Orem自理干预对结肠癌术后患者创伤后应激障碍、生活质量、焦虑情绪的影响

Effect of Orem self-care intervention on post-traumatic stress disorder,quality of life and anxiety in patients with colon cancer after operation

目的探讨Orem自理干预模式对结肠癌术后患者创伤应激、生活质量、焦虑情绪的影响。方法随机数字表法将110例结肠癌患者分为干预组和对照组,每组55例,对照组患者接受常规护理干预,干预组患者接受Orem自理模式护理干预。术后第1天、术后2周、术后4周,采用创伤后应激障碍自评量表(PTSD-SS)和急性应激障碍量表(ASDS)评估两组患者的应激障碍情况;术后第1天、术后4周,采用简明健康状况问卷(SF-36)评估两组患者的生活质量,采用焦虑自评量表(SAS)评估两组患者的焦虑情绪。结果术后第1天,两组患者PTSD-SS、ASDS、SDS、SF-36量表各维度评分比较,差异均无统计学意义(P>0.05)。术后2、4周,两组患者PTSD-SS、ASDS评分均低于本组术后低1天,且干预组患者的PTSD-SS、ASDS评分均低于对照组患者,差异均有统计学意义(P<0.05)。术后4周,两组患者SF-36量表各维度评分均高于本组术后低1天,且干预组患者的SF-36量表各维度评分均高于对照组患者,SAS评分低于对照组患者,差异均有统计学意义(P<0.05)。结论Orem自理干预有利于减轻结肠癌手术患者创伤后应激障碍,改善生活质量,缓解焦虑情绪。

Objective To explore the effect of Orem self-care intervention on traumatic stress disorder,quality of life and anxiety in patients undergoing colon cancer surgery.Method 110 patients undergoing radical surgery for colon cancer were divided into intervention group and control group,55 cases in each,with Orem self-care and conventional nursing given,respectively.The traumatic stress 1 day,2 weeks and 4 weeks after surgery was assesed with post traumatic stress disorder self-rating scale(PTSD-SS)and acute stress disorders scale(ASDS);the quality of life and anxiety 1 day and 4 weeks after surgery were assessed with the medical outcomes study 36-item short form health survey(SF-36)and the medical outcomes study 36-item short form health survey(SAS),respectively.Result There were no significant differences for the scores of PTSD-SS,ASDS,quality of life and SAS 1 day after surgery(P>0.05).2 and 4 weeks after surgery,the scores of PTSD-SS and ASDS were lower than those 1 day after surgery,with significant lower scores in the intervention group than those in the control group(P<0.05).SF-36 scores 4 weeks after surgery were lower than those 1 day after surgery within each group,with significant higher SF-36 scores and lower SAS scores in the invervention group than those in the control group(P<0.05).Conclusion Orem self-care intervention can help reduce the traumatic stress disorder in patients with colon cancer surgery,improve the quality of life and relieve the anxiety.