目的 探讨腰椎间盘突出症(LDH)患者三维平衡正脊治疗中采用ISBAR-CICARE沟通模式对临床疗效的影响。方法 选取2024-10至2025-12在山东第一医科大学附属颈肩腰腿痛医院接受三维平衡正脊治疗的LDH患者144例作为研究对象。采用随机数字表法,分为观察组(ISBAR-CICARE沟通模式组)与对照组(常规沟通组),每组72例。两组患者均接受相同的三维平衡正脊治疗。对照组采用科室常规的健康教育及医患沟通方式进行交流,不进行结构化沟通模式的系统应用。观察组护士在治疗前、中、后系统应用ISBAR-CICARE结构化沟通流程。记录两组患者干预前后,视觉模拟量表(VAS)的疼痛评分、医院焦虑抑郁量表(HADS)评分、日本骨科协会评估治疗分数(JOA),并进行对比,另外,通过住院患者护理存在量表(NPSHP)对两组护理满意度进行比较分析。结果 干预前,两组相关指标差异无统计学意义(P＞0.05)。干预后两组各项评分均有改善;且观察组VAS评分[(1.29±0.95) vs. (2.43±1.01)]、HADS焦虑评分[(2.5±1.27) vs. (5.85±2.85)]、HADS抑郁评分[(1.5±0.93) vs. (3.56±1.63)]的下降幅度均显著大于对照组,JOA评分[(27.46±2.04) vs. (21.17±2.16)]的改善更优,差异均有统计学意义(P<0.05)。观察组患者护理满意度为94.44%,显著高于对照组的79.17%,差异有统计学意义(P<0.05)。结论 LDH患者在三维平衡正脊治疗中应用ISBAR-CICARE沟通模式,可增加患者治疗配合度,缓解疼痛与焦虑抑郁情绪,显著提升服务满意度,对改善腰椎功能有较大作用,建议临床推广应用。

Objective To investigate the effect of the ISBAR-CICARE communication mode on clinical outcomes in patients with lumbar disc herniation(LDH) undergoing three-dimensional balanced chiropractic treatment. Methods A total of 144 patients with lumbar disc herniation(LDH) who underwent three-dimensional balanced chiropractic treatment at the Affiliated, Shoulder, lumbar, and Leg Pain Hospital of to Shandong First Medical University from October 2024 to December 2025 were enrolled. Using a random number table method, they were divided into an observation group(ISBAR-CICARE communication mode group) and a control group(conventional communication group), with 72 patients in each group. Both groups received the same three-dimensional balanced chiropractic treatment. The control group adopted the department's routine health education and doctor-patient communication methods, without systematic application of a structured communication mode. Nurses in the observation group systematically applied the ISBAR-CICARE structured communication process before, during, and after treatment. Comparative analysis was conducted on the visual analog scale(VAS) pain scores, Hospital Anxiety and Depression Scale(HADS) scores, Japanese Orthopedic Association(JOA) assessment scores, and nursing satisfaction based on the Chinese version of the Nursing Presence Scale for Hospitalized Patieats (NPSHP) before and after intervention in both groups. Results No significant differences were found in baseline characteristics and outcome measures between the two groups before the intervention. After the intervention, the observation group demonstrated significantly lower scores than the control group on the VAS[(1.29±0.95) vs. (2.43±1.01)], HADS-Anxiety[(2.5±1.27) vs. (5.85±2.85)], and HADS-Depression[(1.5±0.93) vs. (3.56±1.63)](P<0.05). Furthermore, the observation group showed significantly greater improvement in JOA scores[(27.46±2.04) vs. (21.17±2.16),P<0.05]. The nursing satisfaction rate was significantly higher in the observation group than in the control group(94.44% vs. 79.17%, P<0.05). Conclusions Applying the ISBAR-CICARE communication mode to LDH patients undergoing three-dimensional balanced chiropractic treatment can enhance patient cooperation, relieve pain, reduce anxiety and depression, significantly improve service satisfaction, and promote the recovery of lumbar function. These findings support its broader implementation in clinical practice.