超低位直肠癌ISR术后康复训练依从性的影响因素及护理对策研究

Factors associated with compliance of patients with ultra-low rectal cancer after ISR and the role of nursing rehabilitation training

目的探讨超低位直肠癌经肛门内外括约肌间切除(inter sphincteric resection,ISR)术后康复训练依从性的影响因素及护理对策。方法纳入本院94例行ISR术的超低位直肠癌患者为研究对象,采用自行设计问卷调查患者一般资料、临床疾病资料及康复训练依从性,并对一般资料、临床疾病资料进行单因素、Logistic多因素回归分析,依据影响因素采取相应的护理措施。结果单因素分析显示,年龄、文化程度、家庭人均月收入、Dukes分期、手术方式、内括约肌切除方式、并发症、疼痛程度是影响康复训练依从性的相关因素(P<0.05)。Logistic多因素回归分析表明,文化程度、Dukes分期、手术方式、内括约肌切除类型、并发症、疼痛程度是影响康复训练依从性的主要因素(P<0.05)。结论超低位直肠癌ISR术后康复训练依从性受多种因素影响,尤其是文化程度、Dukes分期、手术方式、内括约肌切除类型、并发症、疼痛程度,护理人员需依据患者具体情况采取有效的护理干预措施,以提高康复训练依从性。

Objective To study factors associated with compliance of patients with ultra-low rectal cancer after inter sphincteric resection（ISR） and the role of nursing strategies of the rehabilitation training. Methods 94 patients with ultra-low rectal cancer who underwent ISR in our hospital were selected as the research subjects. Self designed questionnaire was used to investigate the demographics, clinical data and rehabilitation training compliance. Univariate and logistic multivariate regression analysis were used for data analysis. Results Univariate analysis showed that age, educational level, family income, Dukes stage, surgical approach and internal sphincter resection, complications, degree of pain were factors significantly influencing the compliance of rehabilitation training（P 〈0.05）. Multivariate Logistic regression analysis showed that the factors influencing the compliance of rehabilitation training were the education level, Dukes stage, surgical approach, the type of internal sphincter resection, complications, and the degree of pain（P〈 0.05）. Conclusion The compliance of rehabilitation training for patients with ultra-low rectal cancer after ISR is influenced by many factors, especially the educational level, Dukes stage, surgical methods, types of internal sphincter resection, complications,and the degree of pain. Nursing staff should take appropriate nursing interventions according to the specific circumstances of patients,in order to improve the compliance of rehabilitation training.