个案管理对肠造口患者生活质量、抑郁、自护能力的影响研究  

Effect of case management nursing model on quality of life,psychology and self-care of patients with enterostomy

作　　者：马辉[1] 韦瑞丽[1] 班翠珍[1] 李丽[1] 梁珠明[1] 左萍[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6期779-782,共4页Journal of Colorectal & Anal Surgery

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题;合同号:Z2015532

摘　　要：目的探讨个案管理护理模式对肠造口患者生活质量、抑郁、自我护理能力的影响。方法选择2015年1月至2016年6月在本院接受肠造口手术的86例患者,随机分为观察组与对照组,每组各43例。观察组接受个案管理护理模式,对照组应用常规护理。随防至出院后3个月,比较两组护理前后的生活质量、心理状况、自我护理能力的变化情况,并比较两组造口及造口周围皮肤并发症发生率。结果术前两组生活质量评分(总分及生理、心理、社会、精神健康各维度评分)、抑郁评分与自护能力评分差异均无统计学意义(均P>0.05)。出院3个月后两组生活质量总评分及各维度评分均升高(均P<0.05),且观察组总分和各维度评分均高于对照组(均P<0.05);两组的抑郁评分均下降,且观察组低于对照组(P<0.05);两组自护能力评分均升高(均P<0.05),且观察组高于对照组。两组住院期间与出院后1个月并发症发生率差异均无统计学意义(均P>0.05);观察组出院后3个月并发症发生率均低于对照组(P<0.05)。结论个案管理护理模式有利于提高肠造口患者生活质量、改善心理状态并增强自我护理能力,降低造口并发症发生风险,值得临床推广应用。Objective To study the effect of case management nursing model on quality of life,psychological and self-care in patients with enterostomy. Methods 86 patients with enterostomy were recruited and assigned treatment group and control group using random number table. The treatment group received the case management nursing model during hospitalization, while the control group received routine nursing. The quality of life before and after intervention was evaluated using the Chinese version of City of Hope Qual- ity of Life-Ostomy Questionnaire. The psychological depression status was assessed by the Hamilton Depression Scale. Self-care ability was assessed using the Exercise of Self-Care Agency scale. The incidence of stoma stenosis and the incidence of skin complications around the stoma during hospitalization and at three months of follow-up were compared between the two groups. Results There were no significant difference in the scores of physical,psychological, social and mental health between the two groups before treatment （P 〉 0.05）. After treatment,the scores in both groups increased （P 〈 0.05）. The scores of physical,psychological ,social and mental health and the overall score in the treatment group [（5.1±1.1）points, （4.9±1.0）points, （5.4±1.2）points, （4.4±0.7）points, （4.9±1.3）points,respectively ] were higher than those in the control group [ （4.6±1.0）points, （4.4±0.9）points, （4.8± 1.1）points, （3.7±0.8）points, （4.1 ± 1.1）points, respectively] （P 〈 0.05）. There were no significant difference of HAMA score and ESCA score before intervention between the two groups （P 〉 0.05）. The HAMA scores decreased and the ESCA scores increased in both groups after intervention （P 〈 0.05）. The HAMA score in the treatment group [（13.1±1.6）points] was lower than in the control group [（14.2±1.9）points],and the ESCA score [（55.1±6.5） points] was higher than in the control group[（50.2±7.1）points] （P 〈 0.05）. There was no s

关 键 词：肠造口 个案管理护理模式 生活质量 抑郁 自我护理能力 

分 类 号：R473.73[医药卫生—护理学]