思维导图式健康教育对肠造口患者术后自我护理能力的影响

刘全丽; 张婕; 张静; 霍蕊

doi:10.16766/j.cnki.issn.1674-4152.002662

思维导图式健康教育对肠造口患者术后自我护理能力的影响

doi: 10.16766/j.cnki.issn.1674-4152.002662

刘全丽^{1, 2},
张婕²,
张静²,
霍蕊^1, ,

1.
蚌埠医学院第一附属医院胃肠外科，安徽蚌埠 233004
2.
蚌埠医学院护理学院，安徽蚌埠 233030

基金项目:

安徽高校人文社会科学研究项目 SK2020A0365

详细信息

通讯作者:
霍蕊, E-mail: huorui800914@163.com

中图分类号: R473.6 R656.6
计量
- 文章访问数: 226
- HTML全文浏览量: 128
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-14
- 网络出版日期: 2022-11-29

The influence of mind mapping schema health education on postoperative self-care ability of patients with enterostomy

LIU Quan-li^{1, 2},
ZHANG Jie²,
ZHANG Jing²,
HUO Rui^{1
, ,}

1.
Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨思维导图式健康教育对直肠癌术后行肠造口的患者术后自我护理能力以及造口周围皮肤并发症的影响，旨在提高患者居家自我护理造口的能力，减少造口并发症的发生。方法前瞻性纳入2021年1—9月在蚌埠医学院第一附属医院胃肠外科接受直肠癌根治术并行肠造口的79例患者，采用随机数字表法将患者分为对照组(39例)及观察组(40例)。对照组采用常规造口健康教育，包含造口相关护理知识、生活指导、并发症处理及出院指导等，观察组在常规健康教育的基础上融合思维导图宣教。采用造口自我护理能力量表于出院当日、出院1个月和3个月时分别评估患者对造口的自我护理能力，并记录患者出院后造口周围皮肤并发症的发生情况。结果 2组患者出院当日造口自我护理能力评分差异无统计学意义(P>0.05);观察组与对照组出院1个月[(53.13±2.65)分vs. (47.77±2.44)分]及出院3个月[(58.80±2.60)分vs. (54.92±2.66)分]自我护理能力评分差异有统计学意义(均P < 0.01)。对照组与观察组出院1个月(21人vs. 12人, χ²=4.617，P=0.032)及出院3个月(15人vs. 7人, χ²=4.318，P=0.038)造口并发症发生例数差异均有统计学意义(均P < 0.05)。观察组与对照组住院满意度分别为95.0%(38/40)及76.9%(30/39)，差异有统计学意义(χ²=5.384，P=0.020)。结论思维导图式健康教育能改善肠造口患者术后居家自我护理造口的能力，减少术后造口并发症的发生，提高住院期间满意度。
- 思维导图 /
- 肠造口 /
- 自理能力
Abstract: Objective To investigate the effect of mind map schema health education on postoperative self-care ability and skin complications of patients undergoing enterostomy after rectal cancer operation, so as to improve the ability of self-care at home and reduce the occurrence of complications. Methods Patients undergoing radical colorectal cancer surgery with enterostomy in the Gastrointestinal Surgery Department of First Affiliated Hospital of Bengbu Medical College from January to September 2021 were prospectively enrolled. They were divided into control group (39 cases) and observation group (40 cases) using random numbers method. The control group received routine ostomy health education, including ostomy-related nursing knowledge, life guidance, complication management and discharge guidance, while the observation group received routine health education combined with mind map education. The patients'ability of self-care for ostomy was evaluated by the ostomy self-care ability scale at discharge day, one month and three months. The occurrence of skin complications around ostomy after discharge was recorded. Results There was no significant difference in the ostomy self-care ability score between the two groups on discharge day (P>0.05). The self-care ability scores of the observation group and the control group were statistically significant after discharge for one month [(53.13±2.65) points vs. (47.77±2.44) points] and three months [(58.80±2.60) points vs. (54.92±2.66) points, all P < 0.01]. In terms of ostomy complications, there were statistically significant differences between the control group and the observation group in the number of cases of complications after discharge for one month (21 vs. 12, χ²=4.617, P=0.032) and three months (15 vs. 7, χ²=4.318, P=0.038). The hospitalization satisfaction of the observation group and the control group was 95.0% (38/40) and 76.9% (30/39), respectively, with statistical significance (χ²=5.384, P=0.020). Conclusion Mind mapping schema health education can improve the ability of patients with enterostomy to take care of their stoma at home, reduce the occurrence of stoma complications, and improve satisfaction during hospitalization.
- Mind mapping /
- Enterostomy /
- Self-care ability

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图 1 造口袋倾倒

Figure 1. Dumping of ostomy bag

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图 2 造口袋更换

Figure 2. Replacement of ostomy bag

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图 3 造口患者日常生活指导

Figure 3. Daily living instruction for patients with stoma

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图 4 造口并发症表现及处理

Figure 4. Presentation and management of ostomy complications

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表 1 2组结直肠癌根治术患者一般资料比较[例(%)]

