基于积极心理学的延续护理结合PDSA循环对肠造口患者自我效能感的影响

Effects of extended nursing combined with PDSA circle and based on positive psychology on self-efficacy of patients with colostomy

目的探讨基于积极心理学的延续护理结合PDSA循环在提高肠造口患者自我效能感的作用。方法选取2014年12月-2015年12月80例符合纳入和排除标准的肠造口患者，按照出院日期先后顺序依次分为干预组和对照组；对照组采用常规延续护理，干预组采取基于积极心理学结合PDSA循环对患者进行延续护理，分别于患者出院后1周、出院后第1、2、3个月各进行1次干预。分别于干预前（即基线资料）、第4次干预结束后及干预结束后3个月（分别用T0、T1、T2表示），采用造口相关自我效能问卷进行测评。结果除了对性生活的信心这个单独条目外，造口相关自我效能各维度、各单独条目和总分的干预主效应及时间主效应差异均有统计学意义（P〈0．05），且存在交互效应（P〈0．05），对性生活的信心此单独条目的干预时间主效应差异有统计学意义（P〈0．05），且存在交互效应（P〈0．05）；干预组在干预结束后即刻及干预结束后3个月造口相关自我效能各维度、各单独条目和总分均明显高于干预前。结论基于积极心理学结合PDSA循环的延续护理有助于提高肠造口患者自我效能水平。

Objective To explore the function of extended nursing combined with PDSA circle and based on positivepsychology in improving self-efficacy of patients with colostomy. Methods A total of 80 patients with colostomy match the inclusion and exclusion standard from December 2014 to December 2015, were divided into the control group and the intervention group according to the order of discharge date.Patients in the control group received conventional extended nursing, while patients in the intervention group received extended nursing combined with PDSA circle and based on positivepsychology, and interventions were conducted a week, a month, two months, three months after discharge. Patients were evaluated by stoma related self- efficacy questionnaire before the intervention, after the fourth intervention and 3 months after intervention （ T0 , T1 ,T2）. Results There were significant differences in the dimensions, independent items and total scores of stoma related self-efficacy between two groups at different time after intervention except the item of confidence in sexual life （P〈0.05）, and they also had interactive effect （P〈0.05）.There was significant difference in the main effect of intervention time for the single item ＂confidence in sexual life＂ （P〈0.05）. In the intervention group, the scores of dimensions, independent items and total scores of stoma related self-efficiency after intervention and three months ＇after intervention were significantly higher than those before intervention. Conclusions The extended nursing combined with PDSA circle and based on positivepsychology can improve the self-efficacy of patients with colostomy.