直肠癌永久性造口者出院准备度调查及影响因素分析

Survey on the Readiness for Hospital Discharge of Rectal Cancer Patients Underwent Permanent Ostomy,and Analysis on the Relevant Influence Factors

为调查直肠癌永久性造口者出院准备度情况,并分析影响出院准备度的因素,本研究使用一般资料调查表、出院准备度量表和出院指导质量量表,对2017年4月至2018年4月于甘肃省武威市人民医院和甘肃省肿瘤医院接受永久性肠造口的直肠癌患者进行问卷调查。结果显示,本次共调查184例患者,其中175例(95.1%)患者表示准备好了出院;出院准备度总得分为(159.86±24.82)分,处于低等水平。单因素分析显示,不同年龄、收入水平、工作状态、适应造口情况及有无并发症的患者出院准备度总分比较差异有统计学意义,P<0.05;Pearson相关性分析显示,患者出院准备度与住院时间、出院指导质量及出院指导期待呈正相关,P<0.05。多因素回归分析显示,年龄、造口适应情况、有无并发症、住院时间、出院指导质量是影响患者出院准备度的独立因素。结果表明,直肠癌永久性造口者出院准备度处于低等水平。临床应加强患者出院前管理,对于年龄偏大、存在并发症、难于适应造口者应加强出院前指导,同时适当增加必要住院时间;对于医护人员,应整体优化其出院前指导水平,以提高患者出院准备度。

This study was to survey the readiness for hospital discharge(RHD)of rectal cancer patients underwent permanent ostomy,and analyse the relevant factors influencing RHD,by using normal data scale,readiness for hospital discharge scale(RHDS-C)and quality of discharge teaching scale(QDTS)took questionnaire survey on the rectal cancer patients underwent permanent ostomy in authors’hospitals(2017-04-2018-04).As results,totalled 184 cases received this survey,in them 175 cases(95.1%)indicated them having ready for discharge,thus total ratings of RHD were(159.86±24.82)points being located at lower level;Univariate analysis showed the ratings were related to patient’s age,income,work situation,the adaptation on ostomy,and with or without complication statistically(P<0.05);Pearson relativity analysis showed RHD was proportionally related to hospitalization time,QDT,and expection of discharge teaching(P<0.05);Multivariate analysis showed age,the adaptation on ostomy,with or without complication,hospitalization time,and QDT were independent factors influencing RHD.Results show that RHD of rectal cancer patients underwent permaneat ostomy is located at low-level.Thus it is should be to strength predischarge management on the patients,especially,for whom aged,complicated symptoms,and difficultly adapt to ostomy,more than to strength teaching,at the same time properly increase hospitalization time needed;Besides,to optimum the teaching level before discharge for staff so that uplift patients’RHD.