摘要
目的 探讨“六步标准造口护理流程法”在门诊结肠造口病人中的应用效果。方法 将 2018 年 1月-2019 年 12 月在我院伤口造口门诊就诊的结肠造口病人 201 例，按目的抽样法分为常规组和标准组；常规组 99 例应用常规方法指导病人及家属进行造口护理；标准组 102 例采用“六步标准造口护理流程法”、造口身体形态评估工具表指导病人造口护理及正确选择造口用品；两组病人首次就诊分别建立微信群，通过自制问卷星调查表分别在其就诊后的 1、3、6 个月对造口周围皮肤并发症发生情况、自护能力、生活质量及造口护理指导满意度等进行统计比较。结果 两组病人自护能力、生活质量、造口周围皮肤并发症发生率及对造口护理指导的满意度比较，均有明显差异（P<0.05）；其自护能力、生活质量随着出院时间的延长，差异值逐渐缩小，但在出院后 1 个月及 3 个月的差异较明显，标准组高于常规组（P<0.05）；两组造口周围皮肤并发症发生率分别为 30.3%、5.88%，常规组明显高于标准组（P<0.05）。结论 “六步标准造口护理流程法”能明显提高门诊结肠造口病人的自护能力，造口身体形态评估工具可以帮助病人选择适合自己的造口用品，从而减轻其家庭经济负担，提高了病人的生活质量；标准化的培训、指导，不仅能规范门诊坐诊护士的工作行为，还能提高造口病人的依从性，降低造口周围皮肤并发症的发生，并能提高病人对门诊坐诊护士的满意度。
关键词： 结肠造口；门诊护理；标准化管理；效果评价
Abstract
Objective: To investigate the effect of the standard 6-step colostomy nursing procedure in outpatient colostomy patients. Method 201 cases of colostomy patients who were treated in the wound and stoma clinic of our hospital from January 2018 to December 2019 were divided into routine group and standard group according to the purpose sampling method; 99 cases of routine group were guided by patients and their families with conventional methods Ostomy care;In the standard group, 102 cases were guided by the six-stepstandard colostomy nursing procedure and the the ostomy self-assessment tools based on the conventional group to guide the patient's stoma care and the correct selection of stoma supplies. WeChat group was established for the first treatment of two groups of patients. The incidence of stoma complications, self-care ability, quality of life and satisfaction with stoma nursing guidance were investigated and compared through self-made questionnaire 1, 3 and 6 months after the first treatment of two groups of patients. Result There were significant differences in the self-care ability, quality of life, incidence of skin complications around the stoma, and satisfaction with ostomy care guidance between the two groups of patients (P<0.05).The self-care ability and quality of life of the two groups of patients gradually decreased with the length of discharge, but the differences were more significant at 1 and 3 months after discharge. The standard group was higher than the conventional group (P <0.05); The incidence of skin complications around the stoma in the two groups was 30.3% and 5.88%, respectively, which was significantly higher in the conventional group than in the standard group (P <0.05). Conclusion Standardized management can significantly improve self-care ability of outpatient colostomy patients. And the ostomy self-assessment tools can help patients choose their own stoma supplies, thereby reducing their family financial burden and improving the quality of life of patients.Standardized training and guidance can not only standardize the working behavior of outpatient nurses, but also improve the compliance of stoma patients and reduce the incidence of skin complications around the stoma; standardized management of stoma can improve patient satisfaction with outpatient nurses.
Key words： Colostomy; Outpatient nursing; Standardized management; Effect evaluation
参考文献 References
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
[14]
[15]
[16]
[17]
[18]
[19]
[20]
[21]
[22]
[23]
[24]
[25]