延续护理模式对结直肠癌高危人群结直肠镜筛查依从性的影响

Effect of continuous nursing mode on compliance of colonoscopy screening in high-risk populations of colorectal cancer

目的:评价基于网络和电话随访的延续护理干预措施对提高结直肠癌高危人群结直肠镜筛查依从性的效果。方法:选取2017年1月至2017年11月经风险评估模型评估为结直肠癌的高危人群,共300人,随机分为干预组和对照组,每组150人。收集研究对象基本信息,2组均接受常规结直肠癌相关健康教育。此外,干预组还接受研究小组提供的延续护理干预措施,采用微信、电话方式实施延续护理及教育。在3个月和6个月随访期间观察研究对象参加结直肠镜筛查情况,利用t检验、卡方分析和logistic回归分析比较2组接受肠镜筛查率的差异。结果:在6个月的随访过程中,共266例完成随访研究,其中干预组137例,对照组129例。t检验或卡方分析显示,干预组和对照组研究对象的基线资料在2组间差异无统计学意义(P>0.05);干预组在3个月和6个月结直肠镜筛查的依从性均高于对照组,差异有统计学意义(P<0.05)。针对3个月干预效果进行多因素logistic回归分析结果表明,基于网络和电话随访的延续护理干预是影响高危人群接受结直肠镜筛查的独立因素(RR=2.697,95%CI=1.307~5.567;P<0.05)。针对6个月干预效果进行多因素logistic回归分析结果表明,基于网络和电话随访的延续护理干预依然是影响高危人群接受结直肠镜筛查的独立因素(RR=2.574,95%CI=1.396~4.749;P<0.05)。结论:基于网络和电话随访的延续护理干预措施可以提高结直肠癌高危人群结直肠镜筛查率,对早期发现、早期诊治和改善高危人群预后具有一定推广价值。

Objective:To evaluate the effect of continuous nursing mode based on network and telephone follow-up on the compliance of colonoscopy screening in high-risk populations with colorectal cancer. Methods:A total of 300 patients with high-risk colorectal cancer which were evaluated by risk evaluation model from January 2017 to November 2017 were selected and were randomly divided into the intervention group and the control group,with 150 people in each group. Basic information were collected and patients in both groups received routine health education related with colorectal cancer. In addition,patients in the intervention group received the continuous nursing intervention conducting through WeChat and telephone. Colonoscopy screening in two groups were observed during the 3-month and 6-month follow-up period,and differences were compared by using t-test,chi-square analysis and logistic regression analysis. Results:During the 6-month follow-up,266 patients were completely followed up,including 137 in the intervention group and 129 in the control group. According to the t-test or chi-square analysis showed that baseline data between the intervention group and the control group had no statistically significant difference(P>0.05). The compliance of colorectal screening at the 3 rd and6 th month in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05). Multivariate logistic regression analysis of the effect of the 3-month intervention showed that continuous nursing intervention based on network and telephone follow-up was the independent factor influencing high-risk populations with colorectal cancer to accept colonoscopy screening(RR=2.697,95%CI=1.307-5.567;P<0.05). Multivariate logistic regression analysis of the effect of the 6-month intervention also showed that continuous nursing intervention based on network and telephone follow-up was the independent factor influencing high-risk populations with colorectal cancer to accept colonoscopy screening(RR =2.574,95%CI=1.396-4.749;P<0.05). Conclusion:Continuous nursing intervention based on network and telephone follow-up can improve the colonoscopy screening rate in high-risk populations with colorectal cancer,with a certain promoted value for early detection,early diagnosis and improving diagnosis.