自我效能干预联合常规护理在永久性肠造口患者中的应用

Effect of Self-efficacy Intervention Combined with Conventional Nursing on Psychological Fluctuation in Patients with Permanent Enterostomy

目的观察自我效能干预联合常规护理在永久性肠造口患者中的护理效果及对心理波动的影响。方法选择2015年1月至2016年8月于本院行永久性肠造口的70例患者为研究对象,随机分为对照组(n=35)和观察组(n=35)。对照组实施常规护理,观察组在此基础上联合自我效能干预。采用一般自我效能量表对两组护理前以及护理后1个月进行评分,采用汉密尔抑郁量表(hamilton depression scale,HAMD)及焦虑自评量表(self-rating anxiety scale,SAS)对患者护理前、后进行评定,比较2组护理效果及对心理波动的影响。结果护理前,两组自我护理概念、自我护理责任感、自我护理知识、自我护理技能及自我效能总分差异均无统计学意义(均P>0.05);护理1个月后,观察组上述项目评分均显著高于对照组,差异均有统计学意义(均P<0.05)。护理前,两组HAMD及SAS评分差异均无统计学意义(均P>0.05);护理1个月后,观察组上述评分均显著低于对照组,差异均有统计学意义(均P<0.05)。两组护理后并发症总发生率差异无统计学意义(P>0.05)。结论永久性肠造口患者在常规护理基础上联合自我效能干预效果理想,对患者心理波动影响较小,值得推广应用。

Objective To observe the effect of self-efficacy intervention and routine nursing on psychological fluctuation in patients with permanent colostomy Methods 70 patients with permanent colostomy were randomly divided into two groups： control group（n =35） and treatment group（n = 35）. The control group received the routine nursing,treatment group with self-efficacy intervention. The self-efficacy scale of 2 groups before and 1 months after nursing were compared. Total self nursing concept,self-care responsibility,self-care knowledge,self-care skills and self-efficacy;Hamilton Depression Scale（hamilton depression scale,HAMD） and self rating Anxiety scale（self-rating anxiety scale,SAS） were evaluated before and after the nursing,and were compared between the two groups to investigate the nursing effect and influence on psychological fluctuations. Results The total score of self nursing concept,self-care responsibility,self-care knowledge,self-care skills and self-efficacy in the treatment group after nursing is higher than that of control group（P〈0. 05）.The depression scale and anxiety scale score in the treatment group after nursing were lower than those in the control group（P〈0. 05）.Complication rate was lower in the treatment group than in the control group（P〈0. 05）. Conclusion The effect of self efficacy intervention on the basis of routine nursing for the patients with permanent colostomy is good,and has little effect on the patients psychological fluctuation. It has potential for wide clinical application.