永久性肠造口患者社会适应性和病耻感研究

Study on the Social Adaptability and Stigma of Patients with Permanent Enterostomy

目的探讨协同护理对直肠癌根治术后永久性造口患者回归社会适应能力和病耻感的影响。方法于2020年1月—12月在进行直肠癌根治术永久性造口的患者中随机选择30例作为实验组,并于2019年1月—12月以性别、年龄等为配对条件选择30例同样行直肠癌根治术永久性造口的患者作为对照组。实验组采取协同护理措施,对照组采用常规护理措施。所有患者均使用社会影响量表(SIS)、中文版造口患者社会心理适应量表及造口患者生活质量量表来进行回归社会适应能力及病耻感水平的调查。结果实验组患者的社会心理适应能力总评分(65.74±4.95)高于对照组(50.46±5.82),差异具有统计学意义(t=10.954,P<0.001)。实验组患者的内在羞耻感评分(10.06±2.01)低于对照组(16.31±2.16),实验组社会排斥感得分(22.90±2.23)低于对照组(25.50±3.24),差异比较均具有统计学意义(t值分别为11.602和3.621,P<0.01)。实验组患者的生活质量总评分(58.12±4.49)明显高于对照组(50.46±4.05),差异具有统计学意义(t=6.939,P<0.01)。结论协同护理能提高直肠癌根治术后永久性造口患者回归社会适应能力,降低患者术后病耻感,提高生活质量,值得临床推广。

Objective To explore the effect of collaborative nursing on social adaptability and stigma of patients with permanent stoma after radical resection of rectal cancer.Methods From January to December in 2020,a total of 30 patients with permanent stoma after radical resection of rectal cancer were randomly selected as the experimental group.From January to December in 2019,another 30 patients with permanent stoma after radical resection of rectal cancer were selected as control group based on gender and age.The experimental group adopted collaborative nursing measures,while the control group adopted conventional nursing measures.The social impact scale(SIS),Chinese version of social psychological adaptation scale for colostomy patients and quality of life scale for colostomy patients were used to investigate the social adaptability and stigma level of all patients.Compare the two groups of patients with colostomy social psychological adaptability,the level of stigma,colostomy patients quality of life improvement results.Results The total score of social and psychological adaptability(65.74±4.95)of the experimental group was significantly higher than that of the control group(50.46±5.82),and the difference was statistically significant(t=10.954,P<0.001).The score of intrinsic shame in the experimental group(10.06±2.01)was significantly lower than that of the control group(16.31±2.16),and the score of social rejection in the experimental group(22.90±2.23)was significantly lower than that of the control group;all were statistically significant(t=11.602,3.621,P<0.01).The total quality of life score(58.12±4.49)of the experimental group was significantly higher than that of the control group(50.46±4.05),and the difference was statistically significant(t=6.939,P<0.01).Conclusion Collaborative nursing can improve the social adaptability of patients with permanent stoma after radical resection of rectal cancer,reduce the postoperative shame and improve the quality of life.It is worthy of clinical promotion.