Pacientes com cirurgia espinhal marcada foram divididos em dois grupos, A e B, pelo método de números aleatórios. O grupo B foi conduzido com base na gestão rotineira para prevenção de IPH; já no grupo A, foram implementadas medidas de treinamento em competência de saúde. As pontuações do questionário sobre competência em saúde, a temperatura aferida em diferentes momentos, complicações relacionadas à IPH e hospitalização dos dois grupos foram observadas e comparadas.

RESULTADOS

Os principais índices de avaliação, como a pontuação do questionário sobre competência em saúde, a variação de temperatura e as complicações relacionadas à IPH durante o período perioperatório foram significativamente melhores no grupo A do que no grupo B (p<0,05). Os índices de anestesia, despesas hospitalares totais e satisfação com o serviço de saúde também foram significativamente melhores no grupo A do que no B, o que demonstra as vantagens do cultivo da competência de saúde tanto em médicos como em pacientes.

CONCLUSÃO

Por meio do cultivo de competências de saúde e de medidas viáveis de gestão da saúde, a equipe médica pode melhorar a qualidade da prevenção e gestão da IPH.

Período perioperatório; Hipotermia; Gestão em saúde

Competence Health	Risk Elements	Patient Education and Evaluation	Medical Education and Evaluation	Expected Indicators
Physiological Competence Health	Diagnosis and treatment of physiological abnormalities	Preoperative evaluation of physiological function	Omnidirectional Risk Assessment Ability	Individual physiological health indicators can be based on
	Central hypothermia	Whole-course temperature monitoring and management	Regulations and Professional Insight	Scientific and Reasonable Equipment Technical Data
	Physiological function injury	Visceral Compensation and Prevention and Control	Risk Awareness and Recognition Preventive Ability	Precise Regulation and Timely Emergency Prevention and Control
Spirit Competence Health	Health cognitive impairment	Medical risk and coping Education	Health Humanities and Medical Effectiveness Evaluation	Health Cognition and IPH Knowledge Sharing
	Psychological adaptation disorder	Early Warning Guidance and Assistant Intervention Management	Occupational Behavior Habits and Care	Understanding Care and Joint Response under Expected Goals
	Abnormal moral behavior	Risk Communication and Moral Behavior Guidance	Professional Ethics and Patient Participation in Management	Behavior Regulation and Sharing under Security Expectation
Social Competence Health	Role Recognition Adaptation	Patient Role Adaptation and Family Care	Professional Role and Professional Behavior Standards	Role Orientation and Behavior Appropriateness
	Medical Expenditure Burden	Family Economic Burden and Medicare Model	Medical Benefit Welfare and Patient Health	Optimal Medical Benefit Based on Quality and Safety
	Communication, coordination and understanding	Active and Passive Communication and Cultural Understanding Ability	Health Education and Risk Sharing Awareness	Risk Consensus Awareness and Coordination Ability

Number	Core Measures	Standard Achievement	Score Assignment Standard
1	Risk Cognitive Education and Competence Guidance 48 hours before Operation	Familiar with the condition, know the operation method, confirm the risk early warning	2 points per item
2	High-energy diet and physical exercise guidance to ensure sleep quality	Energy reserve > 30%, physical stability, adequate sleep > 8 hours	2 points per item
3	Adaptive Education and Participatory Skills Guidance 24 hours before Operation	Familiar with operating room environment, clear hypothermia response and understanding of treatment cooperation requirements	2 points per item
4	Preoperative IPH Cognitive Education for Relatives and Patient Care Guidance	Actively provide health information, cooperate with patients to control diet and complete physical exercise	2 points per item
5	Education and preoperative preparation of patients within 4 hours before operation	Psychological comfort and intervention of patients, preoperative preparation and evaluation, nursing handover to meet the standard	2 points per item
6	Patient guidance, anesthesia induction preheating and environmental adaptation	Timely communication and cooperation, accurate feedback, preheating body temperature feeling up to standard	3 points per item
7	Position protection and accurate temperature monitoring and control equipment connection	Room temperature standard, effective coverage, accurate monitoring data, clear physical monitoring location	3 points per item
8	The alarm response and expectation are appropriate, and the fluctuation of monitoring indicators is up to the standard	Active physical monitoring, adapting to alarm response, early warning management up to standard, data fluctuation up to standard	3 points per item
9	Awakening Preheating Management and Comfort Feedback Reaching the Standard after Awakening	Pre-heating management before operation, temperature of awake precursor reaching standard and feedback reaching standard after awakening	3 points per item
10	Transfer body temperature up to standard, key handover and monitoring clear	Transfer temperature monitoring, ward handover, patients’feelings and relatives’ evaluation to reach the standard	2 points per item
11	Postoperative 24-hour temperature monitoring, doctor-patient cooperation with rehabilitation exercise	24-hour body temperature monitoring after operation, patient cooperation and rehabilitation, active prevention and control of relatives	2 points per item
12	No complications occurred 72 hours after operation, and the diet and physical fitness were up to standard.	Overall health assessment, post-operative infection, cardio-cerebral accident, and overall data evaluation	3 points per item

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] CORRESPONDING AUTHOR: Ji-Yue Shi Department of Pain, Affiliated Hospital of Hebei University of Engineering Congtai Road, n.81, Congtai District, Handan, Hebei, China – 056002 E-mail: jiyue_shi2@foxmail.com