改良路径化教育应用于尿路造口患者的效果观察及分析

Effect analysis of modified path education in patients with urinary tract ostomy

目的研究改良路径化教育应用于尿路造口患者的效果。方法选择山东省菏泽市立医院2016年8月至2017年10月收治的96例膀胱癌患者，所有患者均接受膀胱全切术＋尿流改道术，采用随机数字表法将患者分为观察组与常规组各48例，常规组患者提供科室传统路径化教育流程，观察组患者在常规组护理基础上提供改良路径化教育，评价2组患者造口知识掌握度评分、满意度、并发症发生情况。结果观察组患者术后3个月造口并发症发生率为6．25％（3，48），低于常规组的25．00％（12／48），差异有统计学意义（r=7．157，P〈0．01）。观察组患者对造口相关知识掌握度评分平均为（54．63 ±4．10）分，高于常规组的（40．38 ±3．40）分，差异有统计学意义（t=18．536，P〈0．05）。观察组患者对护理服务满意度为95．83％（46／48），高于常规组的72．92％（35／48），差异有统计学意义（r=9．561，P〈0．01）。结论改良路径化教育应用后，可有效提高患者满意度及造口护理知识掌握度，降低造口并发症发生率，具有可行性。

Objective To study the effect of improved path education in patients undergoing urostomy. Methods A total of 96 cases of bladder cancer patients in Heze Municiple hospital of Shandong Province from August 2016 to October 2017 were selected. All patients underwent radical cystectomy and urinary diversion, randomly divided patients into the observation group and the routine group with 48 cases in each group. Patients in the observation group were provided with improved path education on the basis of the routine nursing, while patients in the routine group provided traditional pathway education flow in departments. The quality of life score, the mastery degree of stoma, satisfaction degree and the occurrence of complications were evaluated in the two groups. Results The incidence of stoma complications in the observation group was 6.25% （3/45） after 3-month operation, which was lower than 25.00% （12/48） in the conventional group （.12=7.157, P〈0.05）. The average score of stoma related knowledge in the observation group was 54.63 ± 4.10, which was higher than 40.38 ± 3.40 in the conventional group （t=18.536, P〈0.05）. The satisfaction rate of patients in the observation group was 95.83% （46/48）, which was higher than 72.92% （35/48） in the routine group （x^2=9.561, P〈0.05）. Conclusions The application of improved path education can effectively improve patient satisfaction and knowledge of stoma nursing knowledge, and reduce the incidence of stoma complications, which is feasible.