微信群延续干预对永久性肠造口患者术后早期社会心理适应和生活质量的影响

Effect of continuous intervention of WeChat group on the early psychosocial adaptation and quality of life of patients undergoing permanent enterostomy

目的:探讨微信群延续性干预对永久性肠造口患者术后早期社会心理适应和生活质量的影响。方法:以2015年10月-2016年8月我院收治的86例永久性肠造口术后患者为对象,随机数字表法均分为对照组和观察组各43例,对照组术后接受常规干预,观察组在此基础上另实施微信群延续性干预,观察干预前后两组早期社会心理适应量表(OAI-20)评分、自我护理能力实施量表(ESCA)评分、生活质量问卷(COHQOL-OQ)量表评分及出院3个月后并发症发生情况。结果:与出院时相较,出院后3个月两组正性情绪、负性情绪及社会生活适应评分、生理维度、心理维度、社会维度和精神维度评分明显升高,差异显著(t观察组=18.003,28.973,18.280,4.433,5.299,6.889,7.932;t对照组=8.814,15.543,10.616,2.235,3.142,4.678,5.011;P<0.05),并且观察组各项指标的升高幅度较对照组明显(t=8.498,17.216,8.309,2.390,2.295,2.421,3.106;P<0.05);出院后1、3个月两组ESCA评分明显升高,差异显著(F=8.923,7.502;P<0.001),观察组升高幅度较对照组明显(F=6.852,P<0.05);出院后3个月观察组并发症发生率11.63%较对照组34.88%明显低,差异有统计学意义(χ2=6.515,P<0.05)。结论:微信群延续性干预可有效提高永久性肠造口术后患者早期社会心理适应能力和自我护理能力,达到提升术后患者生活质量及降低并发症发生率的目的。

Objective:To investigate the effect of continuous care of WeChat group on the early psychosocial adaptation and quality of life of patients undergoing permanent enterostomy.Methods:A total of 86 patients undergoing permanent enterostomy in the hospital from October 2015 to August 2016 were selected as subjects,and they were randomly divided into the control group and the observation group,with 43 cases in each group.The control group was given routine intervention while the observation group was additionally given continuous intervention of WeChat group after operation.Scores of the Ostomates’Adjustment Inventory-20(OAI-20),the exercise of self-care agency scale(ESCA)and quality of life questionnaire(COHQ O L-O Q)and the incidence of complications in 3 months after discharge in the two groups were recorded.Results:Scores of positive emotion,negative emotion,social adaptation,physiological dimension,psychological dimension,social dimension and spiritual dimension in the two groups at 3 months after discharge were significantly higher than those at discharge(t=18.003,28.973,18.280,4.433,5.299,6.889,7.932,8.814,15.543,10.616,2.235,3.142,4.678,5.011,P<0.05),and the increased ranges of above-mentioned indexes in the observation group were more obvious than those in the control group(t=8.498,17.216,8.309,2.390,2.295,2.421,3.106,P<0.05).ESCA scores of the two groups were significantly increased at 1 month and 3 months after discharge(F=8.923,7.502;P<0.001),and the increased ranges in observation group was more obvious than those in the control group(F=6.852,P<0.05).The incidence of complications in the observation group in 3 months after discharge was significantly lower than that in the control group(χ^2=6.515,P<0.05).Conclusion:Continuous intervention of WeChat group can effectively improve the psychosocial adaptation and self-care ability of patients undergoing permanent enterostomy,so as to improve the quality of life and reduce the incidence of complications in patients after operation.