无缝隙护理对直肠癌造口患者负性情绪及其应对方式选择的影响

Effect of intensive nursing on negative emotion and coping style in patients undergoing rectal cancer ostomy

目的观察无缝隙护理对直肠癌造口患者负性情绪及其应对方式选择的影响。方法选取我院2012年8月至2014年8月68例直肠癌永久性造口患者为研究对象,随机分为观察组与对照组(每组各34例),观察组实施无缝隙护理流程并采取无缝隙护理质量控制标准,对照组采取常规直肠癌永久性造口护理路径。比较两组护理前、出院前及出院后3月的焦虑(SAS)及抑郁(SDS)评分变化,采用应对方式评价量表(CCMQ量表)分析护理前后对负性情况的应对方式选择及生活质量情况。结果护理前,两组SAS、SDS评分比较无统计学意义(P>0.05);护理后,两组评分较组内前一时点降低,差异有统计学意义(P<0.05),观察组同时点SAS、SDS评分显著低于对照组,差异有统计学意义(P<0.05)。护理前,两组应对方式评分各维度评分比较,差异无统计学意义(%0.05);护理后,观察组CCMQ量表面对维度评分高于护理前及对照组护理后,差异有统计学意义(P<0.05)。观察组回避和压抑、发泄、屈服、幻想评分低于对照组,差异有统计学意义(P<0.05)。护理前,两组生活质量各维度比较差异无统计学意义(P>0.05),观察组社会维度、情感维度及总分高于对照组,差异有统计学意义(P<0.05)。结论无缝隙护理可较好改善直肠癌永久造口患者院内及院外负性情绪,提高患者术后生活应对能力,使生存质量获益。

Objective To investigate the effect of intensive nursing on negative emotion and coping style in patients undergoing rectal cancer ostomy. Methods Sixty-eight patients who underwent permanent rectal cancer ostomy from August 2012 to August 2014 were selected as the study subjects and were randomly assigned into the treatment group and the control group, with 34 cases in each group. Intensive nursing and quality control were provided for the treatment group and routine nursing was provided for the control group. The scores of anxiety （SAS） and depression （SDS） were compared between the two groups before nursing and at different time points after nursing. The Cancer Coping Modes Questionnaire （CCMQ） was used to evaluate the changes of coping style and quality of life before and after nursing. Results SAS and SDS scores did not differ between the two groups at baseline. After the treatment, SAS and SDS scores decreased significantly in both groups （both P〈 0.05） and were significantly lower in the treatment group than in the control group （P〈 0.05）. Scores of CCMQ did not differ between the two groups at baseline. After treatment, score of facing decreased signifi- cantly in the treatment group and was significantly higher than in the control group （P〈 0.05）. The scores of avoidance, depression, abreaction, yielding and illusion in the treatment group were lower than control group （P〈 0.05 ）. There was no significant difference in the quality of life between the two groups at baseline （P 〉 0.05 ）. After treatment, the scores of social dimensions, affective dimensions and total score in the treatment group were significantly higher than in the control group （P 〈 0.05 ）. Conclusion Intensive nursing can relieve negative emotion of patients undergoing permanent rectal cancer ostomy and improve the coping ability and quality of life in these patients.