个案管理模式在直肠癌肠造口患者围手术期的应用及效果评价  

Application of case management of patients with rectal cancer with stoma during perioperative period

作　　者：白燕 

机构地区：[1]国家肿瘤临床医学研究中心天津市“肿瘤防治”重点实验室天津市恶性肿瘤临床医学研究中心天津医科大学肿瘤医院结直肠科,300060

出　　处：《中国实用护理杂志》2018年第4期265-269,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨个案管理模式在直肠癌肠造口患者围手术期护理管理中的应用及效果。方法将2016年1—6月收治的直肠癌Miles手术患者38例设为对照组，采取常规责任制护理模式；2016年7-12月收治的直肠癌Miles手术患者36例设为试验组，运用个案管理模式。比较2组患者干预前后焦虑、抑郁水平、造口适应能力、患者满意度，并对数据进行分析。结果干预前2组患者焦虑、抑郁水平差异无统计学意义（P〉0．05），干预后出院后3个月试验组焦虑水平由（53．65±5．34）分下降至（36．43±6．55）分，抑郁水平由（52．33±9．34）分下降至（35．43±9．85）分，试验组比对照组改善更明显，差异有统计学意义（t=-3．893、-2．637，P〈0．05），试验组患者造口适应能力3个维度、满意度明显高于对照组，差异有统计学意义（t=6．584～13．787，P〈0．05）。结论个案管理模式能够改善直肠癌造口患者的焦虑、抑郁水平，提高造口术后适应能力及患者满意度。Objective To implement the nursing process of case management to rectal cancer patients who received surgical procedure of ostomy and evaluate the effect of this nursing process, Methods The control group included 38 patients who underwent the surgery of Miles and received regular nursing care between January 2016 and June 2016, while the experimental group included 36 patients underwent the same surgery but received the nursing process of case management between July 2016 and December 2016. Both groups were followed from admission till 3 months after discharge. Data of anxiety scores, depression scores, adjustment scores and satisfaction scores were compared between two groups. Results The anxiety and depression scores were not statistically significant between two groups by the time of admission（P 〉0.05）, while the anxiety scores of the experimental group dropped from （53.65± 5.34） points down to （36.43 ± 6.55） points, and the depression scores decreased from （52.33 ± 9.34） points to （35.43±9.85） points. The anxiety and depression scores of the experimental group differed significantly from the control group（t =-3.893,- 2.637, P〈0.05）. The data of adjustment scores and satisfaction scores indicated significant differences between two groups （t=6.584-13.787, P〈0.05）. Conclusions Nursing process of case management improves the level of anxiety, depression, adjustment and satisfaction.

关 键 词：肛门肿瘤 生活质量 肠造口术 围手术期 个案管理 

分 类 号：R473.73[医药卫生—护理学]