Table 1. Comparison of general data between the two groups of patients undergoing radical resection of colorectal cancer [cases (%)]

项目	类别	对照组(n=39)	观察组(n=40)	统计量	P值
年龄(x±s, 岁)		60.69±7.92	60.20±9.33	0.251^a	0.802
性别[例(%)]	男性	31(79.5)	30(75.0)	0.226^b	0.635
	女性	8(20.5)	10(25.0)
文化程度[例(%)]	文盲	8(20.5)	11(27.5)	-0.336^c	0.737
	小学	18(46.2)	15(37.5)
	初中	8(20.5)	10(25.0)
	高中及以上	5(12.8)	4(10.0)
婚姻状况[例(%)]	已婚	37(94.9)	39(97.5)	0.001^b	0.982
	未婚/丧偶	2(5.1)	1(2.5)
职业[例(%)]	农民	28(71.8)	28(70.0)	2.210^b	0.530
	工人	8(20.5)	10(25.0)
	教师	0(0.0)	1(2.5)
	退休人员	3(7.7)	1(2.5)
家庭人均收入[例(%)]	< 1 000元	6(15.4)	4(10.0)	-1.133^c	0.257
	1 000~3 000元	20(51.3)	18(45.0)
	>3 000元	13(33.3)	18(45.0)
长期居住地[例(%)]	农村	31(79.5)	29(72.5)	0.528^b	0.468
	城镇	8(20.5)	11(27.5)
住院时间[例(%)]	≤15 d	38(97.4)	36(90.0)	0.801^b	0.371
	>15 d	1(2.6)	4(10.0)
造口类型[例(%)]	永久性	17(43.6)	19(47.5)	0.122^b	0.727
	临时性	22(56.4)	21(52.5)
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 2组结直肠癌根治术患者自我护理意愿得分比较(x±s, 分)

Table 2. Comparison of self-care intention score between two groups of patients undergoing radical resection of colorectal cancer (x±s, points)

组别	例数	自我护理意愿
组别	例数	出院当日	出院1个月	出院3个月
对照组	39	33.87±1.89	35.64±1.44^a	38.23±2.16^a
观察组	40	33.90±2.26	37.73±1.87^a	39.80±2.14^a
t值		0.060	5.543	3.246
P值		0.952	< 0.001	0.002
注：F_组别=22.968，P < 0.001;F_时间=132.144，P < 0.001;F_交互=5.731，P=0.004。与出院当日比较，^aP < 0.05。

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表 3 2组结直肠癌根治术患者自我护理知识得分比较(x±s, 分)

Table 3. Comparison of self-care knowledge scores between two groups of patients undergoing radical resection of colorectal cancer (x±s, points)

组别	例数	自我护理知识
组别	例数	出院当日	出院1个月	出院3个月
对照组	39	9.72±1.36	10.97±1.87^a	12.79±1.69^a
观察组	40	9.90±1.10	12.03±1.37^a	14.25±1.86^a
t值		0.655	2.855	3.634
P值		0.514	0.006	0.001
注：F_组别=17.339，P < 0.001;F_时间=118.065，P < 0.001;F_交互=3.613，P=0.029。与出院当日比较，^aP < 0.05。

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表 4 2组结直肠癌根治术患者自我护理技能得分比较(x±s, 分)

Table 4. Comparison of self-care skill scores of patients undergoing radical resection of colorectal cancer between 2 groups (x±s, ponits)

组别	例数	自我护理技能
组别	例数	出院当日	出院1个月	出院3个月
对照组	39	0.67±0.48	2.36±0.99^a	4.33±0.48^a
观察组	40	0.70±0.46	3.38±0.84^a	4.78±0.42^a
t值		0.315	4.939	4.661
P值		0.754	< 0.001	< 0.001
注：F_组别=43.848，P < 0.001;F_时间=649.335，P < 0.001;F_交互=10.519，P < 0.001。与出院当日比较，^aP < 0.05。

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表 5 2组结直肠癌根治术患者自我护理能力总得分比较(x±s, 分)

Table 5. Comparison of total score of self-care ability in patients with radical resection of colorectal cancer between 2 groups (x±s, points)

组别	例数	自我护理能力
组别	例数	出院当日	出院1个月	出院3个月
对照组	39	44.26±2.28	47.77±2.44^a	54.92±2.66^a
观察组	40	44.50±2.58	53.13±2.65^a	58.80±2.60^a
t值		0.444	9.328	6.547
P值		0.658	< 0.001	< 0.001
注：F_组别=79.678，P < 0.001;F_时间=514.852，P < 0.001;F_交互=22.858，P < 0.001。与出院当日比较，^aP < 0.05。

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表 6 2组结直肠癌根治术患者不同时间点并发症发生例数比较[例(%)]

Table 6. Comparison of complications at different time points between the two groups after radical resection of colorectal cancer [cases (%)]

组别	例数	出院1个月末	出院3个月末
对照组	39	21(53.8)	15(38.5)
观察组	40	12(30.0)	7(17.5)
χ²值		4.617	4.318
P值		0.032	0.038

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