Effect of graded nursing model on the incidence of incontinence-associated dermatitis in patients with fecal incontinence in orthopedics department
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摘要:
目的 为预防及缓解骨科大便失禁患者发生失禁性皮炎，本研究将分级护理模式应用于临床骨科护理中，并观察其对患者失禁性皮炎发生情况、患者生活质量及其自理能力的影响。 方法 选择2019年1月—2020年1月于绍兴市柯桥区中医医院骨科住院治疗的大便失禁患者150例，按照随机数字表法将其分为对照组和干预组，每组75例。对照组患者给予常规护理，干预组在对照组的基础上应用分级护理模式。对比2组患者失禁性皮炎发生率、失禁性皮炎严重程度(皮损严重程度评估量表IADS)、生活质量(健康调查简表SF-36)以及自我护理能力(自我护理能力量表ESCA)。 结果 干预后，干预组患者失禁性皮炎发生率为4.00%，对照组发生率为21.33%，干预组显著低于对照组(P < 0.05)；干预后，干预组患者失禁性皮炎严重程度评分为(8.4±1.5)分，明显低于对照组的(15.1±1.7)分，P < 0.05；干预前，2组患者SF-36评分及自我护理能力评分差异无统计学意义(P＞0.05)，干预后，干预组患者SF-36评分及ESCA评分分别为(86.75±6.12)分、(126.75±11.22)分明显高于对照组[(76.37±6.75)分，(76.37±10.71)分，均P < 0.05]。 结论 分级护理模式可以有效降低骨科大便失禁患者失禁性皮炎的发生率，缓解其严重程度，同时提升患者生活质量及自我护理能力。 Abstract:Objective The aim of this paper was to prevent and reduce the occurrence of incontinence-associated dermatitis (IADS) in orthopedic patients with fecal incontinence, the graded nursing mode was applied to the nursing of clinical orthopedic patients with fecal incontinence, and observe effects of the graded nursing mode on the occurrence of incontinent dermatitis, the quality of life of the patients and their self-care ability. Methods A total of 150 patients with fecal incontinence who were hospitalized in the Department of Orthopedics, Keqiao District Traditional Chinese Medicine Hospital, Shaoxing City, Zhejiang Province from January 2019 to January 2020 were selected and divided into a control group and an intervention group according to a random number table, with 75 cases in each group. Patients in the control group were given routine nursing care, and the intervention group applied a graded nursing model on the basis of the control group. The incidence of IADS, the severity of IADS, the quality of life (by health survey short form SF-36) and self-care ability (self-care ability scale, SCAS) were compared between the two groups. Results After intervention, the incidence of IADS was 4.00% in the intervention group and 21.33% in the control group, which the difference was statistically significantly between the two groups (P < 0.05). After intervention, the severity score of IADS in the intervention group was (8.4±1.5) points, which was significantly lower than that in the control group (15.1±1.7) points, P < 0.05; Before intervention, there was no statistical significance in SF-36 score and self-care ability score between the two groups (P>0.05). After intervention, SF-36 score and ESCA score in the intervention group were (86.75±6.12) points and (126.75±11.22) points respectively, which were significantly higher than (76.37±6.75) points and (76.37±10.71) points in the control group (all P < 0.05). Conclusion The hierarchical nursing model can effectively reduce the incidence of IADS in orthopedic patients with fecal incontinence, relieve its severity, and improve the quality of life and self-care ability of patients. -
表 1 2组大便失禁患者失禁性皮炎发生率及严重程度比较
组别 例数 失禁性皮炎[例(%)] 严重程度评分(x±s，分) 对照组 75 16(21.33) 15.1±1.7 干预组 75 3(4.00) 8.4±1.5 统计量 25.593a 10.180b P值 < 0.001 < 0.001 注：a为χ2值，b为t值。 
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表 2 2组大便失禁患者生活质量评分比较(x±s，分)
组别 例数 干预前 干预后 t值 P值 对照组 75 60.25±7.24 76.37±6.75 14.103 < 0.001 干预组 75 60.43±7.21 86.75±6.12 24.102 < 0.001 t值 0.153 9.866 P值 0.879 < 0.001
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表 3 2组大便失禁患者干预前后自我护理能力评分比较(x±s，分)
组别 例数 干预前 干预后 t值 P值 对照组 75 75.25±7.24 76.37±10.71 0.750 0.454 干预组 75 75.44±7.01 126.75±11.22 33.588 < 0.001 t值 0.163 28.129 P值 0.871 < 0.001
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