自我管理干预在膀胱癌输尿管皮肤造口患者中的应用  

Application of self-management intervention in patients with bladder cancer undergoing cutaneous ureterostomy

作　　者：赵会平[1] 阚全玲 肖瑶 王航 梁馨月 Zhao Huiping;Kan Quanling;Xiao Yao;Wang Hang;Liang Xinyue(Department of Urinary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《中华现代护理杂志》2021年第20期2771-2775,共5页Chinese Journal of Modern Nursing

摘　　要：目的:探讨自我管理干预在膀胱癌输尿管皮肤造口患者中的应用效果。方法:选取2019年1—10月某三甲级医院泌尿外科实施根治性膀胱全切加输尿管皮肤造口并符合纳入标准的119例患者为研究对象,按照随机数字表法分为对照组(60例)与干预组(59例)。对照组采用常规护理方法,干预组在对照组的基础上实施自我管理干预。干预6个月后,应用造口患者适应量表与造口患者生活质量量表比较两组患者的适应水平与生活质量情况。结果:干预后,干预组患者的造口适应水平总分[(57.26±10.35)分]及各维度评分[接受(16.43±3.64)分,持续担忧(24.18±5.11)分,积极的生活态度(16.65±3.26)分]均高于对照组[(51.07±10.84)、(15.06±3.73)、(22.02±5.35)、(13.99±3.18)分],差异均有统计学意义(t值分别为3.185、2.027、2.252、4.506;P<0.05)。干预后,干预组患者的生活质量总分[(136.10±35.57)分]及各维度评分[生理健康(32.41±7.44)分,心理健康(49.22±14.36)分,社会健康(35.36±9.04)分,精神健康(19.11±5.98)分]低于对照组[(153.09±36.19)、(36.02±7.63)、(54.84±15.29)、(39.15±9.76)、(23.08±5.86)分],差异均有统计学意义(t值分别为2.582、2.613、2.066、2.197、3.658;P<0.05)。结论:自我管理干预能改善膀胱癌输尿管皮肤患者的造口适应水平,提高患者的生活质量,适合应用于造口患者的延续性护理中。Objective To explore the application effect of self-management intervention in patients with bladder cancer undergoing cutaneous ureterostomy.Methods A total of 119 patients who received radical total cystectomy and cutaneous ureterostomy in Department of Urinary Surgery of a ClassⅢGrade A hospital from January to October 2019 and met the inclusion criteria were selected as the research objects.According to the random number table,they were randomly divided into the control group(n=60)and in the intervention group(n=59).The control group adopted conventional nursing methods,while the intervention group implemented self-management intervention on the basis of the control group.After 6 months of intervention,Adaptation Scale for Stoma Patients and Quality of Life Scale for Stoma Patients were used to compare the adaptation level and quality of life of patients of the two groups.Results After intervention,the total score of ostomy adaptation level(57.26±10.35)and scores of various dimensions[acceptance(16.43±3.64),continuous worry(24.18±5.11)and positive attitude towards life(16.65±3.26)]of patients in the intervention group were higher than those of the control group[(51.07±10.84),(15.06±3.73),(22.02±5.35),(13.99±3.18)],and the differences were statistically significant(t=3.185,2.027,2.252,4.506;P<0.05).After the intervention,the total score(136.10±35.57)and various scores[physical health(32.41±7.44),mental health(49.22±14.36),social health(35.36±9.04)and mental health(19.11±5.98)]of patients in the intervention group were lower than those of the control group[(153.09±36.19),(36.02±7.63),(54.84±15.29),(39.15±9.76)and(23.08±5.86)],and the differences were statistically significant(t=2.582,2.613,2.066,2.197,3.658;P<0.05).Conclusions Self-management intervention can improve the stoma adaptation level of patients with bladder cancer undergoing cutaneous ureterostomy and improve the quality of life of them,so it is suitable to be applied in the continuous care of patients with stoma.

关 键 词：膀胱肿瘤 膀胱造口术 生活质量 适应 自我管理 延续护理 

分 类 号：R473.73[医药卫生—护理学]