模拟训练法对肠造口术后早期照护者造口护理能力的影响  

Effect of simulation training method on ostomy care ability of early caregivers after colostomy

作　　者：陈晓丽 周茹珍 吴秀琴 孙琪 邱群 Chen Xiaoli;Zhou Ruzhen;Wu Xiuqin;Sun Qi;Qiu Qun(Department of Colorectal Surgery,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Outpatient Clinic,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院肛肠外科,上海200433 [2]海军军医大学第一附属医院门诊部,上海200433

出　　处：《中华结直肠疾病电子杂志》2021年第4期436-440,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：上海市青年科技英才扬帆计划(No.20YF1448700);海军军医大学第一附属医院234学科攀峰计划项目(No.2020YZL010)。

摘　　要：目的探讨模拟训练法对照护者造口护理能力的影响。方法选取海军军医大学第一附属医院肛肠外科2019年4月至2019年9月直肠癌造口术后患者的照护者为研究对象,按手术后时间顺序分为对照组和试验组。对照组(47例)接受常规宣教造口袋更换;试验组(49例)在对照组基础上增加造口模型模拟训练。采用自我护理量表-早期版评价照护者出院前1天造口护理能力,电话或微信随访评价照护者1个月内造口护理能力、患者造口门诊护理率和造口周围皮肤并发症的发生率。结果试验组照护者出院前1天更换造口袋能力显著高于对照组(39.12±2.49 vs.37.02±2.82,t=-3.877;P<0.001)。试验组照护者1个月内更换造口袋时间显著短于对照组(20.73±4.04 vs.24.00±5.21,t=3.442;P=0.001)。试验组造口门诊护理率和造口周围并发症发生率均显著低于对照组(χ^(2)=6.773,4.426;P=0.009,0.035)。结论模拟训练法能有效提高照护者造口护理能力,减少了造口门诊依赖及造口周围并发症的发生。Objective To explore the effect of simulation training method on the care ability of early caregivers.Methods The caregivers of rectal cancer patients after colostomy were selected from Department of Colorectal Surgery in the First Affiliated Hospital of Naval Medical University between April,2019 and September,2019,and divided into control group and experimental group according to operation time.Fortyseven cases in the control group received routine education on colostomy bag replacement.Forty-nine cases in the experimental group were given simulated stoma model training besides routine education.SSCS-early stage version was used to evaluate the care ability of caregivers on the day before discharge.The care ability of caregivers,outpatient nursing rate and stoma complication incidence were also evaluated by phone and outpatient clinic in the forth week.Results The care ability of cases in the experimental group was stronger than that of cases in the control group(39.12±2.49 vs.37.02±2.82,t=-3.877;P<0.001).The time of changing ostomy bag of cases in the experimental group was significantly shorter than that of cases in the control group(20.73±4.04 vs.24.00±5.21,t=3.442;P=0.001).The outpatient nursing rate and incidence of stoma complications in the experimental group were significantly lower than those in the control group(χ^(2)=6.773,4.426;P=0.009,0.035).Conclusions The simulation training method can effectively improve the ostomy care ability of the caregivers,reduce the stoma outpatient clinic dependence and stoma complications incidence.

关 键 词：直肠肿瘤 结肠造口术 模拟训练 照护者 造口护理能力 影响因素 

分 类 号：R473.73[医药卫生—护理学]