行动研究实践在直肠癌造口院外健康管理中的应用

Application of action research practice in the out-of-hospital health management of patients with rectal cancer stoma

目的探讨行动研究实践在直肠癌造口院外健康管理中的应用价值。方法采用便利抽样法,选取河南省南阳市中心医院2017年3月—2018年3月行动研究实践实施前收治的直肠癌造口患者46例为对照组,2018年4月—2019年4月行动研究实践实施后收治的直肠癌造口患者46例为观察组。对照组患者术后行常规护理,观察组术后开展行动研究实践护理。实施前后采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、自我护理能力量表(ESCA)和简明健康状况量表(SF-36)比较两组实施效果。结果观察组护理后HAMA(15.65±10.31)分、HAMD(17.41±9.25)分,均低于对照组,差异有统计学意义(t值分别为2.181,2.384;P<0.05)。观察组护理后ESCA总分(114.96±20.45)分,对照组(100.28±16.80)分,差异有统计学意义(t=3.762,P<0.05)。观察组护理后SF-36量表总体健康(19.11±5.08)分、对照组(17.11±4.12)分,差异有统计学意义(t=2.074,P<0.05)。结论开展行动研究实践对直肠癌造口患者进行院外健康管理,可缓解患者负性情绪,提高患者自我护理能力及生活质量,具有较高的临床应用价值。

Objective To explore application values of action research practice in the out-of-hospital health management of patients with rectal cancer stoma.Methods According to the convenience sampling method,46 patients with rectal cancer stoma who were admitted to Nanyang Central Hospital of Henan Province from March 2017 to March 2018 before the implementation of the action research practice were selected as the control group and 46 patients with rectal cancer stoma who were admitted from April 2018 to April 2019 after the implementation of the action research practice were selected as the observation group.The control group was given routine nursing after surgery while the observation group was given action research practice nursing after surgery.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Exercise of Self-Care Agency Scale(ESCA)and MOS 36-Item Short-Form Health Survey(SF-36)were used before and after implementation to compare the implementation effects between the two groups.Results After nursing,scores of HAMA and HAMD in the observation group were respectively(15.65±10.31)points and(17.41±9.25)points,both lower than those in the control group and the differences were statistically significant(t=2.181,2.384;P<0.05).After nursing,the total score of ESCA of the observation group and the control group were respectively(114.96±20.45)points and(100.28±16.80)points and the difference was statistically significant(t=3.762,P<0.05).After nursing,the overall health of SF-36 scale was(19.11.±5.08)points in the observation group and(17.11±4.12)points in the control group and the difference was statistically significant(t=2.074,P<0.05).Conclusions Carrying out action research practice for out-of-hospital health management of patients with rectal cancer stoma can alleviate negative emotions and improve self-care ability and quality of life of patients,which has relatively high clinical application value.