连续护理对回肠造口患者自我管理效能感的影响研究

发布时间：2018-11-13 19:19

【摘要】：目的了解回肠造口患者自我管理效能感水平的影响因素,探讨连续护理对回肠造口患者自我管理效能感水平的影响,为护理人员及时有效调整干预方案,合理的进行连续护理,最大程度提高回肠造口患者的自我管理能力。从而达到保障回肠造口患者健康、降低医疗费用、节省卫生资源的目标。方法本研究属于类实验性研究。将2014年5月至2014年12月于长沙市某三级医院行回肠造口术的60例患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组30例,其中对照组给予医院常规治疗和护理;干预组除参加常规治疗和护理外,同时接受连续护理,并于研究前、研究第1个月、研究第3个月使用一般资料调查问卷、造口情况统计表、肠造口患者自我管理效能水平问卷系统化评价连续护理对回肠造口患者造口情况、自我管理效能感水平、及术后患者预后的影响情况。所有资料使用spss18.0软件进行统计分析,主要统计学方法包括描述性分析、两样本t检验、单因素方差分析、重复测量设计资料的方差分析等。结果1.基线结果显示:研究对象自我管理效能感均分为:59.23±4.64分,患者自我管理效能感水平处于中低水平;2.回肠造口患者自我管理效能感影响因素分析结果显示:研究对象的自我管理效能感水平与患者的年龄、文化程度、工作状态以及职业情况等因素有关。3.重复测量方差分析结果表明:自我管理效能感得分的干预主效应有统计学意义(P0.01),即不考虑时间的因素,干预水平的不同,患者自我管理效能感水平得分有差异;自我管理效能感得分的时间主效应有统计学意义(P0.05),即不考虑干预的因素,患者自我管理效能感水平得分随时间的变化而变化。研究对象自我管理效能感水平得分的时间因素、干预水平均存在交互作用(P0.05)。交互轮廓图显示,随着时间的变化,干预组患者自我管理效能感得分的上升幅度大于对照组。4.造口情况统计结果显示:干预组比对照组造口产品费用减少、造口护理能力提高、术后造口并发症的发生率降低,差异有统计学意义,但两组患者术后性生活的恢复差异无统计学意义。结论1.回肠造口患者术后自我管理效能感水平较低,其自我管理效能感水平与患者的年龄、文化程度、工作状态以及职业情况等因素有关。2.通过实施连续护理,可显著提高回肠造口患者的自我管理效能感水平。干预组回肠造口患者的自我管理效能感水平明显高于对照组,造口并发症发生情况较少,本研究确定的连续护理方案在临床的实施过程中有较好的效果。
[Abstract]:Objective to investigate the influencing factors of self-management efficacy level of ileostomy patients, and to explore the influence of continuous nursing on self-management efficacy level of ileostomy patients, so as to adjust the intervention scheme in time and effectively, and to carry out reasonable continuous nursing care for nursing staff. To improve the ability of self-management of ileostomy patients. In order to ensure the health of ileostomy patients, reduce medical costs and save health resources. Methods this study is an experimental study. From May 2014 to December 2014, 60 patients undergoing ileostomy in a level-III hospital in Changsha were divided into observation group (n = 30) and control group (n = 30). The control group was given routine treatment and nursing care. In addition to routine treatment and nursing, the intervention group received continuous care at the same time. Before the study, the first month of the study and the third month of the study, the general information questionnaire was used. Evaluation of the effect of continuous nursing care on the patients with ileostomy, the level of self-management efficacy and the prognosis of the patients after operation were systematically evaluated by the questionnaire of self-management efficacy level of patients undergoing enterostomy. All the data were analyzed by spss18.0 software. The main statistical methods included descriptive analysis, t-test of two samples, analysis of variance of single factor, ANOVA of repeated measurement design data and so on. Result 1. The baseline results showed that the subjects' self-management efficacy was 59.23 卤4.64, and the level of self-management efficacy was low and low. 2. The results showed that the level of self-management efficacy was related to the age, education, working status and professional status of the patients. The results of ANOVA showed that the main effect of intervention in self-management efficacy score was statistically significant (P0.01), that is, regardless of time, the level of intervention was different, and the score of self-management efficacy was different. The time main effect of self-management efficacy scores was statistically significant (P0.05), that is, the patients' self-management efficacy scores changed with time without taking into account the factors of intervention. The time factor and intervention level of self-management efficacy level were all interactive (P0.05). The interactive contour showed that, with the change of time, the scores of self-management efficacy in the intervention group were significantly higher than those in the control group. 4. The statistical results showed that the cost of the products in the intervention group was lower than that in the control group, and the nursing ability of the patients was improved, and the incidence of postoperative complications was decreased, and the difference was statistically significant. But there was no significant difference in the recovery of sexual life between the two groups. Conclusion 1. The level of self-management efficacy was lower in patients with ileostomy. The level of self-management efficacy was related to the age, education, working status and professional status of the patients. 2. Continuous nursing care can significantly improve the level of self-management efficacy of patients with ileostomy. The level of self-management efficacy of patients with ileostomy in the intervention group was significantly higher than that in the control group.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.6

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