术前仿真造口体验促进直肠癌造口患者术后健康行为的效果观察

Effect of simulated ostomy experience on postoperative health behavior of rectal cancer patients with ostomy

目的观察术前仿真造口体验促进直肠癌造口患者术后健康行为的效果。方法选取我院2016年1月至2020年6月收治的112例拟行直肠癌造口术患者为研究对象,按照随机数字表法分为对照组(n=56,围术期接受常规护理)和观察组(n=56,在对照组基础上开展仿真造口体验)。比较两组汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、自我护理能力测定量表(ESCA)评分、健康调查简表(SF-36)评分及并发症发生情况。结果入院时,两组HAMA评分、HAMD评分、ESCA各维度评分及总分、SF-36各维度评分比较差异均无统计学意义(均P>0.05);术后6个月,两组HAMA评分、HAMD评分低于本组入院时,ESCA各维度评分及总分、SF-36各维度评分高于本组入院时,且观察组HAMA评分、HAMD评分均低于对照组,ESCA各维度评分及总分、SF-36各维度评分均高于对照组,差异有统计学意义(均P<0.05)。观察组并发症总发生率为8.9%,低于对照组的28.6%,差异有统计学意义(P<0.05)。结论仿真造口体验用于直肠癌患者造口术前可减轻术后焦虑、抑郁等负性情绪,同时提高患者术后自我护理能力及生活质量,降低术后并发症的发生率。

Objectives To investigate the effect of simulated ostomy experience on postoperative health behavior of rectal cancer patients with ostomy.Methods One hundred and twelve rectal cancer patients who were going to have ostomy at our hospital between January 2016 and June 2020 were recruited.Patients were randomly assigned to the control group(n=56,receiving routine nursing during the perioperative period)and treatment group(n=56,receiving simulated ostomy experience in addition to routine nursing during the perioperative period).The following were compared between the two groups:Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Exercise of Self-Care Agency scale(ESCA),the MOS 36-item short from health survey(SF-36),and incidence of complications.Results At admission,the two groups did not differ significantly in HAMA score,HAMD score,all ESCA subscales and ESCA total score,and SF-36 subscales(P>0.05).At six months postoperatively,HAMA score and HAMD score decreased,while ESCA subscales,ESCA total score,and SF-36 subscales increased in both groups,HAMA score and HAMD score were significantly lower,while ESCA subscales,ESCA total score,and SF-36 subscales were significantly higher in the treatment group than in the control group(P<0.05).The overall incidence of complications was 8.9%in the treatment group and 28.6%in the control group,with a significant between-group difference(P<0.05).Conclusion In rectal cancer patients with ostomy,simulated ostomy experience can alleviate postoperative negative emotions such as anxiety and depression,improve patients’postoperative self-nursing ability and quality of life,and reduce the risk of postoperative complications.