文章摘要

多学科协作式延续性护理在直肠癌造口患者中的应用效果

作者: 1赵娜, 1郑海平, 1冯美丽, 1白雅玲, 2赵晨阳, 1鲍博婕
1 张家口市第一医院(西院区)普外一科，河北 张家口 075000
2 张家口市第一医院(西院区)心胸外科，河北 张家口 075000
通讯: 赵娜 Email: zhaonana12@163.com
DOI: 10.3978/j.issn.2095-6959.2022.12.035
基金: 河北省重点科研项目(20201600)。

摘要

目的：探讨多学科延续性护理在直肠癌造口患者中的应用效果。方法：选取2019年9月至2020年9月张家口市第一医院收治的130例直肠癌行永久性结肠造口术患者为研究对象。采用随机数字表法分为对照组与研究组，各65例。对照组予以常规护理，研究组在常规护理的基础上实施多学科协作式延续性护理。干预3个月后，比较两组造口周围皮肤评分、并发症发生率、自我护理能力评分、心理状况评分、生活质量评分及护理满意度。结果：干预后，研究组造口周围皮肤变色、侵蚀、组织增生评分及造口周围皮肤总分均明显低于对照组(均P<0.05)。研究组粪水性皮炎及并发症总发生率均明显低于对照组(均P<0.05)。研究组自我护理能力各分量表自我技能、自护责任感、自我概念、自护知识评分及总分均明显高于对照组(均P<0.05)。研究组焦虑评分及抑郁评分均明显低于对照组(均P<0.05)。研究组生活质量问卷(Quality of Life Questionnaire Core 30，QLQ-C30)各分量表躯体功能、角色功能、认知功能、情绪功能、社会功能评分均明显高于对照组(均P<0.05)。研究组护理总满意率为92.31%，明显高于对照组的75.38%(P<0.05)。结论：直肠癌造口术后应用多学科协作式延续性护理能明显降低患者造口周围皮肤评分及并发症的发生率，提高患者的自我护理能力、生活质量、满意度。
关键词： 多学科协作；延续性护理；直肠癌造口；造口周围皮肤；自我管理能力

Application effect of multidisciplinary collaborative continuous nursing in colostomy patients for rectal cancer

Authors: 1ZHAO Na, 1ZHENG Haiping, 1FENG Meili, 1BAI Yaling, 2ZHAO Chenyang, 1BAO Bojie
1 Department of General Surgery 1, Zhangjiakou First Hospital (West Campus), Zhangjiakou Hebei 075000, China
2 Department of Cardiothoracic Surgery, Zhangjiakou First Hospital (West Campus), Zhangjiakou Hebei 075000, China

CorrespondingAuthor: ZHAO Na Email: zhaonana12@163.com

DOI: 10.3978/j.issn.2095-6959.2022.12.035

Foundation: This work was supported by the Key Scientific Research Projects of Hebei Province, China (20201600).

Abstract

Objective: To explore the application effect of multidisciplinary continuous nursing in colostomy patients of rectal cancer. Methods: A total of 130 patients with rectal cancer who underwent permanent colostomy in Zhangjiakou First Hospital from September 2019 to September 2020 were selected as research objects. A random number table method was used to divide the patients into a control group and a study group, with 65 cases in each group. The control group was given routine nursing, and the study group was given multidisciplinary collaborative continuous nursing on the basis of routine nursing. After 3 months of intervention, the skin score around the stoma, the incidence of complications, self-care ability score, psychological status score, quality of life score, and nursing satisfaction were compared between the 2 groups. Results: After the intervention, the scores of skin discoloration, erosion, tissue hyperplasia, and total score of skin around the stoma in the study group were significantly lower than those in the control group (all P<0.05). The total incidence of fecal dermatitis and complications in the study group was significantly lower than that in the control group (both P<0.05). The scores of self-skills, self-care responsibility, self-concept, self-care knowledge, and total score of elf-care ability in the study group were significantly higher than those in the control group (all P<0.05). The anxiety score and depression score of the study group were significantly lower than those of the control group (both P<0.05). The scores of physical function, role function, cognitive function, emotional function, and social function in each subscale of Quality of Life Questionnaire Core 30 (QLQ-C30) in the study group were significantly higher than those in the control group (all P<0.05). The total satisfaction rate of nursing in the study group was 92.31%, which was significantly higher than 75.38% in the control group (P<0.05). Conclusion: The application of multidisciplinary collaborative continuous nursing after colostomy for rectal cancer can significantly reduce the skin score around the stoma and the incidence of complications, improve the self-care ability, quality of life of patients, and satisfaction.

Keywords： multidisciplinary collaboration; continuous nursing; rectal cancer colostomy; skin around stoma; self-management ability

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