基于知信行理论的护理在膀胱癌患者术后造口感染预防中的应用效果

Application effect of nursing based on knowledge,attitude and practice theory in the prevention of postoperative stoma infection in patients with bladder cancer

目的探讨基于知信行理论的护理预防膀胱癌患者术后造口感染的效果。方法采用便利抽样法,选取于2016年3月—2020年10月在徐州市中心医院住院的78例膀胱癌术后造口患者为研究对象,按照随机数字表法将患者分为对照组和观察组,各39例。对照组采用常规术后造口护理,观察组在对照组基础上给予基于知信行理论的护理。干预后比较两组患者造口感染相关的血液指标(红细胞、白细胞、血小板、血红蛋白计数);观察并记录两组患者并发症发生情况(血尿、休克、尿潴留、伤口破裂);记录两组患者住院期间造口感染及术后1、3、6个月内再感染情况。结果干预后,观察组患者红细胞计数、血红蛋白、血小板计数均高于对照组,差异具有统计学意义(P<0.05)。观察组患者术后出现血尿、休克、尿潴留、伤口破裂的并发症总发生率为2.6%(1/39),低于对照组的17.9%(7/39),差异具有统计学意义(P<0.05)。观察组患者住院期间发生造口感染1例(2.6%),对照组6例(15.4%),差异具有统计学意义(P<0.05);进一步随访发现,观察组患者术后1、3、6个月内再感染比例均低于对照组,但两组比较差异无统计学意义(P>0.05)。结论基于知信行理论的护理能有效改善膀胱癌患者造口术后感染相关的血液指标,减少并发症以及造口感染的发生。

Objective To explore the effect of nursing based on knowledge,attitude and practice theory in the prevention of postoperative stoma infection in patients with bladder cancer.Methods Using the convenient sampling method,a total of 78 patients with bladder cancer postoperative stoma who were hospitalized in Xuzhou Central Hospital from March 2016 to October 2020 were selected as the research objects.According to the random number table method,the patients were divided into the control group and the observation group,with 39 cases in each.The control group was given routine postoperative stoma nursing,while the observation group was given nursing based on knowledge,attitude and practice theory on the basis of the control group.After the intervention,the blood indexes(red blood cells,white blood cells,platelets and hemoglobin counts)related to stoma infection were compared between the two groups.Complications(hematuria,shock,urinary retention,wound rupture)were observed and recorded in the two groups;stoma infection during hospitalization and reinfection within 1,3 and 6 months after surgery of the two groups were recorded.Results After intervention,the red blood cell,hemoglobin and platelet counts in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications of hematuria,shock,urinary retention and wound rupture in the observation group was 2.6%(1/39),which was lower than 17.9%(7/39)in the control group,and the difference was statistically significant(P<0.05).There was 1 case(2.6%)of stoma infection in the observation group and6 cases(15.4%)in the control group,and the difference was statistically significant(P<0.05).Further follow-up showed that the proportions of reinfection in the observation group at 1,3 and 6 months after surgery were lower than those in the control group,but there was no statistically significant difference between the two groups(P>0.05).Conclusions Nursing based on the knowledge,attitude and practice theory can effectively improve the blood indexes related to infection after ostomy in bladder cancer patients and reduce the occurrences of complications and stoma reinfection.