of patients with disuse syndrome (x ±s, points)

组别	例数	MMT评分		改良Barthel指数
组别	例数	护理前	护理后	护理前	护理后
a组	60	2.26±0.57	3.10±0.51^b	48.98±5.11	58.78±6.05^b
b组	60	2.39±0.78	3.67±0.66^b	49.34±6.03	65.89±7.11^b
统计量		1.042^a	13.561^c	0.353^a	16.334^c
P值		0.299	＜0.001	0.725	＜0.001
注：^a为t值，^c为F值; 与同组护理前比较，^bP＜0.05。

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表 4 2组废用综合征患者护理前后心理状态比较(分，x ±s)

Table 4. Comparison of psychological status before and after nursing care between two groups of patients with disuse syndrome (points, x ±s)

组别	例数	SAS评分		SDS评分
组别	例数	护理前	护理后	护理前	护理后
a组	60	56.98±5.61	49.81±6.78^b	57.79±6.04	51.87±5.01^b
b组	60	57.19±6.70	40.12±5.36^b	58.08±7.03	45.24±6.09^b
统计量		0.186^a	20.871^c	0.242^a	18.973^c
P值		0.853	＜0.001	0.809	＜0.001
注：^a为t值，^c为F值; 与同组护理前比较，^bP＜0.05。

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