全程化延续性护理对机器人辅助根治性膀胱切除术联合腹壁造口患者自我管理、生活质量和造口并发症的影响  

Effect of whole-course continuity of care on self-management,quality of life and stoma complications in patients undergoing robot-assisted radical cystectomy combined with abdominal wall ostomy

作　　者：原晓婷 王李倩 弥长虹 程蕊 YUAN Xiaoting;WANG Liqian;MI Changhong;CHENG Rui(Department of Urology,the First Affiliated Hospital of Air Force Medical University,Xi’an 71000,China)

机构地区：[1]空军军医大学第一附属医院泌尿外科,陕西西安710000

出　　处：《机器人外科学杂志（中英文）》2024年第6期1260-1265,共6页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(2019JM7152)。

摘　　要：目的:探讨全程化延续性护理对机器人辅助根治性膀胱切除术(RARC)联合腹壁造口患者自我管理能力、生活质量和造口并发症的影响。方法:选取2018年1月—2023年9月行RARC联合腹壁造口的152例患者,以随机数表法分为对照组(行常规护理干预,76例)和研究组(行全程化延续性护理干预,76例),比较两组患者的自我管理效能、生活质量和造口并发症发生情况。结果:与干预前比较,干预后3个月两组患者癌症自我管理效能感量表(SUPPH)各维度评分及总分均升高,且研究组SUPPH各维度评分及总分高于对照组(P<0.05)。与干预前比较,干预后3个月两组患者欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)中的总体健康、功能评分升高,症状、特异性评分降低,且研究组总体健康、功能评分高于对照组,症状、特异性评分低于对照组(P<0.05)。与对照组比较,研究组的周围皮炎发生率及造口总并发症发生率更低(P<0.05)。结论:全程化延续性护理应用于RARC联合腹壁造口患者,可提高患者的自我管理能力和生活质量,降低造口并发症发生率。Objective:To investigate the effects of whole-course continuity of care on the self-management ability,quality of life and stoma complications of patients who underwent robot-assisted radical cystectomy(RARC)combined abdominal wall ostomy.Methods:152 patients who underwent RARC combined abdominal wall ostomy from January 2018 to September 2023 were selected.They were divided into the control group(n=76)and the study group(n=76)using a random number table.The control group received routine nursing intervention,while the study group received whole-course continuity of care.Self management efficacy,quality of life,and stoma complication of patients in the two groups were compared.Results:Compared with that before intervention,the scores of all dimensions and total scores of strategies used by people to promote health(SUPPH)were all increased in the two groups after 3 months’intervention,and the scores of all dimensions and total scores of SUPPH in the study group were higher than those in the control group(P<0.05).Compared with that before intervention,patients in both groups at 3 months post-intervention had higher overall health and functioning scores and lower symptom and specificity scores in the European Organization for Research and Treatment of cancer quality of life questionnaire(EORTC QLQ-C30).The overall health and functional scores of the study group were higher than those of the control group,and the symptom and specificity scores were lower than those of the control group(P<0.05).Compared with the control group,the incidence rate of peripheral dermatitis and total stoma complications were lower in the study group(P<0.05).Conclusion:Application of whole-course continuity of care in patients who underwent RARC combined abdominal wall ostomy can improve patients’self-management ability and quality of life,and reduce the incidence of stoma complications.

关 键 词：全程化延续性护理 机器人辅助手术 根治性膀胱切除术 腹壁造口 自我管理 生活质量 造口并发症 

分 类 号：R473.6[医药卫生—护理学] R737.14[医药卫生—临床医学]