The application of mind mapping in health education of perioperative with ileal bladder stoma
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摘要:
目的 探讨运用思维导图模型对膀胱癌回肠代膀胱尿流改道术后患者的回肠膀胱造口护理进行健康教育的应用效果。 方法 根据纳入和排除标准搜集2016年8月—2019年12月中国科学技术大学附属第一医院行全膀胱切除+回肠代膀胱尿流改道术的患者68例，采用随机数余数分组法将纳入研究的患者分为对照组和观察组，各34例。对照组采用传统的护理宣教方式对患者进行健康教育；观察组应用思维导图进行健康教育。在患者出院时评价健康教育效果及满意度；出院后定期随访患者，以评价患者造口相关知识的知晓度、造口自我管理能力及造口相关并发症的发生情况。 结果 本研究共纳入68例患者，年龄为(64.31±7.87)岁，2组患者年龄、性别、体重指数、一般病情及文化程度等方面差异均无统计学意义(均P>0.05)。观察组患者对于造口相关知识完全知晓率为79.41%，较对照组对造口相关知识的知晓率明显提高(Z=-2.690, P=0.007)；观察组自我管理能力方面可以独自护理率显著升高(Z=-2.265，P=0.024)，同时观察组对健康教育的满意度显著高于对照组(Z=-2.149, P=0.032)。在造口相关并发症的发生方面，观察组患者造口相关并发症的发生率显著低于对照组[造口炎症(2 vs. 9), 造瘘渗漏(3 vs. 10), 造口周围皮炎(5 vs. 12), 均P < 0.05]。 结论 膀胱癌患者行全膀胱切除+回肠代膀胱尿流改道术，在围手术期健康教育中引入思维导图是一种较好的术后健康教育方法，值得在今后临床中推广和应用。 Abstract:Objective To explore the application effect of the mind mapping model to the health education of patients with bladder cancer undergo cystectomy+ileal replacement of bladder urinary diversion. Methods According to the inclusion and exclusion criteria, patients who underwent total cystectomy and Bricker urinary diversion in The First Affiliated Hospital of University of Science and Technology of China from August 2016 to December 2019 were enrolled in the study. According to the randomized principle, patients included in the study were divided into the control and observation groups, 34 cases in each group. The control group was given health education by traditional nursing education, and the observation group used design and mind map for health education. The health education effect and satisfaction were evaluated when the patient was discharged from the hospital. Patients were regularly followed up after discharge to evaluate their stoma-related knowledge, their self-management ability and the occurrence of stenosis-related complications. Results A total of 68 cases were recruited in this experiment, and the average age was (64.31±7.87) years old. No statistical differences in age, gender, body mass index, general illness and education level were found between the two groups (all P>0.05). Patients in the observation group had 79.41% complete knowledge rate of ostomy-related knowledge, which was significantly higher than in the control group (Z=-2.690, P=0.007). Patients in the observation group showed significantly enhanced rate of self-management (Z=-2.265, P=0.024). The satisfaction of the observation group with health education was significantly higher than that of the control group (Z=-2.149, P=0.032). In terms of the occurrence of ostomy-related complications, the incidence of ostomy-related complications in the observation group was significantly lower than that in the control group (2 vs. 9), similar results were found for ostomy leakage (3 vs. 10) and peri-ostomy dermatitis (5 vs. 12), all P < 0.05. Conclusion Patients with bladder cancer undergo cystectomy+ileal replacement of bladder urinary diversion. The introduction of mind mapping in perioperative health education is a satisfactory postoperative health education method that is worthy of clinical promotion and application in the future. -
Key words:
- Mind map /
- Bladder cancer /
- Ileal bladder ostomy /
- Health education
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表 1 2组行全膀胱切除+回肠代膀胱尿流改道术患者对造口相关知识知晓度情况比较(例)
组别 例数 完全知晓 部分知晓 不知晓 对照组 34 20 11 3 观察组 34 30 3 1 注：2组造口相关知识知晓度比较，Z=-2.690, P=0.007。 
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表 2 2组行全膀胱切除+回肠代膀胱尿流改道术患者早期造口自我管理能力比较(例)
组别 例数 独自护理 辅助护理 不能护理 对照组 34 16 14 4 观察组 34 26 5 3 注：2组自我管理能力比较，Z=-2.265, P=0.024。
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表 3 2组行全膀胱切除+回肠代膀胱尿流改道术患者满意度情况比较(例)
组别 例数 满意 一般 不满意 对照组 34 24 6 4 观察组 34 31 2 1 注：2组满意度比较，Z=-2.149, P=0.032。
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表 4 2组行全膀胱切除+回肠代膀胱尿流改道术患者并发症情况比较(例)
组别 例数 造口炎症 造口渗漏 造口周围皮炎 造口坏死 对照组 34 9 10 12 5 观察组 34 2 3 5 0 χ2值 5.314 4.660 3.843 3.454 P值 0.021 0.031 0.050 0.063
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