延续护理对直肠癌造口患者康复期抑郁程度的影响

Effect of continuous nursing treatment on the depression degree reducing of rectal cancer patients with stoma

目的探讨延续护理对降低直肠癌造口患者康复期抑郁程度的效果。方法采用Zung抑郁自评量表（SDS），在进行延续护理前后分别对2011年6—8月在北京某三级甲等医院接受直肠癌造口手术出院后康复期的31例患者进行测评，并对数据进行分析。结果31例患者手术出院后康复期的SDS评分（61．45±9．66）分，31例患者中有抑郁症状者23例，其中轻度抑郁1例，中度抑郁17例，重度抑郁5例。延续护理前SDS得分（61．45±9．66）分，高于国内常模的（41．85±10．57）分，差异有统计学意义（t=11．293，P〈0．01）。采用延续护理后该31例患者康复期的SDS评分（44．35±10．41）分，与干预前得分比较，差异有统计学意义（t=6．702，P〈0．01）；干预后得分和国内常模比较，差异无统计学意义（t=1．34，P〉0．05）。结论直肠癌造口患者术后康复期存在不同程度的抑郁，延续护理可有效改善直肠癌造口患者的抑郁状况。护理人员应关注康复期的直肠癌造口患者，通过提供延续护理，进行针对性健康教育和心理指导。

Objective To explore the effect of continuous nursing treatment on the depression degree reducing of rectal cancer patients with stoma. Methods The study used the SDS and ordinary investigation material, evaluated 31 rectal cancer patients with stoma in one of Beijing Grade A hospitals between June and August in 2011, who had received continuous nursing treatment in convalescence stage after discharging. Results SDS score of 31 operated patients in convalescence stage after discharging was （61.45 ±9.66）, 23 of them were suffered depression. Among 23 patients, one cases was diagnosed mild depression, 17 cases were moderate depression, 5 cases were sever depression. SDS score before the nursing treatment （61.45 ± 9.66） was higher than that of domestic normal model （41.85 ± 10.57）, and the difference was statistically significant （ t = 11.293, P 〈0.01）. After continuous nursing, the SDS score of 31 patients （44.35 ± 10.41） decreased significantly than that of before intervention, and the difference was statistically significant （ t = 6. 702, P 〈 0.01 ）. while the score was no significant difference compared with that of the domestic normal model （ P 〉 0.05）. Conclusions There are different depression degree of the rectal cancer patients with stoma in convalescence stage. Continuous nursing can effectively improve the depression degree of the patients. The nurses should pay attention to those discharged patients, and offer corresponding health education and psychological advice to the patients by providing continuous nursing service.