结构-过程-结果三维模式在腹壁尿路造口患者全程化管理中的应用  

Application of Three-dimensional Model of Structure-process-outcome on the Whole-course Management of Patients with Abdominal Urinary Ostomy

作　　者：李瑞[1] 欧密[1] 李艳[1] 杨瑛[1] 王春晖[1] 吕凤琳[1] LI Rui;OU Mi;LI Yan;YANG Ying;WANG Chun-hui;LV Feng-lin(Dept.of Urology,Yan’an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院泌尿外科,云南昆明650051

出　　处：《昆明医科大学学报》2020年第5期163-166,共4页Journal of Kunming Medical University

基　　金：云南省科技惠民专项基金资助项目(2017RA017)。

摘　　要：目的探讨结构-过程-结果三维质量评价模式在膀胱全切+腹壁尿路造口患者全程化管理中的应用效果评价。方法选取2016年1月至2018年9月在昆明市某三级甲等医院泌尿外科住院治疗的膀胱癌尿流改道行腹壁尿路造口的65例患者为研究对象,将2016年1月至2017年6月住院治疗的33例患者设为对照组,实施常规的护理措施及出院后电话回访;2017年7月至2018年9月住院治疗的32例患者设为干预组,实施三维质量评价模式管理方案。结果干预组患者住院满意度和自我护理能力得分明显优于对照组(P<0.05),术后3个月内总体并发症发生率低于对照组,差异具有统计学意义(P<0.05)。结论结构-过程-结果三维质量评价模式可以作为膀胱癌腹壁尿路造口患者全程化管理的有效干预模式,值得临床推广应用。Objective To evaluate the application of structure-process-outcome three-dimensional quality evaluation model in the whole-course management of patients with total cystectomyplus abdominal urinary ostomy.Methods Sixty-five patients with bladder cancer who underwent total cystectomyplus abdominal urinary ostomy in a urological department of a third-grade hospital in Kunming from January 2016 to September 2018 were included.33 hospitalized patients from January 2016 to June 2017 were set as the control group,routine nursing measures and telephone interviews after discharge were performed;32 hospitalized patients from July2017 to September 2018 were set as the intervention group.For this group,we built the whole-process nursing program based on the structure-process-outcome three-dimensional quality evaluation model.Results The hospitalization satisfaction rate andself-care ability score in the intervention group were higher than those in the control group(P<0.05).On the overall complication rate in 3 months,the intervention group were lower than that in the control group(P<0.05).The differences were statistically significant.Conclusion The structure-process-outcome three-dimensional quality evaluation model can be used as an effective intervention model for the whole-course management of bladder cancer patients withabdominal urinary ostomy,which is worthy of clinical application.

关 键 词：结构-过程-结果三维质量评价模式 膀胱癌 膀胱全切 尿流改道 尿路造口 

分 类 号：R473[医药卫生—护理学]