互联网＋健康宣教在肠造口患者中的应用

Application of internet plus health education in stoma patients

目的探讨互联网+健康宣教在肠造口患者中的应用效果。方法选取2017年1月至8月在国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科住院的270例肠造口患者,按照宣教的时间顺序分为观察组和对照组。对照组采用常规围手术期护理模式。观察组在对照组的基础上增加互联网+的模式,通过公众号的互动、云课堂、门诊病历互联网反馈等形式进行健康宣教,比较两组患者在出院后造口并发症的发生率及护理宣教满意度情况。结果观察组患者在出院后1个月造口周围粪水性皮炎(χ~2=5.391,P=0.02)、皮肤黏膜分离(χ~2=4.014,P=0.045)均低于对照组,观察组出院3个月造口周围粪水性皮炎(χ~2=5.137,P=0.023)及造口回缩的发生率(χ~2=4.060,P=0.044)均低于对照组。统计观察组患者在出院后第3个月的患者满意度,其中宣教途径及方式(χ~2=5.40,P=0.02)、问题反馈及时效性(χ~2=5.065,P=0.024)优于对照组,差异均有统计学意义(P <0.05)。结论互联网+健康宣教在肠造口患者的应用中能明显降低患者早期造口并发症的发生率,提升了患者的生活质量,增加了患者对护理宣教的满意度,值得借鉴和推广。

Objective To explore the application effect of Internet plus health education in patients with colostomy. Methods From January to August 2017, 270 colostomy patients hospitalized at the National Cancer Center/National Clinical Research Center for Cancer/Colorectal Surgery Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College were selected and divided into the observation group and the control group according to the chronological order of the mission. The control group used a conventional perioperative care model. The observation group increased the Internet plus model on the basis of the control group and conducted health education through the public number interaction, cloud classroom, outpatient medical record internet feedback and other forms. The incidence of complications and nursing education satisfaction were compared between the two groups of patients after discharge from the hospital. Results In the observation group, fecal dermatitis around the stoma （χ^2=5.391, P=0.02） and skin mucous membrane separation （χ^2=4.014, P=0.045） were lower than those in the control group one month after discharge. The observation group was discharged for three months. The incidence of fecal dermatitis （χ^2=5.137, P=0.023） and ostomy retraction （χ^2=4.060, P=0.044） was lower in the mouth than in the control group. The patient satisfaction rate of the observation group in the 3rd month after discharge was better than that of the control group in terms of the way and way of education （χ^2=5.40, P=0.02）, problem feedback and timeliness （χ^2=5.065, P=0.024）. All have statistical significance （P 〈 0.05）. Conclusion Internet plus health education can significantly reduce the incidence of early ostomy complications in the application of enterostomal patients, improve the patient＇s quality of life, increase the patient＇s satisfaction with nursing education, it is worth learning and promotion.