泌尿造口患者居家支持性照护方案的构建与应用

Construction and application of home supportive care plan for patients with urinary stoma

目的 构建泌尿造口患者居家支持性照护方案,并评价其应用效果。方法 成立研究小组,在文献分析的基础上初步构建泌尿造口患者居家支持性照护方案,通过现状调查和质性研究进行补充,经过专家评议后形成最终方案。采用便利抽样法,抽取76例膀胱癌行泌尿造口术患者为研究对象,根据患者的主治医师所在组别分为观察组41例和对照组35例。观察组采用泌尿造口患者居家支持性照护方案护理和随访,对照组采用常规护理和随访。比较两组患者造口适应评分、并发症发生率、生活质量评分。结果 出院后3个月,观察组患者造口适应评分、生活质量评分明显优于对照组,经比较差异有统计学意义(P<0.05)。随访期间,观察组患者过敏性皮炎、造口出血、造口水肿、造口皮肤黏膜分离、造口回缩及造口黏膜肉芽肿发生率低于对照组,但差异无统计学意义(P>0.05)。结论 泌尿造口患者居家支持性照护方案能提高造口患者的适应性,提高患者的生活质量。

Objective To construct the home supportive care plan for patients with urinary stoma and evaluate its application effect. Method Form a study group and construct the home supportive care plan for patients with urinary stoma preliminarily based on literature analysis. Supply the plan by survey on present status and qualitative research. Confirm the final plan through expert review. Choose 76 bladder cancer patients undergoing urinary stoma by the group of their physicians into observation group(n=41) and control group(n=35) randomly. Patients in observation group receive home supportive care and follow-up interview for patients with urinary stoma. Patients in control group receive routine nursing care and follow-up interview. Compare the score on stoma adaptability, incidence of complications and score on quality of life between two groups. Result The scores on stoma adaptability and quality of life is significantly higher in observation group than in control group 3 months after discharge(P<0.05). The incidence of allergic dermatitis, stoma bleeding, stoma edema, stoma mucocutaneous separation, stoma contraction and stoma mucomembranous granuloma is lower in observation group than in control group during follow-up interview. The difference is not significant(P>0.05). Conclusion Home supportive care plan for patients with urinary stoma can improve patients’ adaptability and quality of life.