以自我超越理论为指导的护理模式在膀胱癌术后腹壁造口患者中的应用

Application of nursing model guided by the theory of self transcendence in patients with abdominal wall ostomy after bladder cancer surgery

目的观察以自我超越理论为指导的护理模式在膀胱癌术后腹壁造口患者中的应用效果。方法选取2020年7月至2022年7月南京市第一医院接受膀胱癌尿流改道腹壁造口术的100例患者为研究对象,按照随机数字表法将其分为对照组与观察组,每组50例。对照组采用常规护理干预,观察组在对照组基础上采用以自我超越理论为指导的护理干预,共干预4周。比较护理前及护理2周、护理4周两组自我超越水平[采用自我超越量表(STS)评估],比较两组护理前、护理4周自我护理能力[采用自我护理能力实施量表(ESCA)评估],比较护理4周内两组造口周围感染情况及造口相关并发症。结果整体分析发现,两组STS评分组间、时点、组间时点交互比较,差异有统计学意义(P<0.05);组内比较,两组各时间点STS评分比较,差异有统计学意义(P<0.05);组间比较,观察组护理2、4周STS评分高于对照组(P<0.05)。护理4周,两组自我护理技能、自我概念、自我护理责任感、健康知识水平及ESCA总分高于护理前,且观察组高于对照组(P<0.05)。观察组造口周围感染率、造口相关并发症发生率低于对照组(P<0.05)。结论以自我超越理论为指导的护理模式能有效提高膀胱癌术后腹壁造口患者自我超越水平,增强患者自我护理能力,减少术后造口周围感染及造口相关并发症的发生率。

Objective To observe the application effect of the nursing model guided by the theory of self transcendence in patients with abdominal wall ostomy after bladder cancer surgery.Methods A total of 100 patients who underwent urinary flow diversion abdominal wall ostomy for bladder cancer in Nanjing First Hospital from July 2020 to July 2022 were selected as the study objects,according to the method of random number table,they were divided into the control group and the observation group,with 50 cases in each group.The control group was treated with routine nursing intervention,and the observation group was treated with nursing intervention guided by self transcendence theory on the basis of the control group,with a total of four weeks of intervention.The self transcendence level of patients in the two groups was compared before nursing,two and four weeks of nursing(evaluated by self transcendence scale[STS]),the self-care ability of patients in the two groups was compared before nursing and four weeks of nursing(evaluated by self care ability implementation scale[ESCA]).The periostomy infection and related complications were compared between the two groups within four weeks of nursing.Results The overall analysis showed that there were significant differences between groups,time points and time points of STS evaluation between two groups(P<0.05).There were significant differences in STS scores between the two groups at each time point(P<0.05).The observation group was higher than the control group after two and four weeks of nursing(P<0.05).After four weeks of nursing,the total scores of self-care skills,self-concept,self-care responsibility,health knowledge,and ESCA of patients in the two groups were higher than those before nursing,and the observation group was higher than the control group(P<0.05).Incidence of peristomal infection and stoma-related complications in observation group was lower than that in control group(P<0.05).Conclusion The nursing model guided by the theory of self transcendence can effectively improve the self transcendence level of patients with abdominal wall ostomy after bladder cancer surgery,enhance the patients’ability of self-care,and reduce the incidence of infection around stoma and stoma related complications after surgery.