基于行为分阶段改变理论的护理干预在低位直肠癌保肛术后患者中的应用
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摘要
目的探讨基于行为分阶段改变理论为指导的护理干预对低位直肠癌保肛术后患者排便功能及生活质量的影响。方法选择2013年6月至2016年6月在本院住院的84例低位直肠癌保肛术后患者,根据入院时间分为对照组和干预组,每组各42例。对照组院内进行伤口护理、饮食、生活指导及肛门功能锻炼指导;院外实施电话随访和家访,共6个月。干预组院内和院外实施基于行为分阶段改变理论为指导的护理干预,院外共干预6个月。比较两组患者术后6个月后肛门失禁程度、排便功能和生活质量的差异。结果干预组术后大便失禁程度轻于对照组;排便功能和生活质量优于对照组(P<0.05,P<0.001)。结论基于行为分阶段改变理论为指导的护理干预可减轻低位直肠癌保肛术后患者大便失禁程度,改善排便功能,进而提高其生活质量。
Objective To study the effect of behavior-changes-in-stages theory on defecation function of lower rectal cancer after sphincter-preserving operation.Methods 84 patients with lower rectal cancer undergoing sphincter-preserving operation from June2013 to June 2016 were divided into control group(n=42) and intervention group(n=42) according to their willingness to care.The control group implemented routine nursing,mainly for diet intervention,wound care,bowel function training and in the intervention group the behavior-changes-in-stages theory was used.Comparisons were done between the groups in terms of the anus incontinence defecation function and quality of life for 6 months after operation.Result The degrees of anus incontinence and defecation function in the intervention group were both significantly better than those in the control group 6 months after the operation(P<0.05).Conclusions The behavior-change-in-stages plays a significant role in the postoperative rehabilitation.It can significantly reduce the anus incontinence,better the bowel function,improve the quality of life and promote rehabilitation.
Objective To study the effect of behavior-changes-in-stages theory on defecation function of lower rectal cancer after sphincter-preserving operation.Methods 84 patients with lower rectal cancer undergoing sphincter-preserving operation from June2013 to June 2016 were divided into control group(n=42) and intervention group(n=42) according to their willingness to care.The control group implemented routine nursing,mainly for diet intervention,wound care,bowel function training and in the intervention group the behavior-changes-in-stages theory was used.Comparisons were done between the groups in terms of the anus incontinence defecation function and quality of life for 6 months after operation.Result The degrees of anus incontinence and defecation function in the intervention group were both significantly better than those in the control group 6 months after the operation(P<0.05).Conclusions The behavior-change-in-stages plays a significant role in the postoperative rehabilitation.It can significantly reduce the anus incontinence,better the bowel function,improve the quality of life and promote rehabilitation.
引文
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[9]苏连菊.综合护理干预在Dixon术治疗低位直肠癌患者围术期护理中的应用效果[J].国际护理学杂志,2016,35(8):1053-1055.
[10]EFTHIMIADIS C,BASDANIS G,ZATAGIAS A,et al.Maonmetric and clinical evaluation of patients after low anterior resection for recatal cancer[J].Tech Coloproctol,2004,8(Suppl 1):205-207.
[11]RAO S S.Diagnosis and management of fecal incontinence.American College of Gastroenterology Practice PaRameters Committee[J].Am J Gastroenterol,2004,99(8):1585-1604.
[12]HO P,LAW W L,CHAN S C,et al.Functional outcomefollowing low anterior in the elderly[J].Int J Colorectal Dis,2003,18(3):230-233.
[13]HIDA J,YOSHIFUJI T,TOKORO T,et al.Long-term functional outcomen of low anterior resection with colonic Jpouch recons truction for rectal cancer in the elderly[J].Dis Colon Rectum,2004,47(9):1448-1454.
[14]GLAN K,RIMER BK,VISWAN ATH K.Health pehavior and hearth education:theory research,and practice IMI[M].4th ed.San Frabcisco:Jossey-Bass,a wiley Impvint,2008:97-108.
[2]罗莉,吕真冰,杨华,等.协同护理模式对低位直肠癌患者保肛术后肛门括约肌功能训练效果的影响[J].中华现代护理杂志,2016,22(17):2404-2407.
[3]梁雪亭,王千心,孙田杰.高龄低位直肠癌保肛术后患者排便功能训练的研究.中国医科大学学报,2014,43(6):512-514.
[4]AARON S R,DAVID W D,GEORGE J C,et al.High rate of positive circumferential resection margins following rectal cancer surgery:a call to action[J].Annals of surgery,2015,262(6):891-898.
[5]GILLIAN K,RACHEL H,GATRIONA M,et al.Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life[J].Eur J Oncol Nurs,2013,17(5):570-577.
[6]RULLIER E,ZERBIB F,MARREL A,et al.Validation of the French version of the fecal incontinence quality-of-life(FIQL)scale[J].Gastroenterol Clin Biol,2004,28(6-7):562-568.
[7]Q DENOST,J L FAUCHERON,J H LEFEVRE,et al.French current management and oncological results of locally recurrent rectal cancer[J].Eur J Oncol Nurs,2015,19(12):1645-1652.
[8]陈彩玲,杨梅,李艳华,等.腹部无切口经肛门切除肿瘤腹腔镜低位直肠癌根治吻合器结肠造口的护理模式[J].护理实践与研究,2016,13(2):70-72.
[9]苏连菊.综合护理干预在Dixon术治疗低位直肠癌患者围术期护理中的应用效果[J].国际护理学杂志,2016,35(8):1053-1055.
[10]EFTHIMIADIS C,BASDANIS G,ZATAGIAS A,et al.Maonmetric and clinical evaluation of patients after low anterior resection for recatal cancer[J].Tech Coloproctol,2004,8(Suppl 1):205-207.
[11]RAO S S.Diagnosis and management of fecal incontinence.American College of Gastroenterology Practice PaRameters Committee[J].Am J Gastroenterol,2004,99(8):1585-1604.
[12]HO P,LAW W L,CHAN S C,et al.Functional outcomefollowing low anterior in the elderly[J].Int J Colorectal Dis,2003,18(3):230-233.
[13]HIDA J,YOSHIFUJI T,TOKORO T,et al.Long-term functional outcomen of low anterior resection with colonic Jpouch recons truction for rectal cancer in the elderly[J].Dis Colon Rectum,2004,47(9):1448-1454.
[14]GLAN K,RIMER BK,VISWAN ATH K.Health pehavior and hearth education:theory research,and practice IMI[M].4th ed.San Frabcisco:Jossey-Bass,a wiley Impvint,2008:97-108.