社区结肠造口术后管理模式承接出院后患者管理的效果分析

Analysis for the effect of discharged colostomy patients management supervised by community post-colostomy management mode

目的探讨社区结肠造口术后管理模式承接出院后患者管理的效果。方法选取广州市居住的出院造口患者62例,进行社区结肠造口术患者的管理,管理3个月,前后分别使用SF36生活质量评价量表和社会支持评定量表及健康行为能力自评量表进行管理效果评估。结果 SF36生活质量评价量表调查问卷对患者干预前后生活质量进行多维评价。干预前后一般健康状况、精力、情感职能、精神健康以及总分的差异有统计学意义(P<0.05)。社会支持评定量表SSRS评价中,其中主观支持、对支持的利用度及总分差异有统计学意义(P<0.01)。健康行为能力自评量表SRAHP4个分量表干预后得分均高于干预前,其中营养、心理安适及总分的差异有统计学意义(P<0.01)。结论社区结肠造口术后管理模式承接出院后患者管理能提高造口患者的综合状态和生命质量,为社区开展出院后造口患者的继续康复提供可操作性的经验。

Objective To observe the management efficiency of discharged patients supervised by community postcolostomy management mode. Methods 62 post-colostomy patients in Huanghuagang street community,who were discharged from the top three hospitals in Guangzhou and under recovery at home, lived on their own were enrolled into the study. Community doctors, nurses with colostomy specialist training provided technical support, and community health managers and social workers took part in the management of the patients. Before and after 3 months management, the MOS 36-item Short Form Health Survey, Social Support Rating Scale（SSRS）, and self-rated abilities for health practices scale（SRAHP） were used in evaluating the efficiency of the management. Results Patients’ qualities of life before and after discharged were evaluated by the MOS 36-item Short Form Health Survey. The general health status, energy,emotional function, mental health and total score had significantly improved after management（P ≤0.05）. In social support revalued scale（SSRS）, the subjective support, utilization degree of support, and the difference of total score of every item had significantly improved after management（P≤0.01）. The scores of all 4 subscales in self-rated abilities for health practices scale（SRAHP） after intervention exceeded those before intervention. Among subscales, the differences in nutrition, psychological well-being and total score had statistical significant improved. Conclusion To apply community post-colostomy management mode to supervise discharged colostomy patients could advance the patients’ general health status and quality of life. It offers a set of feasible experiences for the rehabilitation of discharged colostomy patients in community.