三级联动干预模式对直肠癌造口患者并发症、病耻感及社会适应性的影响

Effects of the three-level linkage intervention mode on the complications,stigma and social adaptability of the patients with rectal cancer stoma

目的 探讨三级联动干预模式对直肠癌造口患者并发症、病耻感及社会适应性的影响。方法 选取2018年2月至2021年2月在海南西部中心医院就诊并行结肠造口术的120例直肠癌患者作为研究对象,依据数字表法随机将其分为试验组和对照组,每组各60例。对照组采用常规健康宣教及出院指导干预模式,试验组采用医院-社区-家庭三级联动干预模式。比较2组患者社会适应性、病耻感、自我护理能力及并发症之间的差异。结果 干预前,2组患者正性情绪、负性情绪、社会生活适应评分比较差异无统计学意义(P>0.05)。干预后,试验组上述评分显著高于对照组,且高于试验组干预前(P<0.05);对照组干预前后上述评分比较差异无统计学意义(P>0.05)。干预前,2组患者病耻感评分比较差异无统计学意义(P>0.05);干预后2组评分均有所下降,且试验组评分显著低于对照组(P<0.05)。干预后,试验组自我护理能力评分(自我照护能力、自我责任感、自我概念掌握、健康知识、总分)显著高于对照组(P<0.05)。试验组并发症总发生率(10.00%)明显低于对照组(33.33%),差异有统计学意义(P<0.05)。结论 对直肠癌造口患者采取三级联动干预模式可有效降低患者并发症,减少病耻感,提高社会适应性和自我护理能力。

Objective To explore the effects of the three-level linkage intervention mode on the complications,stigma and social adaptability of the patients with rectal cancer stoma.Methods A total of 120 patients with rectal cancer who were treated with colostomy in the hospital from February 2018 to February 2021 were recruited as research subjects,and were randomly divided into the experimental group and the control group,each consisting of 60 patients.The control group received routine health education and instructive intervention after discharge,while the experimental group were treated with the hospital-community-family three-level linkage intervention mode.The differences in social adaptability,stigma,self-care ability and complications were compared between the patients of the two groups.Results Before intervention,there was no statistical significance in the scores of positive emotion,negative emotion,and social life adaptation,when comparisons were made between the 2 groups(P>0.05).After intervention,the scores of the above indexes in the experimental group were significantly higher than those of the control group,and were also higher than those before intervention(P<0.05).As for the control group,there was no statistical significance in the above scores,when comparisons were made before and after intervention(P>0.05).Before intervention,there was no statistical significance in the stigma scores of the two groups(P>0.05).However,the scores of the two groups decreased to a certain extent after intervention,with the scores of the experimental group being significantly lower than those of the control group(P<0.05).Following intervention,the selfcare ability scores of the experimental group(including the scores of self-care ability,self-responsibility,self-concept mastery,health knowledge,as well as total scores) were significantly higher than those of the control group(P<0.05).The total complication rate of the experimental group(10.00%) was significantly lower than that of the control group(33.33%),with statistical significance(P<0.05).Conclusion Three-level linkage intervention mode in treatment of patients with rectal cancer stoma could effectively decrease complications,reduce stigma and improve social adaptability and self-care ability.