阶段变化理论联合动机性心理访谈在永久结肠造口患者中的应用效果

Application effect of transtheoretical model combined with motivational interviewing in patients with a permanent stoma

目的分析在直肠癌切除术后行永久性结肠造口患者中实施阶段变化理论联合动机性心理访谈的效果。方法回顾性分析2018年7月至2021年6月南京市第一医院收治的82例直肠癌切除术后行永久性结肠造口患者的临床资料,将所有患者依据护理方法分为对照组(42例患者,予以常规护理)和观察组(40例患者,予以阶段变化理论联合动机性心理访谈)。对比2组的并发症发生情况、术后恢复情况、心理弹性、自我护理能力以及生活质量。结果观察组的相关并发症总发生率低于对照组(P<0.05)。观察组的术后恢复时间均早于对照组(P均<0.05)。干预3个月后,2组的心理弹性量表3个维度评分和自我护理能力量表评分均较干预前升高(P均<0.05),且观察组均高于对照组(P均<0.05)。干预3个月后,2组的癌症患者生命质量测定量表评分均较干预前升高(P均<0.05),且观察组的评分高于对照组(P<0.05)。结论将阶段变论联合动机性心理访谈用于在直肠癌切除术后行永久性结肠造口的患者,可明显降低并发症发生率、加快术后康复进程、提升患者心理弹性、改善自护能力和生活质量。

Objective To analyze the application effect of transtheoretical model combined with motivational interviewing in the patients with a permanent stoma after rectal cancer surgery.Methods The clinical data of 82 patients undergoing permanent colostomy after rectal cancer surgery at Nanjing First Hospital from July 2018 to June 2021 were retrospectively analyzed.According to the nursing methods,all patients were divided into the control group(42 patients,given routine nursing)and the observation group(40 patients,given transtheoretical model and motivational interviewing).The occurrence of complications,postoperative recovery,psychological resilience,self-care ability,and quality of life were compared between the two groups.Results The total incidence of related complications in the observation group was lower than that in the control group(P<0.05).The postoperative recovery time of the observation group was shorter than that of the control group(all P<0.05).After 3 months of intervention,the scores of 3 dimensions of the Connor-Davidson Resilience Scale and the scores of the Exercise of Self-Care Agency in the two groups were increased compared with those before intervention(all P<0.05),and the scores of the observation group were higher than those of the control group(all P<0.05).After 3 months of intervention,the scores of the Quality of Life Questionnaire-Core 30 in the two groups were increased compared with those before intervention(both P<0.05),and the scores of the observation group were higher than those of the control group(P<0.05).Conclusion The application of transtheoretical model combined with motivational interviewing in patients undergoing permanent colostomy after rectal cancer surgery can significantly reduce the incidence of complications,speed up the recovery process,and improve the psychological resilience,self-care ability,and quality of life of patients.