出院计划在直肠癌肠造口患者中的应用效果  

Application of discharge planning in rectal cancer patients with a stoma

作　　者：罗小红[1] 邓丽彩[1] 张燕飞[1] 黄秀荣[1] 陈德凤[1] Xiao-Hong Luo;Li-Cai Deng;Yan-Fei Zhang;Xiu-Rong Huang;De-Feng Chen(Department of Gastrointestinal Surgery,the People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi Zhuang Autonomous,China)

机构地区：[1]广西壮族自治区人民医院胃肠外科,广西壮族自治区南宁市530021

出　　处：《世界华人消化杂志》2019年第7期435-441,共7页World Chinese Journal of Digestology

基　　金：广西壮族自治区卫生和计划生育委员会基金资助项目;No.桂卫Z2016767;No.桂卫Z20170406~~

摘　　要：背景直肠癌是常见的消化系统恶性肿瘤,手术是治疗的主要方式,术后肠造口影响患者的躯体结构、生活方式、心理调试、社会适应性.探索提高直肠癌肠造口患者造口适应性和生活质量的方法有助于患者顺利回归家庭与社会.目的探讨出院计划服务对直肠癌肠造口患者造口适应性、生活质量与造口并发症的影响.方法采用便利抽样法选择2016-10/2018-03在广西壮族自治区人民医院治疗的直肠癌肠造口患者100例为研究对象.采用随机数字表将其分为对照组与观察组,每组50例.对照组采用常规护理及电话随访,观察组在常规护理的基础上实施出院计划模式进行延续性护理,两组病人干预时间均为6 mo.比较两组患者的造口适应性、生活质量、造口并发症发生率等指标.结果出院3 mo和6 mo,观察组造口适应性明显高于对照组,差异均有统计学意义(t=2.136和6.713, P<0.05);观察组总体生活质量高于对照组,差异均有统计学意义(t=22.52和24.87, P<0.05); 6 mo内,观察组造口并发症发生率低于对照组,差异有统计学意义(χ~2=15.072, P <0.05).结论出院计划模式应用于直肠癌肠造口患者的延续护理中,能提高患者了造口适应性及生活质量,降低造口并发症发生率,值得进一步推广应用.BACKGROUND Rectal cancer is a common malignant tumor of the digestive system. Surgery is the main method of treatment for rectal cancer. Enterostomy affects the patient’s body structure, lifestyle, psychological adjustment, and social adaptability. Exploring ways to improve the stoma adaptability and quality of life in patients with rectal cancer can help patients return to their families and society smoothly. AIM To evaluate the effects of discharge planning in rectal cancer patients with a stoma. METHODS Using the convenience sampling method, 100 rectal cancer patients with a stoma were selected and randomly divided into a control group and an observation group, with 50 cases in each group. The control group received routine nursing intervention and telephone followup, while the observation group received planned nursing intervention at discharge and routine nursing intervention. The adaptation level to stoma, quality of life, and incidence of colostomy complications were compared between the two groups. RESULTS Three and six mo after discharge, the ostomy adjustment inventory (OAI) scores in the observation group were significantly higher than those of the control group (t = 2.136 and 6.713, P < 0.05). The scores of quality of life in the observation group were significantly higher than those in the control group (t = 22.52 and 24.87, P < 0.05). The incidence of colostomy complications in the observation group was significantly lower than that of the control group (χ^2 = 15.072, P < 0.05).CONCLUSION The application of discharge planning in rectal cancer patients with a stoma can help improve the adaptation level to stoma, effectively improve the quality of life, and reduce the incidence rate of colostomy complications.

关 键 词：直肠癌 造口 造口适应性 生活质量 延续护理 

分 类 号：R473.73[医药卫生—护理学]