Abstract:

Objective　To explore the effect of nursing intervention of empowerment mode of family-center care (FCC) for patients taking enterostomy after radical resection of colorectal cancer (Miles' operation). Methods　From June 2020 to June 2022, 80 patients with rectal cancer who underwent enterostomy after Miles' operation in First Hospital, Henan University of Science and Technology were selected for the prospectively study, and were divided into a control group and an observation group according to the admission order, with 40 case in each group. The control group had 21 males and 19 females who were 43-75 (57.98±5.69) years old, and received routine nursing care. The observation group had 23 males and 17 females who were 42-76 (58.19±6.04) years old, and were given routine nursing care and FCC empowerment mode intervention. The compliances, scores of Readiness for Hospital Discharge Scale (RHDS), Self-rating Anxiety Scale (SAS), Self-Care Ability Scale for the Elderly (ESCA), and Quality of Life C-30 (QLQ-C30), and satisfaction of the two groups were compared. t and χ² tests were applied. Results　The compliance of the observation group was higher than that of the control group [95.00% (38/40) vs. 75.00% (30/40)], with a statistical difference (χ²=6.28, P<0.05). After the nursing, the scores of ESCA and SAS in the observation group were better than those in the control group [(98.45±5.26) vs. (86.46±6.28) and (41.69±4.58) vs. (46.82±4.68)], with statistical differences (t=9.26 and 4.96; both P<0.05). After the nursing, the scores of role, body, cognition, social function, emotion, and overall health of QLQ-C30 in the observation group were higher than those in the control group [(73.45±5.25) vs. (67.14±4.38), (75.68±5.82) vs. (68.49±5.91), (82.94±6.33) vs. (73.58±5.69), (81.68±4.68) vs. (72.68±5.74), (89.45±5.21) vs. (74.54±6.88), and (77.94±5.28) vs. (72.69±8.26)], with statistical differences (t=5.84, 5.48, 6.96, 7.66, 10.93, and 3.39; all P<0.05). After the nursing, the scores of personal status, expectant support, and adaptability and total score of RHDS in the observation group were higher than those in the control group [(25.47±1.05) vs. (21.45±2.38), (42.51±2.45) vs. (38.94±3.15), (33.67±0.89) vs. (30.67±2.82), and (101.65±2.36) vs. (91.06±4.53)], with statistical differences (t=9.77, 5.66, 6.42, and 13.11; all P<0.05). The satisfaction of the observation group was higher than that of the control group [97.50% (39/40) vs. 80.00% (32/40)], with a statistical difference (χ²=4.51, P<0.05). Conclusion The nursing intervention of FCC empowering mode can promote the completion of the patients' discharge preparation, compliance after discharge, and quality of life, increase their self-care ability, reduce their negative emotions, and deepen their recognition of nursing work.

Key words:

Rectal cancer, Family center care, Enterostomy, Quality of life

摘要：

目的　探究以家庭为中心护理（FCC）赋权模式的护理干预在肠癌腹会阴联合直肠癌根治术（Miles术）后肠造口患者中的应用效果。方法　选取2020年6月至2022年6月河南科技大学第一附属医院80例接受Miles术后肠造口的直肠癌患者进行前瞻性研究，以入院顺序不同分为对照组和观察组，各40例。对照组男21例，女19例，年龄43～75（57.98±5.69）岁，均给予常规护理；观察组男23例，女17例，年龄42～76（58.19±6.04）岁，均给予常规护理+FCC赋权模式干预。对比两组依从性、出院准备度量表（RHDS）、焦虑自评量表（SAS）、自我护理能力实施量表（ESCA）、生活质量核心量表（QLQ-C30）及满意度。统计学方法采用t检验、χ²检验。结果　观察组依从性高于对照组［95.0%（38/40）比75.0%（30/40）］，差异有统计学意义（χ²=6.28，P<0.05）；护理后观察组ESCA评分高于对照组［（98.45±5.26）分比（86.46±6.28）分］，SAS评分低于对照组［（41.69±4.58）分比（46.82±4.68）分］，差异均有统计学意义（t=9.26、4.96，均P<0.05）；观察组护理后QLQ-C30量表角色、躯体、认知、社会功能、情绪及总体健康评分均高于对照组［（73.45±5.25）分比（67.14±4.38）分、（75.68±5.82）分比（68.49±5.91）分、（82.94±6.33）分比（73.58±5.69）分、（81.68±4.68）分比（72.68±5.74）分、（89.45±5.21）分比（74.54±6.88）分、（77.94±5.28）分比（72.69±8.26）分］，差异均有统计学意义（t=5.84、5.48、6.96、7.66、10.93、3.39，均P<0.05）；观察组RHDS量表个人状态、预期性支持、适应能力及总分均高于对照组（25.47±1.05）分比（21.45±2.38）分、（42.51±2.45）分比（38.94±3.15）分、（33.67±0.89）分比（30.67±2.82）分、（101.65±2.36）分比（91.06±4.53）分，差异均有统计学意义（t=9.77、5.66、6.42、13.11，均P<0.05）；观察组护理满意度为97.5%（39/40），高于对照组［80.0%（32/40）］，差异有统计学意义（χ²=4.51，P<0.05）。结论　FCC赋权模式的护理干预可促进患者出院准备工作的完成，提高出院后患者依从性，增加自护能力，降低不良情绪，提高生活质量，加深患者对护理工作的认可。

关键词:

直肠癌, 以家庭为中心护理, 肠造口, 生活质量