应用路径式管理对结肠造口病人实施延续护理的效果

THE EFFECTS OF CONTINUEING NURSING ON COLOSTOMY PATIENTS USING PATH MANAGEMENT

目的探讨应用路径式管理对结肠造口病人实施延续护理的效果。方法将入选的51例直肠癌术后结肠造口病人随机分为试验组（26例）和对照组（25例）。出院时建立造口病人联系档案,试验组发放路径式造口门诊复诊单,对其复诊实行路径式管理,对照组采用普通复诊方式。两组分别于干预前、干预后3个月及1年,运用DET评分系统对造口周围皮肤进行量化评估。结果干预前两组造口周围皮肤的健康状况评分比较差异无统计学意义（P〉0.05）;干预后3个月和1年试验组评分均显著低于对照组（t′=2.65~3.42,t=3.69~5.59,P〈0.05）。结论应用路径式管理模式对造口病人实施延续护理,能增强造口病人自我护理的意识及技能,降低造口周围皮肤并发症发生的概率,提高生活质量。

Objective To explore the effects of path management on continueing nursing care for patients with colostomy. Methods Fifty-one patients with colostomy after surgery for rectal cancer were selected in this study,who were randomized to experimental group（n=26）and control group（n=25）.A file was established for the patients on discharge for keeping in touch.For the patients in experimental group,an outpatient follow-up single was provided to carry out path-management,and for those in the control group,a normal further consultation was done.DET scoring system was applied to quantitatively evaluate the skin around the stoma in the two groups,before the intervention,and three months as well as one year after the intervention.ResultsBefore intervention,the health condition of peristomal skin was not statistically different between the two groups with regard to the score（P〉0.05）;after the intervention,the score in the experimental group was obviously lower than that in the control（t′=2.65-3.42,t=3.69-5.59;P〈0.05）. Conclusion Using nursing path management model to carry out continueing nursing care for patients with colostomy can strengthen the patient＇s self-care awareness and skills and lower the chance of complications of peristomal skin,improve the quality of life.