基于COM-B模型的结直肠癌肠造口患者自我护理健康平台的应用及效果评价

Application and effect evaluation of self-care health platform for colorectal cancer patients with enterostomy based on COM-B model

目的探讨基于能力、机会、动机-行为(COM-B)模型的结直肠癌肠造口患者自我护理健康平台的应用效果。方法选取2020年5月至2021年4月在秦皇岛市中医医院接受治疗的结直肠癌行永久性肠造口的患者共84例,采用随机数字表法分为干预组和对照组,每组42例。其中对照组采用常规护理,干预组在常规护理基础上采用基于COM-B模型构建的自我护理健康平台进行干预,分别于干预前后对患者的自我护理能力、自我效能水平和肠造口相关并发症发生率进行评价。结果最终干预组纳入41例,对照组纳入40例。干预前,2组患者自我概念、自我护理技能、自我责任感、健康知识水平和自我护理能力总分以及自我效能得分比较差异无统计学意义(均P>0.05)。干预后,干预组患者自我概念、自我护理技能、自我责任感、健康知识水平和自我护理能力总分分别为(26.14±1.13)、(39.49±2.13)、(16.20±2.08)、(50.95±5.56)、(132.78±6.47)分,高于对照组的(19.35±2.07)、(29.88±3.52)、(9.85±3.25)、(43.13±6.71)、(102.20±11.47)分,差异有统计学意义(t值为5.72~18.28,均P<0.05);干预后,干预组自我效能得分为(88.20±6.90)分,高于对照组的(74.63±3.59)分,差异有统计学意义(t=11.14,P<0.05);干预后,干预组患者的肠造口相关并发症发生率为7.31%(3/41),低于对照组的27.50%(11/40),差异有统计学意义(χ^(2)=5.36,P<0.05)。结论构建基于COM-B模型的结直肠癌肠造口患者自我护理健康平台能够有效提升患者的自我护理能力、自我效能水平、减少并发症的发生。

Objective To explore the application effect of capacity,opportunity,motivation-behavior(COM-B)model based self-care health platform for colorectal cancer patients with enterostomy.Methods A total of 84 patients with permanent enterostomy for colorectal cancer treated in our hospital from May 2020 to April 2021 were selected and divided into the intervention group and the control group by random number table method,42 cases in each group.The control group was treated with routine nursing,and the intervention group was treated with a self-care health platform based on COM-B model.Patients′self-care ability,self-efficacy level and the incidence of enterostomy-related complications were evaluated before and after the intervention.Results Finally,41 cases were included in the intervention group and 40 cases in the control group.Before intervention,there were no significant differences in self-concept,self-care skills,self-responsibility,health knowledge level and total score of self-care ability between the 2 groups(P>0.05).After intervention,the total scores of self-concept,self-care skills,self-responsibility,health knowledge and self-care ability in the intervention group were(26.14±1.13),(39.49±2.13),(16.20±2.08),(50.95±5.56),(132.78±6.47),which were higher than those in the control group(19.35±2.07),(29.88±3.52),(9.85±3.25),(43.13±6.71),(102.20±11.47),the difference was statistically significant(t values were 5.72-18.28,all P<0.05).Before intervention,there was no significant difference in self-efficacy scores between the 2 groups(P>0.05).After intervention,the self-efficacy score of the intervention group(88.20±6.90)was higher than that of the control group(74.63±3.59),the difference was statistically significant(t=11.14,P<0.05).After intervention,the incidence of enterostomy-related complications in the intervention group was 7.31%(3/41),lower than 27.50%(11/40)in the control group,the difference was statistically significant(χ^(2)=5.36,P<0.05).Conclusion The construction of self-care health platform for colorectal cancer patients with enterostomy based on COM-B model can effectively improve the self-care ability and self-efficacy of patients,and reduce the incidence of complications.