直肠癌保肛术后患者自我管理方案的构建与应用  

Construction and application of self-management program for patients with rectal cancer after sphincter-preserving surgery

作　　者：张亚静 朱卉[1] 龙裕[1] 马宏文[2] ZHANG Yajing;ZHU Hui;LONG Yu;MA Hongwen(Department of Colorectal Surgery,Tianjin Union Medical Center,Tianjin,300121,China)

机构地区：[1]天津市人民医院肛肠科,天津市300121 [2]天津市人民医院护理部,天津市300121

出　　处：《中国护理管理》2025年第1期145-150,共6页Chinese Nursing Management

基　　金：天津市卫生健康科技项目资助(TJWJ2024QN049);天津市护理学会2023年度立项科研课题(tjhlky2023QN04);天津市人民医院科研项目(2022YJHL001)。

摘　　要：目的:基于个人与家庭自我管理理论,构建直肠癌保肛术后患者自我管理方案并评价其应用效果,为改善患者症状提供参考。方法:采用文献回顾、小组讨论、半结构访谈及专家函询方法构建直肠癌保肛术后患者自我管理方案。便利选取2021年1月至2023年8月天津市某三级甲等医院直肠癌保肛术后患者为研究对象,将患者按入院先后分为对照组和干预组各48例。对照组按常规实施护理,干预组接受直肠癌保肛术后患者自我管理方案,干预时长为3个月。比较干预前后两组低位前切除综合征症状发生情况、自我管理能力及生活质量得分。结果:干预组低位前切除综合征症状发生情况优于对照组,差异有统计学意义(P<0.05);干预组自我管理得分高于对照组,生活质量得分低于对照组,差异均有统计学意义(P<0.05)。结论:构建的直肠癌保肛术后患者自我管理方案可改善低位前切除综合征症状,提高患者的自我管理能力和生活质量。Objective:To construct a self-management program for patients with rectal cancer after sphincter-preserving surgery based on the individual and family self-magement theory and evaluate its application effects,so as to provide reference for improving patients'symptoms.Methods:Using literature review,group discussion,semi-structured interviews and expert correspondence,a self-management program for patients with rectal cancer after sphincter-preserving surgery was constructed.Patients with rectal cancer after sphincter-preserving surgery in a tertiary hospital in Tianjin from January 2021 to August 2023 were selected by convenience sampling,and the patients were divided into a control group(48 cases)and an intervention group(48 cases)according to the order of admission.Those in the control group received routine nursing care,while those in the intervention group were with self-management program for 3 months.The incidence of symptoms of Low Anterior Resection Syndrome(LARS),self-management ability and quality of life were compared between the two groups before and after intervention.Results:The incidence of LARS in the intervention group was lower than those in the control group(P<0.05),the scores of self-management was higher than that in the control group(P<0.05),and the score of quality of life was lower that in the control group(P<0.05).Conclusion:The self-management program for patients with rectal cancer after sphincter-preserving surgery can alleviate the symptoms of LARS,improve the self-management ability and quality of life of patients.

关 键 词：直肠癌保肛术 个人与家庭自我管理理论 低位前切除综合征 自我管理 生活质量 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]