个案管理护理模式对肠造口患者主要照顾者心理韧性和生活质量的影响研究  

Effect of personalized management nursing on psychological resilience and quality of life of primary caregivers in patients with colostomy

作　　者：马辉[1] 韦瑞丽[1] 班翠珍[1] 李丽[1] 梁珠明[1] 

机构地区：[1]广西医科大学第一附属医院结直肠肛门外科,广西南宁530021

出　　处：《结直肠肛门外科》2017年第5期656-659,共4页Journal of Colorectal & Anal Surgery

基　　金：广西医药卫生自筹经费计划课题(Z201553)

摘　　要：目的探讨个案管理模式对肠造口患者主要照顾者心理韧性及生活质量的影响。方法纳入2015年1月至2016年6月于本院接受永久性肠造口患者的主要照顾者(130例)为研究对象,随机均分为两组,每组各65例。对照组予常规护理干预,观察组接受个案管理护理。所有对象持续随访至患者出院后6个月,分别于出院时、出院1月、3月、6月时采用康纳-戴维森韧性量表(CD-RISC)测评照顾者心理韧性,采用照顾者负担量表(ZBI)、生活满意度指数A(LSIA)测评照顾者生活质量。结果观察组出院后CD-RISC评分、ZBI评分、LSIA评分明显升高,对照组出院后CD-RISC评分明显下降,ZBI评分明显升高,LSIA评分先下降后上升,自身不同时间比较差异均有统计学意义(均P<0.05)。观察组出院1月、3月、6月时CD-RISC评分明显高于对照组,ZBI评分明显低于对照组,LSIA评分明显高于对照组,两组间差异均有统计学意义(均P<0.05)。结论个案管理模式能够有效提升肠造口患者主要照顾者心理韧性,这有助于减轻其照顾负荷,从而提升其生活质量。Objective To investigate the effect of personalized management nursing on psychological resilience and quality of life of primary caregivers in patients with colostomy. Methods 130 primary caregivers of patients who underwent colostomy in our hospital from January 2015 to June 2016 were randomly assigned to 2 groups. The control group received routine nursing intervention, and the treatment group received personalized management nursing. All cases were follow-up for 6 months after discharge. At discharge, 1 month, 3 months and 6 months after discharge, psychological resilience of caregivers were examined by Connor-Davidson Resilience Scale（CD-RISC）, quality of life by Zarit Caregiver Burden Interview（ZBI） and Life Satisfactory Index A（LSIA）. Results In the treatment group, scores of CD-RISC, ZBI and LSIA increased significantly after discharge, while in the control group, scores of CD-RISC decreased significantly, ZBI increased significantly, and LSIA decreased first then increased after discharge. These change trends were statistically significant（P〈0.05）. The scores of CD-RISC in the treatment group were significantly higher, the scores of ZBI significantly lower, and the scores of LSIA significantly higher than in the control group at 1 month, 3 months and 6 months after discharge. These differences were statistically significant（P〈0.05）. Conclusion Personalized management nursing can effectively improve psychological resilience of the primary caregivers in patients with colostomy, which helps to ease the burden of care and improve their quality of life.

关 键 词：个案管理 肠造口 主要照顾者 心理韧性 生活质量 

分 类 号：R473.6[医药卫生—护理学]