以自我效能为核心的护理路径在肠造口患者中的应用

Application of Self-efficacy Oriented Nursing Pathway in Patients Using the Enterostomy

目的:探讨以自我效能为核心的护理路径在肠造口患者中的应用价值,为临床后续治疗方案的制定提供依据。方法:选取2020年3月—2021年3月九江市第一人民医院收治的60例肠造口患者作为研究对象,采用随机数表法将其分为对照组和观察组,每组各30例。对照组实施常规护理,观察组在常规护理基础上实施以自我效能为核心的护理路径干预。比较两组患者护理前后心理状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分]、自我效能及日常生活能力[自我效能量表评分、日常生活能力量表(ADL)评分]、自我护理能力[自我护理能力量表(ESCA)评分]及并发症发生情况。结果:护理后,两组患者HAMA、HAMD评分均低于护理前,且观察组明显低于对照组,差异有统计学意义(t=9.132、12.853,P<0.05)。护理后,两组患者自我效能和ADL评分均高于护理前,且观察组明显高于对照组,差异有统计学意义(t=4.835、5.993,P<0.05)。护理后,两组患者ESCA中各维度评分及总分均高于护理前,且观察组明显高于对照组,差异有统计学意义(t=2.938、9.198、4.046、6.754、9.647,P<0.05)。观察组患者并发症发生率为6.67%,明显低于对照组的26.67%,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论:以自我效能为核心的护理路径能够有效改善肠造口患者的心理状态,使其自我效能感以及生活质量显著提升,提高自我护理能力,降低并发症发生率。

Objective:To explore the value of a self-efficacy-focused care pathway in patients with enterostomies and to provide a basis for the development of clinical follow-up treatment plans.Methods:60 patients with enterostomy admitted to the hospital from March 2020 to March 2021 were selected as the study subjects,and they were divided into control group and observation group using the random number table method,with 30 cases in each group.The control group implemented conventional care,and the observation group implemented a self-efficacy-focused care pathway intervention based on conventional care.The psychological status[Hamilton Anxiety Inventory(HAMA)and Hamilton Depression Inventory(HAMD)scores],self-efficacy and daily living ability[Self-Efficacy Scale scores,Ability to Perform Daily Living(ADL)scores],self-care ability[Self-Care Ability Scale(ESCA)scores]and the occurrence of complications were compared between the two groups of patients before and after care.Results:After care,the HAMA and HAMD scores of both groups were lower than those before care,and the observation group was significantly lower than the control group,with statistically significant differences(t=9.132,12.853,P<0.05).After care,the self-efficacy and ADL scores of both groups were higher than before care,and the observation group was significantly higher than the control group,with statistically significant differences(t=4.835,5.993,P<0.05).After care,the scores and total scores of all dimensions in ESCA were higher in both groups than before care,and the observation group was significantly higher than the control group,with statistically significant differences(t=2.938,9.198,4.046,6.754,9.647,P<0.05).The complication rate in the observation group was 6.67%,which was significantly lower than 26.67%in the control group,and the difference was statistically significant(χ^(2)=4.320,P<0.05).Conclusion:The self-efficacy-centered care pathway can effectively improve the psychological status of patients with colostomy,enhance their self-efficacy and quality of life,improve their self-care ability,and reduce the incidence of complications.