基于思维导图引导的家庭参与式双轨道护理干预在儿童支气管肺炎中的应用效果分析

doi:10.19983/j.issn.2096-8493.20260123

摘要/Abstract

摘要：

目的: 探讨基于思维导图引导的家庭参与式双轨道护理干预在儿童支气管肺炎中的应用效果。方法: 采用回顾性病例对照研究方法,以福建省仙游县总医院儿科护理模式改革为分界点,参照入组标准收集改革前(2025年1—7月)实施常规护理的55例支气管肺炎患儿(常规组)和改革后(2025年8月至2026年1月)实施思维导图引导家庭参与式双轨道护理的60例支气管肺炎患儿(双轨道组)完整病历、护理记录、随访档案,对比两组患儿治疗依从性、护理前后肺功能指标[包括用力肺活量(FVC)、第1秒用力呼气容积(FEV₁)、呼气峰流速(PEF)]及雾化相关不良反应发生情况。结果: 护理干预后,双轨道组总依从率[88.33%(53/60)]明显高于常规组[70.91%(39/55)],差异有统计学意义(χ²=5.445,P=0.020);出院第3天复查,双轨道组FVC[(1.22±0.15)L]、FEV₁[(1.26±0.19)L]、PEF[(3.08±0.45)L/s]均明显高于常规组[FVC:(1.08±0.25)L、FEV₁:(0.98±0.17)L、PEF:(2.65±0.42)L/s],差异均有统计学意义(t=3.676、8.300、5.284,P值均<0.001);双轨道组不良反应总发生率[8.33%(5/60)]与常规组[16.36%(9/55)]的差异无统计学意义(χ²=1.731,P=0.188)。结论: 基于思维导图引导的家庭参与式双轨道护理可有效提升支气管肺炎患儿治疗依从性,显著改善患儿肺功能,且不增加不良反应风险,值得在儿科临床推广应用。

关键词: 儿童, 支气管肺炎, 家庭护理(专业), 护理方法学研究, 病人依从

Abstract:

Objective: To explore the application effect of mind map-guided family-participatory dual-track nursing intervention in children with bronchopneumonia. Methods: A retrospective case-control study was conducted. Taking the pediatric nursing model reform of Xianyou County General Hospital in Fujian Province as the cutoff time, 55 children with bronchopneumonia receiving routine nursing before the reform (January to July 2025) were assigned to the routine group, and 60 children receiving mind map-guided family-participatory dual-track nursing after the reform (August 2025 to January 2026) were assigned to the dual-track group. All participants were recruited in accordance with the inclusion criteria. Complete medical records, nursing records and follow-up files of the two groups were retrieved to compare treatment compliance, pulmonary function indicators before and after nursing intervention (including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), peak expiratory flow (PEF)) and the incidence of atomization-related adverse reactions. Results: After nursing intervention, the total treatment compliance rate of the dual-track group (88.33% (53/60)) was significantly higher than that of the routine group (70.91% (39/55)), with a statistically significant difference (χ²=5.445, P=0.020). Reexamination on the 3rd day after discharge showed that FVC ((1.22±0.15) L), FEV₁ ((1.26±0.19) L) and PEF ((3.08±0.45) L/s) in the dual-track group were all significantly higher than those in the routine group (FVC:(1.08±0.25) L, FEV₁:(0.98±0.17) L, PEF:(2.65±0.42) L/s), and all differences were statistically significant (t=3.676, 8.300, 5.284, all P<0.001). There was no statistically significant difference (χ²=1.731, P=0.188) in the total incidence of adverse reactions between the dual-track group (8.33% (5/60)) and the routine group (16.36% (9/55)). Conclusion: Mind map-guided family-participatory dual-track nursing can effectively improve treatment compliance and significantly ameliorate pulmonary function in children with bronchopneumonia, without increasing the risk of adverse reactions, and is worthy of clinical promotion and application in pediatrics.

Key words: Child, Bronchopneumonia, Family nursing, Nursing methodology research, Patient compliance

中图分类号:

R473.72

李冰娴. 基于思维导图引导的家庭参与式双轨道护理干预在儿童支气管肺炎中的应用效果分析[J]. 结核与肺部疾病杂志, 2026, 7(4): 502-507. doi: 10.19983/j.issn.2096-8493.20260123

Li Bingxian. Analysis of the application effect of mind map-guided family-participatory dual-track nursing intervention for bronchopneumonia in children[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(4): 502-507. doi: 10.19983/j.issn.2096-8493.20260123

