基于ADOPT问题解决模式的个体化护理干预在直肠癌永久性结肠造口患者中的运用研究

发布时间：2017-12-26 20:10

本文关键词：基于ADOPT问题解决模式的个体化护理干预在直肠癌永久性结肠造口患者中的运用研究　出处：《昆明医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：[目的]探讨基于ADOPT问题解决模式的个体化护理干预,对直肠癌永久性结肠造口患者自我护理能力、社会心理适应水平及造口相关并发症发生率的影响。[方法]将昆明医科大学第三附属医院大肠癌中心2014年11月至2015年8月首次行手术治疗的直肠癌永久性结肠造口患者80例为研究对象,随机分为对照组和干预组。干预组采用ADOPT问题解决模式为理论框架对造口患者进行个体化护理干预,对照组按照标准化常规护理规程进行护理教育与康复指导。应用造口患者自我护理能力量表和造口患者社会心理适应量表,评价术后1个月两组患者的自我护理能力和社会心理适应水平,比较两组患者造口并发症的发生率。[结果]本研究成功回收有效问卷77例,其中对照组37例,干预组40例。两组患者临床资料比较,差异无统计学意义(P0.05)；对照组术后1个月的自我护理能力评分总分为43.0±6.1,干预组为54.6±4.3,t==—9.2,两组间评分有统计学差异(p0.05)；对照组的自我护理能力仅有(17/37,46%)处于高水平,而干预组高水平的患者则高达(36/40,89%)；对照组术后1个月的社会心理适应评分总分为31.8±2.7,干预组为40.5±3.1,t=—13.4,两组间评分有统计学差异(0.05),对照组(14/37,39%)的患者处于中等适应水平, (23/37,61%)的患者处于低适应水平；而干预组有(3/40,8%)的患者为高适应水平, (18/40,45%)的患者处于中等适应水平, (19/40,47%)的患者处于低适应水平;术后1个月对照组发生造口并发症11例(30%),干预组发生造口并发症4例(10%),两组患者的造口并发症发生率比较差异有统计学意义(p0.05)。[结论]基于ADOPT问题解决模式的个体化护理干预能有效提高直肠癌永久性结肠造口患者的自我护理能力及社会心理适应水平,减少造口相关并发症的发生。
[Abstract]:[Objective] to explore the effect of individualized nursing intervention based on ADOPT problem-solving mode on self-care ability, social psychological adaptation level and incidence of stoma related complications in patients with rectal cancer undergoing permanent colostomy. [Methods] a total of 80 patients with rectal cancer undergoing permanent colostomy who underwent surgical treatment from November 2014 to August 2015 in the Third Affiliated Hospital of Kunming Medical University were randomly divided into control group and intervention group. The intervention group adopted the ADOPT problem-solving mode as the theoretical framework to individualized nursing intervention for the stoma patients. The control group was guided by the standardized routine nursing instruction for nursing education and rehabilitation. The self-care ability scale of stoma patients and the social psychological adaptation scale of stoma patients were applied to evaluate the self-care ability and social psychological adaptation level of two groups of patients in 1 months after operation. The incidence of stoma complications in two groups was compared. [results] 77 cases of effective questionnaires were successfully recovered, of which 37 cases in the control group and 40 in the intervention group. Comparison of two groups of patients with clinical data, the difference was not statistically significant (P0.05); the control ability of self nursing for 1 months postoperative score was 43 + 6.1, the intervention group was 54.6 + 4.3, t== - 9.2, there were significant differences in scores between the two groups (P0.05); self nursing ability of control group only (17/37,46%) at a high level, while the intervention group patients with high levels of up to (36/40,89%); the control group after 1 months of social psychological adaptation score was 31.8 + 2.7, the intervention group was 40.5 + 3.1, t= - 13.4, there were significant differences in scores between the two groups (0.05), control group (14/37,39%) the patient is in the middle level of adaptation, (23/37,61%) of the patients in the low level of adaptation; and the intervention group (3/40,8%) with high level of adaptation, (18/40,45%) of the patients in the moderate adaptation level (19/40,47%) of the patients in the low level of adaptation; 1 months after surgery, 11 stoma complications occurred in the control group (30%) there were 4 cases of stoma complications in the intervention group (10%), and the incidence of stoma complications in the two groups was statistically significant (P0.05). [Conclusion] individual nursing intervention based on ADOPT problem-solving mode can effectively improve self-care ability and social psychological adaptation level of rectal cancer patients with permanent colostomy, and reduce the occurrence of complications related to stoma.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.73

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