思维导图式健康教育对肠造口患者术后自我护理能力的影响

The influence of mind mapping schema health education on postoperative self-care ability of patients with enterostomy

目的 探讨思维导图式健康教育对直肠癌术后行肠造口的患者术后自我护理能力以及造口周围皮肤并发症的影响,旨在提高患者居家自我护理造口的能力,减少造口并发症的发生。方法 前瞻性纳入2021年1-9月在蚌埠医学院第一附属医院胃肠外科接受直肠癌根治术并行肠造口的79例患者,采用随机数字表法将患者分为对照组(39例)及观察组(40例)。对照组采用常规造口健康教育,包含造口相关护理知识、生活指导、并发症处理及出院指导等,观察组在常规健康教育的基础上融合思维导图宣教。采用造口自我护理能力量表于出院当日、出院1个月和3个月时分别评估患者对造口的自我护理能力,并记录患者出院后造口周围皮肤并发症的发生情况。结果 2组患者出院当日造口自我护理能力评分差异无统计学意义(P>0.05);观察组与对照组出院1个月[(53.13±2.65)分vs.(47.77±2.44)分]及出院3个月[(58.80±2.60)分vs.(54.92±2.66)分]自我护理能力评分差异有统计学意义(均P<0.01)。对照组与观察组出院1个月(21人vs. 12人,χ^(2)=4.617,P=0.032)及出院3个月(15人vs. 7人,χ^(2)=4.318,P=0.038)造口并发症发生例数差异均有统计学意义(均P<0.05)。观察组与对照组住院满意度分别为95.0%(38/40)及76.9%(30/39),差异有统计学意义(χ^(2)=5.384,P=0.020)。结论 思维导图式健康教育能改善肠造口患者术后居家自我护理造口的能力,减少术后造口并发症的发生,提高住院期间满意度。

Objective To investigate the effect of mind map schema health education on postoperative self-care ability and skin complications of patients undergoing enterostomy after rectal cancer operation,so as to improve the ability of self-care at home and reduce the occurrence of complications.Methods Patients undergoing radical colorectal cancer surgery with enterostomy in the Gastrointestinal Surgery Department of First Affiliated Hospital of Bengbu Medical College from January to September 2021 were prospectively enrolled.They were divided into control group(39 cases)and observation group(40 cases)using random numbers method.The control group received routine ostomy health education,including ostomy-related nursing knowledge,life guidance,complication management and discharge guidance,while the observation group received routine health education combined with mind map education.The patients'ability of self-care for ostomy was evaluated by the ostomy self-care ability scale at discharge day,one month and three months.The occurrence of skin complications around ostomy after discharge was recorded.Results There was no significant difference in the ostomy self-care ability score between the two groups on discharge day(P>0.05).The self-care ability scores of the observation group and the control group were statistically significant after discharge for one month[(53.13±2.65)points vs.(47.77±2.44)points]and three months[(58.80±2.60)points vs.(54.92±2.66)points,all P<0.01].In terms of ostomy complications,there were statistically significant differences between the control group and the observation group in the number of cases of complications after discharge for one month(21 vs.12,χ^(2)=4.617,P=0.032)and three months(15 vs.7,χ^(2)=4.318,P=0.038).The hospitalization satisfaction of the observation group and the control group was 95.0%(38/40)and 76.9%(30/39),respectively,with statistical significance(χ^(2)=5.384,P=0.020).Conclusion Mind mapping schema health education can improve the ability of patients with enterostomy to take care of their stoma at home,reduce the occurrence of stoma complications,and improve satisfaction during hospitalization.