输尿管皮肤造口患者自我管理方案的构建与实证研究  

Construction and empirical study of self management program for patients with ureteral skin stoma

作　　者：王双凤[1] 刘会范[1] 丁清清[1] 左书强[1] 齐艳[1] 李文清[1] 

机构地区：[1]郑州大学第一附属医院外科医学部,450052

出　　处：《中国实用护理杂志》2018年第6期417-421,共5页Chinese Journal of Practical Nursing

基　　金：河南省医学科技攻关计划（201503H015）

摘　　要：目的构建一个针对性较强且适合输尿管皮肤造口患者的自我管理方案，并对该方案进行初步验证。 方法经2轮德尔菲专家函询法构建《输尿管皮肤造口患者自我管理方案》，获得专家一致性意见后按照方案的内容要求，通过定期一对一造口护理技能训练、精神支持及动机性面谈、记录造口日记的方式对试验组（41例）输尿管皮肤造口患者进行自我管理干预，对照组（40例）给予常规护理干预，在干预后1、3、6个月对患者的自我管理结果进行评测。 结果对照组患者干预后1、3、6个月的自我管理能力总得分分别为（99.32 ± 10.41）、（105.34 ± 13.75）、（109.18 ± 10.91）分，试验组患者分别为（106.73 ± 13.82）、（117.65 ± 15.47）、（129.43 ± 12.37）分，2组比较差异均有统计学意义（t=7.847、9.318、11.416，均P〈0.01）；对照组患者干预后1、3、6个月的生命质量总得分分别为（167.18 ± 24.62）、（173.36 ± 25.33）、（179.48 ± 22.17）分，试验组患者分别为（178.66 ± 23.47）、（185.41 ± 22.67）、（213.17 ± 26.75）分，2组比较差异有统计学意义（t=6.839、10.241、13.926，均P〈0.01）。 结论构建的输尿管皮肤造口患者自我管理方案提高了患者的自我管理能力，改善了患者术后生命质量。ObjectiveTo construct a self management program for patients with ureteral stoma, then validate the proposal. MethodsThe expert consensus reached an agreement after 2 rounds of Delphi expert consultation of ＂self management programme＂, according with the contents of the manual requirements, the intervention patients （41 cases） were given these self management interventions： regular one-on-one ostomy skills training, mental support and motivational interview, recording stoma diary, the control patients were given routine nursing interventions, after 1, 3 and 6 months of implementation, their results of self management was evaluated. ResultsThe total score of self-management ability was 99.32±10.41, 105.34±13.75, 109.18±10.91 in the control group after the intervention of 1, 3 and 6 months respectively, and 106.73 ± 13.82, 117.65 ± 15.47, 129.43 ± 12.37 in the test group, the differences were statistically significant （t=7.847, 9.318, 11.416, P〈0.01）. The total score of quality of life was 167.18 ± 24.62, 173.36 ± 25.33, 179.48 ± 22.17 in the control group after the intervention of 1, 3 and 6 months respectively, and 178.66 ± 23.47, 185.41 ± 22.67, 213.17 ± 26.75 in the test group, the differences were statistically significant （t=6.839, 10.241, 13.926, P〈0.01）. ConclusionsThe construction of the ureterostomy self-management program, enhance patients’ self-management consciousness, and improve the ability of self-management.

关 键 词：输尿管皮肤造口 自我管理 延续性护理 德尔菲法 

分 类 号：R473.73[医药卫生—护理学]