ADOPT模式对老年结肠造口患者希望水平及生活质量的影响
发布时间：2018-08-10 20:32
【摘要】：目的调查直肠癌结肠造口患者希望水平及生活质量的现状。探讨ADOPT模式对结肠造口患者希望水平及生活质量水平的影响。方法本研究选取莱芜市某三级乙等医院124例直肠癌术后结肠造口患者,将其随机分为对照组和试验组,每组各62例。对照组患者给予常规的护理。试验组患者在常规护理基础上,由从事本专业三年以上,经过造口及心理咨询培训的护士实施ADOPT模式干预。时间为6个月。该模式包括个性化指导、患者小组的干预、结肠造口自我护理手册讲解、电话随访、门诊随访及家访。在术后第1天、出院时及出院6个月时采用希望水平量表、生活质量量表、造口适应量表、造口并发症评估表对两组患者进行评估。结果1.两组患者在性别、年龄、文化程度、婚姻状况、职业、家庭月收入、医疗支付、宗教信仰、家庭关系、居住类别、临床分期、肿瘤转移与否、因本病住院次数、病程、家族史方面差异均无统计学意义(P0.05)。2.在出院时,对照组与试验组患者在造口皮肤并发症、造口回缩和造口皮肤黏膜分离的评分方面无统计学差异(P0.05)。出院后6个月,对照组患者造口皮肤并发症、造口狭窄和造口脱垂评分显著高于试验组(P0.05)。3.两组患者的身体适应、心理适应、社会适应不同时间段,差异存在统计学意义(P0.05)。并且两组患者造口适应量表总分及三个适应方面存在交互效应,差异也均具有统计学意义(P0.05)。4.两组患者在术后第1天时,其希望水平差异无统计学意义(P0.05)。在出院时,两组的希望水平均有所提高,但试验组高于对照组(P0.05)。在经过6个月的干预后,试验组的希望水平评分有明显的提高,并且显著的高于对照组(P0.05)。5.出院前,两组患者在生活质量评价量表的15个大项中的比较均无统计学差异(P0.05)。经过6个月的护理干预后,我们发现试验组的14项生活质量评分均有了显著的改善,并且明显优于对照组(P0.05)。而经济困难评分两组患者在干预前后并无明显改变。结论1.ADOPT模式有利于提高结肠造口患者适应水平及减少造口并发症。2.ADOPT模式有利于提高结肠造口患者希望水平及生活质量。
[Abstract]:Objective to investigate the level of hope and quality of life (QOL) of rectal cancer patients undergoing colostomy. To investigate the effect of ADOPT model on the level of hope and quality of life in patients with colostomy. Methods 124 patients with rectal cancer were randomly divided into control group (n = 62) and experimental group (n = 62). The patients in the control group were given routine nursing care. On the basis of routine nursing, the patients in the test group were treated with ADOPT mode by nurses who had been engaged in this major for more than three years and had undergone stomatology and psychological counseling training. The time is six months. The model includes individualized guidance, patient group intervention, colon colostomy self-care manual, telephone follow-up, outpatient follow-up and home visits. On the first day after operation, at the time of discharge and 6 months after discharge, the two groups were evaluated with the level of Hope scale, the quality of Life scale, the Osteotomy adaptation scale and the Evaluation of complications of Ostomy. Result 1. The patients in the two groups were divided into two groups: sex, age, education, marital status, occupation, family monthly income, medical payment, religious belief, family relationship, type of residence, clinical stage, tumor metastasis or not, number of hospitalizations due to the disease, course of disease. Family history differences were not statistically significant (P0.05). 2. At the time of discharge, there was no significant difference between the control group and the test group in the score of complications, retraction and mucosal separation (P0.05). At 6 months after discharge, the score of complications, stricture and prolapse of stoma in the control group was significantly higher than that in the experimental group (P0.05). 3. Two groups of patients' physical adaptation, psychological adaptation, social adaptation in different time periods, the difference was statistically significant (P0.05). And the two groups of patients with oral adaptation scale total score and three aspects of the interaction effect, the difference is also statistically significant (P0.05). 4. At the first day after operation, there was no significant difference in the level of hope between the two groups (P0.05). At the time of discharge, the level of hope increased in both groups, but higher in the trial group than in the control group (P0.05). After 6 months of intervention, the score of hope level in the experimental group was significantly improved, and significantly higher than that in the control group (P0.05). 5. Before discharge, there was no significant difference between the two groups in the 15 major items of the quality of life evaluation scale (P0.05). After 6 months of nursing intervention, we found that the 14 quality of life scores of the experimental group were significantly improved, and significantly better than the control group (P0.05). However, there was no significant change in the score of economic difficulty between the two groups before and after intervention. Conclusion the model of 1.ADOPT is helpful to improve the level of adaptation and reduce the complications of colostomy. 2.ADOPT is helpful to improve the level of hope and quality of life of patients with colostomy.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73
本文编号：2176121
[Abstract]:Objective to investigate the level of hope and quality of life (QOL) of rectal cancer patients undergoing colostomy. To investigate the effect of ADOPT model on the level of hope and quality of life in patients with colostomy. Methods 124 patients with rectal cancer were randomly divided into control group (n = 62) and experimental group (n = 62). The patients in the control group were given routine nursing care. On the basis of routine nursing, the patients in the test group were treated with ADOPT mode by nurses who had been engaged in this major for more than three years and had undergone stomatology and psychological counseling training. The time is six months. The model includes individualized guidance, patient group intervention, colon colostomy self-care manual, telephone follow-up, outpatient follow-up and home visits. On the first day after operation, at the time of discharge and 6 months after discharge, the two groups were evaluated with the level of Hope scale, the quality of Life scale, the Osteotomy adaptation scale and the Evaluation of complications of Ostomy. Result 1. The patients in the two groups were divided into two groups: sex, age, education, marital status, occupation, family monthly income, medical payment, religious belief, family relationship, type of residence, clinical stage, tumor metastasis or not, number of hospitalizations due to the disease, course of disease. Family history differences were not statistically significant (P0.05). 2. At the time of discharge, there was no significant difference between the control group and the test group in the score of complications, retraction and mucosal separation (P0.05). At 6 months after discharge, the score of complications, stricture and prolapse of stoma in the control group was significantly higher than that in the experimental group (P0.05). 3. Two groups of patients' physical adaptation, psychological adaptation, social adaptation in different time periods, the difference was statistically significant (P0.05). And the two groups of patients with oral adaptation scale total score and three aspects of the interaction effect, the difference is also statistically significant (P0.05). 4. At the first day after operation, there was no significant difference in the level of hope between the two groups (P0.05). At the time of discharge, the level of hope increased in both groups, but higher in the trial group than in the control group (P0.05). After 6 months of intervention, the score of hope level in the experimental group was significantly improved, and significantly higher than that in the control group (P0.05). 5. Before discharge, there was no significant difference between the two groups in the 15 major items of the quality of life evaluation scale (P0.05). After 6 months of nursing intervention, we found that the 14 quality of life scores of the experimental group were significantly improved, and significantly better than the control group (P0.05). However, there was no significant change in the score of economic difficulty between the two groups before and after intervention. Conclusion the model of 1.ADOPT is helpful to improve the level of adaptation and reduce the complications of colostomy. 2.ADOPT is helpful to improve the level of hope and quality of life of patients with colostomy.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73
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