發(fā)布時間：2018-11-13 19:19

【摘要】：目的了解回腸造口患者自我管理效能感水平的影響因素,探討連續(xù)護理對回腸造口患者自我管理效能感水平的影響,為護理人員及時有效調(diào)整干預方案,合理的進行連續(xù)護理,最大程度提高回腸造口患者的自我管理能力。從而達到保障回腸造口患者健康、降低醫(yī)療費用、節(jié)省衛(wèi)生資源的目標。方法本研究屬于類實驗性研究。將2014年5月至2014年12月于長沙市某三級醫(yī)院行回腸造口術(shù)的60例患者作為研究對象,按照隨機數(shù)字表法將其分為觀察組和對照組,每組30例,其中對照組給予醫(yī)院常規(guī)治療和護理;干預組除參加常規(guī)治療和護理外,同時接受連續(xù)護理,并于研究前、研究第1個月、研究第3個月使用一般資料調(diào)查問卷、造口情況統(tǒng)計表、腸造口患者自我管理效能水平問卷系統(tǒng)化評價連續(xù)護理對回腸造口患者造口情況、自我管理效能感水平、及術(shù)后患者預后的影響情況。所有資料使用spss18.0軟件進行統(tǒng)計分析,主要統(tǒng)計學方法包括描述性分析、兩樣本t檢驗、單因素方差分析、重復測量設(shè)計資料的方差分析等。結(jié)果1.基線結(jié)果顯示:研究對象自我管理效能感均分為:59.23±4.64分,患者自我管理效能感水平處于中低水平;2.回腸造口患者自我管理效能感影響因素分析結(jié)果顯示:研究對象的自我管理效能感水平與患者的年齡、文化程度、工作狀態(tài)以及職業(yè)情況等因素有關(guān)。3.重復測量方差分析結(jié)果表明:自我管理效能感得分的干預主效應有統(tǒng)計學意義(P0.01),即不考慮時間的因素,干預水平的不同,患者自我管理效能感水平得分有差異;自我管理效能感得分的時間主效應有統(tǒng)計學意義(P0.05),即不考慮干預的因素,患者自我管理效能感水平得分隨時間的變化而變化。研究對象自我管理效能感水平得分的時間因素、干預水平均存在交互作用(P0.05)。交互輪廓圖顯示,隨著時間的變化,干預組患者自我管理效能感得分的上升幅度大于對照組。4.造口情況統(tǒng)計結(jié)果顯示:干預組比對照組造口產(chǎn)品費用減少、造口護理能力提高、術(shù)后造口并發(fā)癥的發(fā)生率降低,差異有統(tǒng)計學意義,但兩組患者術(shù)后性生活的恢復差異無統(tǒng)計學意義。結(jié)論1.回腸造口患者術(shù)后自我管理效能感水平較低,其自我管理效能感水平與患者的年齡、文化程度、工作狀態(tài)以及職業(yè)情況等因素有關(guān)。2.通過實施連續(xù)護理,可顯著提高回腸造口患者的自我管理效能感水平。干預組回腸造口患者的自我管理效能感水平明顯高于對照組,造口并發(fā)癥發(fā)生情況較少,本研究確定的連續(xù)護理方案在臨床的實施過程中有較好的效果。
[Abstract]:Objective to investigate the influencing factors of self-management efficacy level of ileostomy patients, and to explore the influence of continuous nursing on self-management efficacy level of ileostomy patients, so as to adjust the intervention scheme in time and effectively, and to carry out reasonable continuous nursing care for nursing staff. To improve the ability of self-management of ileostomy patients. In order to ensure the health of ileostomy patients, reduce medical costs and save health resources. Methods this study is an experimental study. From May 2014 to December 2014, 60 patients undergoing ileostomy in a level-III hospital in Changsha were divided into observation group (n = 30) and control group (n = 30). The control group was given routine treatment and nursing care. In addition to routine treatment and nursing, the intervention group received continuous care at the same time. Before the study, the first month of the study and the third month of the study, the general information questionnaire was used. Evaluation of the effect of continuous nursing care on the patients with ileostomy, the level of self-management efficacy and the prognosis of the patients after operation were systematically evaluated by the questionnaire of self-management efficacy level of patients undergoing enterostomy. All the data were analyzed by spss18.0 software. The main statistical methods included descriptive analysis, t-test of two samples, analysis of variance of single factor, ANOVA of repeated measurement design data and so on. Result 1. The baseline results showed that the subjects' self-management efficacy was 59.23 鹵4.64, and the level of self-management efficacy was low and low. 2. The results showed that the level of self-management efficacy was related to the age, education, working status and professional status of the patients. The results of ANOVA showed that the main effect of intervention in self-management efficacy score was statistically significant (P0.01), that is, regardless of time, the level of intervention was different, and the score of self-management efficacy was different. The time main effect of self-management efficacy scores was statistically significant (P0.05), that is, the patients' self-management efficacy scores changed with time without taking into account the factors of intervention. The time factor and intervention level of self-management efficacy level were all interactive (P0.05). The interactive contour showed that, with the change of time, the scores of self-management efficacy in the intervention group were significantly higher than those in the control group. 4. The statistical results showed that the cost of the products in the intervention group was lower than that in the control group, and the nursing ability of the patients was improved, and the incidence of postoperative complications was decreased, and the difference was statistically significant. But there was no significant difference in the recovery of sexual life between the two groups. Conclusion 1. The level of self-management efficacy was lower in patients with ileostomy. The level of self-management efficacy was related to the age, education, working status and professional status of the patients. 2. Continuous nursing care can significantly improve the level of self-management efficacy of patients with ileostomy. The level of self-management efficacy of patients with ileostomy in the intervention group was significantly higher than that in the control group.
【學位授予單位】：湖南師范大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R473.6

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