延续护理联合中医按摩及PDSA循环对永久性肠造口患者的影响

The Functions of Continuous Nursing, TCM Massage and PDSA Cycle on the Patients with Permanent Enterostomy

目的研究以积极心理学为基础的延续护理联合中医按摩及PDSA循环对永久性肠造口患者自我效能感的影响。方法将82例患者随机分为观察组和对照组,每组41例。对照组予以常规延续性护理干预,观察组采用以积极心理学为基础的延续护理联合中医按摩及PDSA循环干预。对2组患者均进行为期3个月的干预,比较2组干预前后自我效能感情况并发症发生情况及患者满意度情况。结果:干预后观察组造口照顾效能、社交效能、饮食选择效能、对性生活的信心、对性生活满意度的信心、从事重体力劳动的信心、保持活力的信心、造口自理的信心评分均明显高于对照组(P<0.05)。观察组粪水性皮炎与造口旁疝发生率分别为4 88%(2/41)、0.00%(0/41)均低于对照组的29.27%(12/41)、12.20%(5/41)差异均有统计学意义(P<0.05)。满意度观察组为97.56%(40/41),对照组为82.93%(34/41) 2组比较差异有统计学意义(P<0.05)。结论:以积极心理学为基础的延续护理联合中医按摩及PDSA循环应用于肠造口患者中可有效提高患者自我效能感,降低粪水性皮炎与造口旁疝发生率,提高患者满意度。

Objective:To study the effects of positive psychology-based continuous nursing,TCM massage and PDSA cycle on self efficacy of the patients with enterostomy.Methods:A total of 82 patients were randomly allocated to the observation group and the control group,41 cases each group.The control group accepted conventional continuous nursing intervention,and the observation group were intervened by positive psychologybased continuous nursing,TCM massage and PDSA cycle.Both groups were intervened for three months,to compare self efficacy conditions,complication incidences and the patientst satisfactory degree between both groups before and after the intervention.Results:After the intervention,the observation group was higher than the control group in the scores of stomal care efficiency,social efficiency,diet selection efficiency,the confidence in sexual life,the confidence in the satisfactory degree to sexual life,the confidence in working in hard physical labor,the confidence in maintaining vatility and stomal self-care notably(P <0.05).The incidences of fecal water-borne dermatitis and parastomal hernia of the observation group were 4.88%(2/41) and 0.00%(0/41),lower than 29.27%(12/41) and 12.20%(5/41) of the control group,and the difference had statistical meaning(P<0.05).The satisfactory degree of the observation group was 97.56%(40/41),higher than 82.93% of the control group(34/41),and there was a significant difference(P<0.05).Conclusion:Positive psychology-based continuous nursing,TCM massage and PDSA cycle applied to the patients with enterostomy could effectively raise self efficacy,lower the incidences of fecal water-borne dermatitis and parastomal hernia,and raise the patientst satisfactory degree.