超低位直肠癌ISR术后患者排便功能训练依从性及影响因素的研究

发布时间：2017-12-27 04:23

本文关键词：超低位直肠癌ISR术后患者排便功能训练依从性及影响因素的研究　出处：《吉林大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:分析超低位直肠癌患者经肛门内外括约肌间切除术(intersphincteric resection,ISR)后排便功能训练的依从性现状及影响因素。为护理人员明确患者训练存在的问题,重视对患者训练的管理,提供理论依据。方法:采用自身对照研究,对吉林省长春市某三甲医院2014年1月至2015年9月间收治的行ISR术的患者进行问卷调查。国际造口治疗师(enterostomal therapist,ET)指导患者进行排便功能训练,一般资料调查问卷、排便功能训练依从性量表、社会支持评定量表(SSRS)、排便日记、大便失禁生活质量问卷(FIQL)作为研究工具。采用Excel录入数据,使用SPSS17.0对资料进行分析,采用描述性分析、χ2检验、方差分析、Spearman秩相关分析、多元回归分析,分析患者排便功能训练依从性的现状及主要影响因素。结果:1.本研究中80例超低位直肠癌ISR术后患者排便功能训练依从性得分为(67.67±5.28)分;仅有21.25%依从率高,56.25%的患者依从率处于中等水平;疾病相关知识依从性最差,康复训练技能依从性较差;2.依从性的主要相关因素为年龄、文化程度、家庭月人均收入水平、社会支持、病理分期、手术方式、内括约肌切除类型、并发症、疼痛程度(P0.05或P0.01);3.术后排便功能训练依从性与肛门功能及大便失禁生活质量呈正相关,依从性好的患者术后9月、12月的肛门功能明显改善(P0.05);4.多元回归分析结果显示,文化程度、社会支持利用度、病理分期、内括约肌切除类型、并发症、疼痛程度为超低位直肠癌ISR术后患者排便功能训练依从性的主要影响因素。结论:1.超低位直肠癌ISR术后患者疾病相关知识依从性、康复训练技能依从性差。这提示护理人员应在患者住院期间给予有效健康教育,出院后给予持续性指导;2.超低位直肠癌ISR术后患者排便功能训练依从性与肛门功能及大便失禁生活质量相关。有效的排便训练计划、术后随访指导对患者排便功能恢复至关重要;3.超低位直肠癌ISR术后患者排便功能训练依从性的影响因素:文化程度、社会支持利用度、病理分期、内括约肌切除类型、并发症、疼痛程度。临床护理人员要充分认识影响因素,以提高患者排便功能训练依从性,促进患者肠道功能的恢复。
[Abstract]:Objective: to analyze the compliance status and influencing factors of defecation function training in patients with ultra-low rectal cancer after intersphincteric resection (ISR). For nursing staff to clear the problems of patient training, pay attention to the management of patients training, and provide theoretical basis. Methods: a self-control study was used to investigate the patients who were treated with ISR from January 2014 to September 2015 in a three a hospital in Changchun, Jilin. Enterostomal therapist (enterostomal therapist, ET) of defecation function training in patients with general information questionnaire, defecation function training compliance scale, social support rating scale (SSRS), fecal incontinence quality of life questionnaire, stool diary (FIQL) as a research tool. Excel was used to input data, and SPSS17.0 was used to analyze data. Descriptive analysis, chi square test, ANOVA, Spearman rank correlation analysis and multiple regression analysis were used to analyze the status and main influencing factors of defecation function training compliance of 2 patients. Results: 1. in this study, 80 cases of low rectal cancer patients after ISR of defecation function training compliance score (67.67 + 5.28); only 21.25% compliance rate is high, 56.25% of the patients compliance rate in the middle level of disease related knowledge; compliance is the worst, rehabilitation training skills compliance is poor; the main factors related to compliance 2. the age, education level, monthly family per capita income level, social support, pathological stage, surgical approach and internal sphincter resection type, complications, degree of pain (P0.05 or P0.01); training compliance and anal function and fecal incontinence quality of life was positively related to defecation function after operation in 3., September, December, the anal function improved obviously good compliance of patients after operation (P0.05); 4. multivariate regression analysis showed that education level, social support utilization, pathological stage, internal sphincter type, complication, Teng Tongcheng The main factors influencing the compliance of defecation training in patients with ultra low rectal cancer after ISR operation. Conclusion: 1. patients with ultra-low rectal cancer have poor compliance with knowledge dependent knowledge and rehabilitation training skills after ISR. This suggests that nurses should give effective health education during their hospitalization and give continuous guidance after discharge. 2. the compliance of defecation function training after ISR operation is related to anal function and fecal incontinence quality of life. Effective defecation training plan, postoperative follow-up guidance on defecation function recovery is crucial; influencing factors of defecation function training compliance of 3. low rectal cancer patients after ISR: education, utilization of social support, pathological stage, internal sphincter type, complications, degree of pain. The clinical nursing staff should fully understand the influencing factors in order to improve the compliance of the patient's defecation training and promote the recovery of the intestinal function of the patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.73

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