【摘要】 目的 ：基于格林模式构建肝移植受者术后自我管理干预方案并验证其应用效果，为提高肝移植受者自我管理能力，提高生活质量提供参考。方法 ：以格林模式为指导，结合文献研究和质性访谈构建肝移植受者术后自我管理干预方案初稿，经两轮德尔菲函询确定方案终稿。采用便利抽样法选取青岛市某三级甲等医院行肝移植手术患者73例，将手术时间为2023年6月—11月的患者作为对照组，给予常规护理干预和随访；2023年12月至2024年5月的患者作为干预组，给予基于格林模式构建的肝移植受者术后自我管理干预方案，比较两组患者在出院时、出院后3个月、出院后6个月的自我管理水平、生活质量、服药依从性以及再入院率。结果 ：两轮函询问卷的有效回收率分别为84.21%、100.00%，肯德尔和谐系数分别为0.358、0.368，差异具有统计学意义（P<0.001），方案终稿包括3大因素、9个干预主题、27项干预措施。根据重复测量方差分析结果，两组患者的自我管理水平、服药依从性和生活质量比较，时间与组间存在交互效应（P<0.05），干预组6个月非计划再入院率低于对照组（P<0.05）。结论 ：基于格林模式构建的肝移植受者术后自我管理干预方案有助于提升肝移植受者术后自我管理能力，改善患者术后生活质量和远期结局。更多还原

【Abstract】 Objective: To develop and evaluate a PRECEDE-PROCEED model-based self-management program for liver transplant recipients to improve their self-management and quality of life. Methods: The program was developed using the PRECEDE-PROCEED model, literature review, and qualitative interviews, then finalized through two rounds of Delphi consultation. A total of 73 patients from a tertiary grade A hospital in Qingdao were enrolled. Those transplanted from June to November 2023 received standard care(control group). Those transplanted from December 2023 to May 2024 received the intervention. Outcomes(self-management, quality of life, medication adherence, and unplanned readmissions) were assessed at discharge, 3 months, and 6 months. Results: Response rates of two rounds consultation were 84.21% and 100.00%. Kendall’s W were 0.358(P<0.001) and 0.368(P<0.001), showing strong consensus. The final program included three domains, 9 themes, and 27 measures. Significant group-by-time interactions were found for self-management, adherence, and quality of life(all P<0.05). Unplanned readmissions were lower in the intervention group(P<0.05). Conclusion: The PRECEDE-PROCEED model-based program improves self-management, quality of life, and reduces readmissions in liver transplant recipients.更多还原