探讨医护协同导向的以专题微课为主要载体的延续性微服务护理模式在留置双J管患者居家健康指导中的应用效果。

编制留置双J管患者居家健康指导系列微课，构建医护协同导向的留置双J管患者居家微服务方案，包括多样化居家健康指导、自动化提醒、可视化疾病咨询、快捷式拔管预约等。选取2021年10月至2022年4月在中山大学附属第三医院泌尿外科住院的泌尿系结石碎石术后留置双J管的出院患者为研究对象，2021年10月至2021年12月的研究对象为对照组（86例），2022年1月至2022年4月的研究对象为观察组（68例），对照组实施常规延续性护理，观察组实施医护协同导向的延续性护理微服务模式。比较两组患者对留置双J管的知信行水平，并发症发生率及非计划返院就诊率，输尿管支架症状困扰情况，对护士延续性护理的满意程度。

观察组患者对双J管相关知识及留置双J管注意事项、疾病恢复信念及遵医行为水平均高于对照组，差异具有统计学意义（t=2.699，P=0.008；t=5.859，P<0.001；t=6.051，P<0.001）。观察组患者肉眼血尿、膀胱刺激征（尿频、尿急、尿痛）、腰痛的发生率和非计划返院就诊率低于对照组，差异有统计学意义（P<0.001）。观察组患者的输尿管支架症状问卷（USSQ）中身体疼痛维度得分低于对照组，差异具有统计学意义（t=6.492，P<0.001），两组患者的USSQ总分和其他维度得分差异均无统计学意义（P>0.05）。观察组患者对留置双J管相关健康教育的方式满意度高于对照组，差异具有统计学意义（P<0.001）。

医护协同导向的以专题微课为主要载体的延续性微服务护理模式能有效提高留置双J管患者的知信行水平，降低相关并发症发生率及非计划返院就诊率，一定程度改善症状困扰，获得更好的患者满意度。

To explore the application effect of continuous micro-service nursing mode with special micro-class as the main carrier, which is guided by medical cooperation, in home health guidance for patients with indwelling double J tubes.

A series of micro-courses of home health guidance for patients with indwelling double J-tubes were compiled, and a micro-service scheme for patients with indwelling double J-tubes was constructed, including diversified home health guidance, automatic reminding, visual disease consultation, and quick extubation appointment. We selected the discharged patients who were hospitalized in the Department of Urology of the Third Affiliated Hospital of Sun Yat-sen University from October 2021 to April 2022 and retained double J tubes after lithotripsy of urinary stones as the research objects. The research objects from October 2021 to December 2021 were the control group (86 cases), and the research objects from January to April 2022 were the observational group (68 cases). The control group was given routine continuous nursing, and the observational group was given continuous nursing micro-service mode guided by medical cooperation. The knowledge, attitude and practice level of indwelling double J catheter, the incidence of complications, the rate of unplanned return to hospital, the symptoms of ureteral stents and the satisfaction degree of nurses' continuous care were compared between the two groups.

The related knowledge of double J tube and indwelling double J tube, the belief of disease recovery and the level of compliance behavior of patients in the observational group were higher than those in the control group, and the difference was statistically significant (t=2.699, P=0.008; t=5.859, P<0.001; t=6.051, P<0.001). The incidence of gross hematuria, bladder irritation (frequent urination, urgency and pain), lumbago and unplanned return to hospital in the observational group were significantly lower than those in the control group (P<0.001). The scores of physical pain dimensions in the Ureteral Stent Symptom Questionnaire (USSQ) of the patients in the observational group were lower than those in the control group, and the difference was statistically significant (t=6.492, P<0.001). There was no significant difference in the total USSQ score and other dimensions between the two groups (P>0.05). Patients in the observational group were more satisfied with the way of health education related to indwelling double J tubes than those in the control group, with the difference statistically significant (P<0.001).

The continuous micro-service nursing mode with special micro-courses as the main carrier guided by medical cooperation can effectively improve the knowledge, attitude and practice level of patients with indwelling double J tubes, which can reduce the incidence of related complications and the rate of unplanned return to hospital, and to some extent, improve symptoms and troubles, and obtain better patient satisfaction.