多学科协作管理对回肠造口刺激性皮炎患者自我管理效能的影响

Effect of multidisciplinary collaboration management on the self-management efficacy of patients with ileostomy irritant dermatitis

目的探讨多学科协作管理干预模式对回肠造口刺激性皮炎患者自我管理效能的影响。方法选取2016年8月到2018年8月中国科学院大学宁波华美医院肛肠外科及造口门诊的回肠造口患者中发生刺激性皮炎者,根据纳入标准和排除标准,最终确定72例刺激性皮炎患者作为研究对象,依据随机数字表法分为对照组和观察组各36例,并对两组患者的年龄、性别、学历方面进行比较。对照组采用常规护理方法,观察组在对照组常规措施基础上进行多学科护理干预,两组干预2个月前后均采用中文版癌症自我管理效能量表进行问卷调查,并对调查结果进行比较分析,采用独立样本t检验进行组间比较,配对样本t检验进行组内比较。结果干预后,自我管理效能总分及正性态度、自我减压和自我决策得分观察组均高于对照组,差异有统计学意义(t=4.192、3.095、4.123、2.267,P均<0.05)。两组干预后自我管理效能总分及各维度得分均高于干预前,差异有统计学意义(P均<0.01)。干预后,再次发生刺激性皮炎的患者观察组是3例(10.0%),对照组13例(43.3%),观察组患者的复发率明显低于对照组,差异有统计学意义(χ^2= 8.357,P<0.05)。结论采用多学科协作管理,能提高刺激性皮炎造口患者自我管理效能感,降低刺激性皮炎的发生。

ObjectiveTo investigate the effects of the multidisciplinary cooperative management intervention model on the self-management efficacy of patients with ileostomy irritant dermatitis. MethodsAmong the patients with irritative dermatitis in the ileostomy section of the Anorectal Surgery and Ostomy Clinic of Hwamei Hospital, the Chinese Academy of Sciences, 72 patients, who visited the clinic from August 2016 to August 2018, met the inclusion criteria and were finally included in the study. According to the random number table method, 36 patients each were assigned to the control and observation groups respectively. There were no significant differences in age, sex and education between the two cohorts. The control groups were compared. The control group was treated with routine nursing methods. The observation group underwent multidisciplinary nursing intervention that was based on the routine measures of the control group. The Chinese version of the cancer self-management efficacy was used as the questionnaire survey that was administered before and after treatment. The results were compared and analyzed between the patient groups. The independent sample t-test was used to compare the results between the groups, and the paired sample t-test was used for intra-group comparisons. ResultsAfter intervention, the total scores of self-management efficacy and positive attitude, self-decompression and self-decision scores were higher in the observation group than in the control group (t=4.192, 3.095, 4.123, 2.267, P<0.05). The scores of self-administration efficacy and each dimension of the two groups were higher than those before intervention, and the difference was statistically significant (P<0.01). After the intervention, 3 patients (10.0%) in the observation group with recurrent dermatitis and 13 patients (43.3%) in the control group. The recurrence rate of the observation group was significantly lower than that of the control group (χ^2= 8.357, P<0.05). ConclusionMultidisciplinary cooperative management can improve the self-management efficacy of patients with irritating dermatitis and reduce the incidence of this condition.