新构建的延续护理模式应用于肠造口患者的效果研究

Study on the practical effect of the newly continuous nursing mode constructed for patients with enterostomy

目的探讨对肠造口患者采用新构建的延续护理模式的实践效果。方法以整体护理为核心理念,以奥马哈系统为理论框架,以需求层次理论和遗忘曲线原理为参考依据,从延续护理团队、随访形式、随访频率、护理内容、护理流程5个方面建立肠造口患者的延续护理模式。选择该院2017年4-12月因结直肠癌行肠造口手术的患者128例作为研究对象,通过随机数字表法分为试验组(n=63)和对照组(n=65)。试验组实施上述建立的延续护理模式,对照组实施常规的出院护理,干预6个月后通过认知-行为-状况(KBS)评分、造口适应能力、造口自我护理能力、造口并发症发生率及出院护理满意度分析实践效果。结果试验组患者干预前后的KBS评分比较,差异有统计学意义(P<0.05),造口适应能力和自我护理能力也较干预前明显提高,差异均有统计学意义(t=-16.217、29.287,P<0.05);试验组造口适应能力、造口自我护理能力、护理服务满意度显著高于对照组,造口并发症发生率明显低于对照组,差异均有统计学意义(t=-9.753、6.648、-9.357,χ^2=12.098,P<0.05)。结论新构建的延续护理模式科学实用,有效改善了肠造口患者的健康状况,降低了并发症发生率,提高了造口适应能力和自我护理能力,提升了护理服务满意度。

Objective To explore the practical effect of the newly continuous nursing mode constructed for patients with enterostomy.Methods With holistic care as the core concept,Omaha system as the theoretical framework,demand level theory and the forgetting curve principle as the reference basis,the model of continuous care for patients with intestinal stoma was established from five aspects:continuous care team,follow-up form,follow-up frequency,nursing content and nursing process.128 cases patients who underwent enterostomy for colorectal cancer in the hospital from April to December 2017 were selected as the study subjects and randomly divided into the experimental group(n=63)and the control group(n=65)through the random number table method.The experimental group implemented the extended care model established above,and the control group received routine discharge care.After 6 months of intervention,the practice effect was analyzed by means of cognitive-behavior-status(KBS)score,stomatal adaptability,stomatal self-care ability,stomatal complication rate and discharge nursing satisfaction.Results The KBS scores of the experimental group before and after the intervention showed statistically significant differences(P<0.05),and the stomatal adaptability and self-care ability were significantly improved compared with those before the intervention(t=-16.217,29.287,P<0.05).In the experimental group,the stoma adaptability,stoma self-care ability and nursing service satisfaction were significantly higher than those in the control group,and the incidence of stoma complications was significantly lower than that in the control group,with statistically significant differences(t=-9.753,6.648,-9.357,χ^2=12.098,P<0.05).Conclusion The continuous nursing model constructed is scientific and practical,which effectively improves the health status of patients with enterostomy,reduces the incidence of complications,improves the stoma adaptability and self-care ability,and improves the satisfaction of nursing.