延续性护理对泌尿造口患者生活质量的影响

Effects of continuing nursing on quality of life in patients with urology stoma

目的：探讨延续性护理改善泌尿造口术后患者生活质量的效果。方法选择2014年1月—2015年6月因肌层浸润性膀胱肿瘤行膀胱全切＋泌尿造口的患者61例,按便利抽样法分为观察组（ n＝30）和对照组（ n＝31）,对照组实施常规的泌尿造口围术期健康教育,观察组在常规健康教育的基础上实施延续性护理,针对性地做好健康教育。采用生活质量各因子评分量表比较两组患者术后生活质量的差异,比较两组造口术后并发症发生率。结果术后3个月,观察组患者在生活质量各因子评分中睡眠质量（71.5±10.68）、活动及感觉（73.4±11.94）、疾病认知能力（71.33±13.52）、工作与适应社会（68.00±16.83）及生活与娱乐（68.3±13.42）分,均优于对照组,差异有统计学意义（t值分别为2.37,2.02,2.06,2.88,2.04；P〈0.05）；术后12个月,对照组患者发生尿酸结晶1例、造口旁疝5例、造口周围皮炎3例,造口并发症发生率高于观察组,差异有统计学意义（χ^2值分别为3.968,4.322,5.985；P〈0.05）。结论将延续性护理充分应用于泌尿造口手术患者,提高了患者的生活质量及社会归属感,满足了护理需求,降低了再入院率及家属的照顾压力。

Objective To explore the effects of continuing nursing on quality of life （ QOL） in patients with urology stoma. Methods Totally 61 patients from January 2014 to June 2015 with muscle invasive bladder cancer who underwent radical cystectomy and urinary colostomy surgery were selected randomly and divided into the experimental group （ n=30） and the control group （ n=31）. Patients in the control group were given conventional urinary colostomy perioperative health education, while patients in the experimental group received continuing nursing on the basis of conventional urinary colostomy perioperative health education. The QOL of patients in two groups were compared by the rating scale of QOL, and the occurrence rate of complications in urinary colostomy surgery was compared in two groups. Results 3 months after surgery, the score of factors in QOL in the experimental group was higher than the control group：the score of sleep quality was （71.5±10.68）;activities and feelings was （73.4±11.94）;cognitive ability of disease was （71.33±13.52）;work and adapt to the society was （68.00±16.83）;life and entertainment was （68.3±13.42）. The differences were significant （t=2.37, 2.02,2.06,2.88,2.04;P〈0.05）. 12 months after surgery, in the control group, there was 1 case of uric acid crystal, 5 cases of parastomal hernia, 3 cases of colostomy dermatitis, and the incidence rate of complications was higher than the experimental group （χ^2=3.968,4.322,5.985;P〈0.05）.Conclusions Continuing nursing applied to the patients with urinary stoma can significantly improve the QOL and social sense of belonging, meet the needs of nursing, and decrease the readmission rate and the nursing stress of families.