本文關(guān)鍵詞：超低位直腸癌ISR術(shù)后患者排便功能訓(xùn)練依從性及影響因素的研究　出處：《吉林大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:分析超低位直腸癌患者經(jīng)肛門內(nèi)外括約肌間切除術(shù)(intersphincteric resection,ISR)后排便功能訓(xùn)練的依從性現(xiàn)狀及影響因素。為護理人員明確患者訓(xùn)練存在的問題,重視對患者訓(xùn)練的管理,提供理論依據(jù)。方法:采用自身對照研究,對吉林省長春市某三甲醫(yī)院2014年1月至2015年9月間收治的行ISR術(shù)的患者進行問卷調(diào)查。國際造口治療師(enterostomal therapist,ET)指導(dǎo)患者進行排便功能訓(xùn)練,一般資料調(diào)查問卷、排便功能訓(xùn)練依從性量表、社會支持評定量表(SSRS)、排便日記、大便失禁生活質(zhì)量問卷(FIQL)作為研究工具。采用Excel錄入數(shù)據(jù),使用SPSS17.0對資料進行分析,采用描述性分析、χ2檢驗、方差分析、Spearman秩相關(guān)分析、多元回歸分析,分析患者排便功能訓(xùn)練依從性的現(xiàn)狀及主要影響因素。結(jié)果:1.本研究中80例超低位直腸癌ISR術(shù)后患者排便功能訓(xùn)練依從性得分為(67.67±5.28)分;僅有21.25%依從率高,56.25%的患者依從率處于中等水平;疾病相關(guān)知識依從性最差,康復(fù)訓(xùn)練技能依從性較差;2.依從性的主要相關(guān)因素為年齡、文化程度、家庭月人均收入水平、社會支持、病理分期、手術(shù)方式、內(nèi)括約肌切除類型、并發(fā)癥、疼痛程度(P0.05或P0.01);3.術(shù)后排便功能訓(xùn)練依從性與肛門功能及大便失禁生活質(zhì)量呈正相關(guān),依從性好的患者術(shù)后9月、12月的肛門功能明顯改善(P0.05);4.多元回歸分析結(jié)果顯示,文化程度、社會支持利用度、病理分期、內(nèi)括約肌切除類型、并發(fā)癥、疼痛程度為超低位直腸癌ISR術(shù)后患者排便功能訓(xùn)練依從性的主要影響因素。結(jié)論:1.超低位直腸癌ISR術(shù)后患者疾病相關(guān)知識依從性、康復(fù)訓(xùn)練技能依從性差。這提示護理人員應(yīng)在患者住院期間給予有效健康教育,出院后給予持續(xù)性指導(dǎo);2.超低位直腸癌ISR術(shù)后患者排便功能訓(xùn)練依從性與肛門功能及大便失禁生活質(zhì)量相關(guān)。有效的排便訓(xùn)練計劃、術(shù)后隨訪指導(dǎo)對患者排便功能恢復(fù)至關(guān)重要;3.超低位直腸癌ISR術(shù)后患者排便功能訓(xùn)練依從性的影響因素:文化程度、社會支持利用度、病理分期、內(nèi)括約肌切除類型、并發(fā)癥、疼痛程度。臨床護理人員要充分認(rèn)識影響因素,以提高患者排便功能訓(xùn)練依從性,促進患者腸道功能的恢復(fù)。
[Abstract]:Objective: to analyze the compliance status and influencing factors of defecation function training in patients with ultra-low rectal cancer after intersphincteric resection (ISR). For nursing staff to clear the problems of patient training, pay attention to the management of patients training, and provide theoretical basis. Methods: a self-control study was used to investigate the patients who were treated with ISR from January 2014 to September 2015 in a three a hospital in Changchun, Jilin. Enterostomal therapist (enterostomal therapist, ET) of defecation function training in patients with general information questionnaire, defecation function training compliance scale, social support rating scale (SSRS), fecal incontinence quality of life questionnaire, stool diary (FIQL) as a research tool. Excel was used to input data, and SPSS17.0 was used to analyze data. Descriptive analysis, chi square test, ANOVA, Spearman rank correlation analysis and multiple regression analysis were used to analyze the status and main influencing factors of defecation function training compliance of 2 patients. Results: 1. in this study, 80 cases of low rectal cancer patients after ISR of defecation function training compliance score (67.67 + 5.28); only 21.25% compliance rate is high, 56.25% of the patients compliance rate in the middle level of disease related knowledge; compliance is the worst, rehabilitation training skills compliance is poor; the main factors related to compliance 2. the age, education level, monthly family per capita income level, social support, pathological stage, surgical approach and internal sphincter resection type, complications, degree of pain (P0.05 or P0.01); training compliance and anal function and fecal incontinence quality of life was positively related to defecation function after operation in 3., September, December, the anal function improved obviously good compliance of patients after operation (P0.05); 4. multivariate regression analysis showed that education level, social support utilization, pathological stage, internal sphincter type, complication, Teng Tongcheng The main factors influencing the compliance of defecation training in patients with ultra low rectal cancer after ISR operation. Conclusion: 1. patients with ultra-low rectal cancer have poor compliance with knowledge dependent knowledge and rehabilitation training skills after ISR. This suggests that nurses should give effective health education during their hospitalization and give continuous guidance after discharge. 2. the compliance of defecation function training after ISR operation is related to anal function and fecal incontinence quality of life. Effective defecation training plan, postoperative follow-up guidance on defecation function recovery is crucial; influencing factors of defecation function training compliance of 3. low rectal cancer patients after ISR: education, utilization of social support, pathological stage, internal sphincter type, complications, degree of pain. The clinical nursing staff should fully understand the influencing factors in order to improve the compliance of the patient's defecation training and promote the recovery of the intestinal function of the patients.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R473.73

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