图/表 1

参考文献 22

[1]	Fan F, Lv J, Yang Q, et al. Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children[J]. Clin Respir J, 2023, 17(7):607-617. doi:10.1111/crj.13620. pmid: 37142438
[2]	Ling Y, Yang D, Yang S. Clinical characteristics, early blood biochemical indicators, and prognostic status of children with bronchopneumonia[J]. Medicine (Baltimore), 2023, 102(47):e36162. doi:10.1097/MD.0000000000036162.
[3]	荣刘涛, 李秀玲, 祝金明, 等. 2016年至2020年1-6岁儿童呼吸道感染病例流行病学特征[J]. 中国医学工程, 2022, 30(5):64-68. doi:10.19338/j.issn.1672-2019.2022.05.015.
[4]	殷玲, 王凌云, 务永勤, 等. 小儿支气管肺炎适时干预联合全程精细化心理干预方法及其临床应用[J]. 中华医院感染学杂志, 2025, 35(7):1037-1041. doi:10.11816/cn.ni.2025-241043.
[5]	缪薛琴, 沈翠珍, 陈晓飞, 等. 炎症性肠病患儿家庭功能评估及护理干预的研究进展[J]. 护理研究, 2024, 38(3):454-458. doi:10.12102/j.issn.1009-6493.2024.03.013.
[6]	熊小秀, 李虹霖, 朱丹. 尿道下裂患儿基于思维导图的家庭护理教育[J]. 护理学杂志, 2023, 38(9):73-76. doi:10.3870/j.issn.1001-4152.2023.09.073.
[7]	王彦利, 孙娟, 张文. 思维导图模式健康宣教对癫痫患儿家属心境状态、应对方式的影响[J]. 中国健康心理学杂志, 2022, 30(3):357-361. doi:10.13342/j.cnki.cjhp.2022.03.008.
[8]	Ji W, Zhu Q. Smart Nursing-Based Tripartite Dual-Track Interactive Nursing in Elderly Patients with Coronary Heart Disease Complicated by the “Three Highs”[J]. J Vis Exp, 2025(223). doi:10.3791/6654.
[9]	国家卫生健康委办公厅, 国家中医药局办公室. 关于印发儿童社区获得性肺炎诊疗规范(2019年版)的通知[EB/OL]. 国卫办医函〔2019〕138号. (2019-02-01)[2026-04-21]. http://www.natcm.gov.cn/bangongshi/zhengcewenjian/2019-02-13/9022.html.
[10]	国家卫生健康委办公厅, 国家中医药局综合司. 关于印发儿童肺炎支原体肺炎诊疗指南(2025年版)的通知[EB/OL]. 国卫办医政函〔2025〕361号. (2025-09-09)[2026-04-21]. https://www.nhc.gov.cn/yzygj/c100068/202509/19e7145436b049a68d4ba8c2060dfa56.shtml.
[11]	王瑞平. 随机对照临床试验设计中的样本量估算方法[J]. 上海医药, 2023, 44(1):48-52. doi:10.3969/j.issn.1006-1533.2023.01.013.
[12]	江载芳, 申昆玲, 沈颖. 诸福棠实用儿科学(第8版)[M]. 北京: 人民卫生出版社, 2015:1253-1256.
[13]	张荣美, 马艳, 黄璐璐. 学龄前支原体肺炎患儿雾化吸入治疗依从性的影响因素及预测模型构建[J]. 现代生物医学进展, 2025, 25(4):706-712. doi:10.13241/j.cnki.pmb.2025.04.014.
[14]	Cen M, Xu J, Chen Y, et al. Impact of Family-Centred Care Combined With Psychological Intervention on Sleep Quality and Psychological Status in Children With Bronchopneumonia:A Controlled Trial[J]. Scand J Caring Sci, 2026, 40(1):e70167. doi:10.1111/scs.70167.
[15]	张影, 徐丽媛. CICARE沟通联合家庭护理技能教育对学龄前支气管肺炎患儿疾病转归及家长焦虑的影响[J]. 妇儿健康导刊, 2024, 3(21):173-177.
[16]	张梦莹, 胡雪晴, 张浩, 等. 思维导图引导优质护理对肺炎支原体感染性大叶性肺炎患儿的干预效果[J]. 海南医学, 2021, 32(21):2853-2856. doi:10.3969/j.issn.1003-6350.2021.21.035.
[17]	许莹莹, 刘小玲. 思维导图模式护理在新生儿呼吸窘迫综合征患儿中的应用价值[J]. 护理实践与研究, 2023, 20(2):274-277. doi:10.3969/j.issn.1672-9676.2023.02.023.
[18]	王园园, 肖锋, 刘素真. 双轨道互动模式下的院外干预对冠脉介入患者的影响[J]. 中国健康心理学杂志, 2024, 32(8):1214-1218. doi:10.13342/j.cnki.cjhp.2024.08.018.
[19]	王月儿, 蔡建利, 张秀丽. 综合护理干预在小儿哮喘急性发作期雾化吸入治疗中的价值[J]. 浙江医学, 2023, 45(12):1320-1322. doi:10.12056/j.issn.1006-2785.2023.45.12.2022-3408.
[20]	周瑞茜, 倪王平, 柯若, 等. 家庭参与式护理模式下支气管肺发育不良早产儿2岁内再入院的影响因素分析[J]. 中华护理杂志, 2022, 57(12):1481-1485. doi:10.3761/j.issn.0254-1769.2022.12.011.
[21]	廖玉珍. 个性化护理结合延续性护理干预对慢性阻塞性肺疾病呼吸衰竭患者肺功能及生活质量的作用[J]. 中国防痨杂志, 2024, 46(S2):268-270.
[22]	马小英, 谌红艳, 江凤琼, 等. 基于IMB模型与思维导图相结合的护理干预对癫痫患儿家属疾病认知及心境状态的影响[J]. 湖南师范大学学报(医学版), 2025, 22(4):198-203. doi:10.3969/j.issn.1673-016X.2025.04.037.

分组	FVC(L,$\overline{\mathit{x}}$±s)				FEV₁(L,$\overline{\mathit{x}}$±s)				PEF(L/s,$\overline{\mathit{x}}$±s)
分组	干预前	干预后	t值	P值	干预前	干预后	t值	P值	干预前	干预后	t值	P值
常规组 (55例)	0.65± 0.23	1.08± 0.25	9.387	<0.001	0.51± 0.17	0.98± 0.17	14.498	<0.001	2.13± 0.35	2.65± 0.42	7.054	<0.001
双轨道组 (60例)	0.69± 0.21	1.22± 0.15	15.908	<0.001	0.57± 0.19	1.26± 0.19	19.891	<0.001	2.10± 0.32	3.08± 0.45	13.748	<0.001
t值	0.975	3.676			1.779	8.300			0.480	5.284
P值	0.332	<0.001			0.078	<0.001			0.632	<0.001