Effects of hospital‐family holistic care model on the health outcome of patients with permanent enterostomy based on the theory of ‘Timing It Right’

肠造口术 结肠造口术 生活质量(医疗保健) 排便 医学 干预(咨询) 康复 检查表 医疗保健 物理疗法 护理部 过渡期护理 随机对照试验 心理学 外科 认知心理学 经济 经济增长
作者
Zhang Xi,Rui Gao,Jin Ling Lin,Ning Chen,Qin Lin,Gui Fang Huang,Long Wang,Xiao Huan Chen,Fang Qin Xue,Hong Li
出处
期刊:Journal of Clinical Nursing [Wiley]
卷期号:29 (13-14): 2196-2208 被引量:30
标识
DOI:10.1111/jocn.15199
摘要

Abstract Aims and objectives To explore the effects of hospital‐family holistic care model based on ‘Timing It Right’ on the health outcome of patients with permanent colostomy. Background Colorectal cancer is a common malignant tumour of digestive system, which seriously threatens human life and health. Colostomy is one of the main treatments for colorectal cancer, which effectively improves the 5‐year survival rate of patients. However, the postoperative psychological and physiological rehabilitation nursing is still faced with great challenges due to the change of body image and defecation pathway caused by colostomy. Methods A randomised controlled trial was conducted, and 119 patients with permanent enterostomy were randomly divided into two groups, with 60 cases in the intervention group and 59 cases in the control group. The intervention group received routine care follow‐up and hospital‐family holistic care intervention based on ‘Timing It Right’, while the control group received routine care and follow‐up. The resilience, self‐care ability, complications and life quality of patients with permanent enterostomy were compared between two groups before intervention, at discharge, 3 months and 6 months after discharge. CONSORT checklist was applied as the reporting guideline for this study (see Appendix S1). Results A total of 108 patients with permanent enterostomy completed the study (90.76%). At 3 months and 6 months after discharge, the resilience and quality of life in the intervention group were significantly better than those in the control group ( t = 4.158 vs. 7.406, t = 4.933 vs. 8.611, p < .05), while the complications in the intervention group were significantly lower than that in the control group (25.5% vs. 41.51%, 14.45% vs. 30.19%; p < .05). The self‐care ability of the intervention group was significantly better than that in the control group ( t = 1.543 vs. 3.656 vs. 6.273, p < .05) at discharge, 3 months and 6 months after discharge. The interaction between time and grouping showed that the effect of time factor varied with the grouping. After intervention, there were significant differences in psychological resilience, self‐care ability, complications and quality of life between the two groups at different observation points ( p < .01). The three evaluation indices of intervention group increased with the migration of observation time points and were significantly better than those of control group, especially the quality of life (84.35 ± 4.25 vs. 60.45 ± 8.42, p < .01). Conclusions The hospital‐family holistic care model based on ‘Timing It Right’ can effectively improve the psychological resilience, self‐care ability and quality of life; reduce complications; and improve the health outcomes of patients with permanent enterostomy. Relevance to clinical practice Patients with permanent enterostomy have different needs for nursing care at different stages of the disease, and they are dynamically changing. The hospital‐family holistic care model based on ‘Timing It Right’ can effectively improve the health outcomes of patients with permanent enterostomy, which is worthy of clinical application.
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