The clinical application of timeliness incentive nursing executed after rectal cancer colostomy

Guangxin Qu, Jing Guo, Ying-tao Dong, Wenli Jia, Xinghua Chang
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Abstract

Objective To study the timeliness incentive nursing intervention applied to rectal cancer postoperative rehabilitation of colostomy. Methods A total of 120 cases of permanent rectal cancer patients who were treated with colostomy in Dalian University affiliated Xinhua Hospital during February 2016 to February 2019 were evenly divided into observation group and control group by random number table method. The control group were caught out by conventional postoperative rehabilitation nursing. The control group were caught out by the timeliness incentive nursing intervention. Two groups of patients were compared before and after continuous care for 3 months in many ways which included the pain degree, the time to get out of bed, the time of first eating, length of hospital stay, negative emotions, compliance, self-management ability and postoperative complications. Results The pain degree, the first activity time away from the bed, the first time to eat and the hospital stay were 1.9±0.5, (14.36±2.43) h, (21.39±3.08) h, (8.78±0.82) d in the observation group, and 3.5±1.1, (20.02±2.97) h, (27.14±3.96) h, (11.01±1.43) d in the control group. The difference was statistically significant (t values were 5.369- 9.539, P<0.05). The negative emotions such as anxiety and depression in the observation group scored 41.4±2.3 and 39.9±2.0 after nursing. However, the control group scored 47.6±3.8 and 45.9±2.2 after nursing, respectively. The difference was statistically significant (t values were 3.509, 3.519, P<0.05). The self-management abilities of patients in the observation group, including emotional cognition management, general life management, disease cognitive management and colostomy nursing management were 23.43±2.12, 24.04±0.96, 23.02±3.22, and 21.43±1.75, significantly higher than those in the control group (18.96±2.82,18.89±1.69, 17.95±2.61, 16.87±2.12). The difference was statistically significant (t values were 17.712-18.879, P<0.05). The compliance of the observation group in nursing, rehabilitation and reexamination was 0.79±0.19, 0.98±0.23 and 0.87±0.35, significantly higher than those of the control group (1.02±0.26, 1.58±0.36, 1.46±0.43). The difference was statistically significant (t values were 5.532, 5.221, 5.645, P < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group. The incidence of observation group was 8.33% (5/60), and the incidence of control group was 23.33% (14/60). The difference was statistically significant (χ2 values were 5.065, P<0.05). Conclusions Timeliness incentive can obviously shorten the postoperative recovery time of colostomy patients in getting out of bed and capacity to eat, length of hospital stay. It can relieve the postoperative pain and the negative emotions, and also improve compliance and relieve self-management ability, and reduce the occurrence of postoperative complications. Key words: Timeliness incentive; Rectal cancer colostomy; Clinic application
直肠癌结肠造口术后实施及时激励护理的临床应用
目的探讨激励性护理干预在直肠癌结肠造口术后康复中的及时性。方法选取2016年2月至2019年2月在大连大学附属新华医院行结肠造口术的120例永久性直肠癌患者,采用随机数字表法随机分为观察组和对照组。对照组采用常规术后康复护理。对照组护理干预及时性较好。比较两组患者连续护理3个月前后疼痛程度、下床时间、首次进食时间、住院时间、负面情绪、依从性、自我管理能力、术后并发症等方面的差异。结果观察组患者疼痛程度、首次活动离床时间、首次进食时间、住院时间分别为1.9±0.5、(14.36±2.43)h、(21.39±3.08)h、(8.78±0.82)d,对照组为3.5±1.1、(20.02±2.97)h、(27.14±3.96)h、(11.01±1.43)d。差异有统计学意义(t值为5.369 ~ 9.539,P<0.05)。观察组患者护理后焦虑、抑郁等负性情绪得分分别为41.4±2.3分和39.9±2.0分。对照组护理后得分分别为47.6±3.8分和45.9±2.2分。差异有统计学意义(t值分别为3.509、3.519,P<0.05)。观察组患者情绪认知管理、一般生活管理、疾病认知管理、结肠造口护理管理的自我管理能力分别为23.43±2.12、24.04±0.96、23.02±3.22、21.43±1.75,显著高于对照组(18.96±2.82、18.89±1.69、17.95±2.61、16.87±2.12)。差异有统计学意义(t值为17.712 ~ 18.879,P<0.05)。观察组患者在护理、康复和复查方面的依从性分别为0.79±0.19、0.98±0.23和0.87±0.35,显著高于对照组(1.02±0.26、1.58±0.36、1.46±0.43)。差异有统计学意义(t值分别为5.532、5.221、5.645,P < 0.05)。观察组术后并发症发生率明显低于对照组。观察组发病率为8.33%(5/60),对照组发病率为23.33%(14/60)。差异有统计学意义(χ2值为5.065,P<0.05)。结论及时激励能明显缩短结肠造口患者术后恢复时间、下床时间、进食能力、住院时间。减轻术后疼痛和负面情绪,提高依从性,减轻自我管理能力,减少术后并发症的发生。关键词:时效性激励;直肠癌结肠造口术;临床应用
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