延续性护理对永久性结肠造口患者自护能力及自我效能的影响

Influence of continuous nursing on self-caring ability and self-efficacy in patients with permanent colonic fistula

目的研究延续性护理对永久性结肠造口患者自护能力及自我效能的影响。方法将2013年1月～2015年1月沈阳医学院附属中心医院外科收治的永久性结肠造口患者100例作为研究对象。按照手术日期分为对照组及观察组，每组50例。对照组患者给予常规的出院指导及随访教育，观察组在常规指导的基础上给予延续性护理，建立患者的疾病资料档案，制订个性化的健康指导方案，通过各种通讯设施随时进行回访、答疑并解决患者问题。分别对两组患者出院时、出院1个月末、出院3个月末进行自我护理能力测评和一般自我效能量表（GSES）评分。结果两组患者在出院时自我护理能力及自我效能差异无统计学意义（P〉0．05），出院1个月末、出院3个月末观察组患者的自我护理能力及自我效能显著优于对照组，差异有统计学意义（P〈O．05）。结论延续性护理能提高永久性结肠造口患者的自护能力及生活质量，通过回访答疑，解决了患者疾病康复知识缺乏的问题，增强了其自我效能感，值得临床推广。

Objective To study the influence of continuous nursing on self-caring ability and self-efficacy in patients with permanent colonic fistula. Methods 100 cases of patients with permanent colonic fistula treated in Surgery Department of Center Hospital Affiliated to Shenyang Medical School from January 2013 to January 2015 were selected as research objects. According to the date of surgery patients were divided into the control group and observation group, each group had 50 cases. Patients in the control group were given conventional discharge guidance and follow-up education. On the basis of the control group, patients in the observation group were given continuous nursing, established disease data files, developed personalized health guidelines, through a variety of communications to review, answer questions and solve the problem of patients. Self-care ability assessment and general self-efficacy scale were evaluated at discharge, 1 month after discharge, 3 months after discharge. Results The self-caring ability and self-efficacy of patients had no significant differences between the two group at discharge （P 〉 0.05）. 1 month and 3 months after discharge, the self-caring ability and self-efficacy of patients in the observation group were all better than those in the control group, with statistically significant differences （P 〈 0.05）. Conclusion Continuous nursing can improve the self-caring ability and living quality of patients with permanent colonic fistula. Through the return visit, can solve the problem of patients＂ lack of disease rehabilitation knowledge, enhance their self-efficacy, which is worthy of clinical promotion.