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 ( χ 2 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.
ABSTRACT
Objective To explore the clinical effects of integrative nursing for rectal cancer patients with colostomy.Methods A total of 80 cases of rectal cancer patients after colostomy were selected from our hospital from December 4,2009 to May 15,2013.They were assigned to the control group and the observation group according to the admission sequence with 40 patients in each group.The control group had been treated with conventional care,the observation group had been treated with integrative care intervened by ostomy technician.Postoperative anxiety,quality of life and complication rates were analyzed between the two groups.Results Anxiety score from the Self-Rating Anxiety Scale was lower in the treatment group respectively on the day of the operation,one month after operation and one year after operation (58.22 ± 8.23 vs.64.46 ± 9.82,50.55 ± 7.53 vs.59.76 ± 9.83,42.26 ± 2.88 vs.58.46 ± 9.82),P ＜ 0.05.the incidences of complications were significantly rarer than the control group such as the postoperative infection [7.50％ (3/40) vs.25.00％ (10/40)],colostomy hemorrhage [5.00％ (2/40) vs.25.00％ (10/40)],colostomy necrosis [2.50％ (1/40) vs.30.00％ (12/40)],other complications [5.00％ (2/40) vs.15.00％ (6/40)],P ＜0.01 or ＜0.05.Moreover,the defecation function,psychological function,social function and material life (92.55 ± 20.56 vs.84.03 ± 24.60,83.05 ± 23.66 vs.61.86 ± 18.20,79.95 ± 36.02 vs.71.09 ± 27.56,59.08 ± 28.56 vs.50.55 ± 25.96) were improved obviously in the observation group,while the incidences of nausea and vomiting and pain (10.15 ± 3.67 vs.18.99± 7.29,12.05 ± 7.90 vs.22.10 ± 9.56) were lower than the control group,based on QLQ-C30 core questionnaire for the European Quality of Life Evaluation,P ＜ 0.05.Conclusions Integrative nursing may effectively improve rectal cancer patients' quality of life after colostomy,reduce the postoperative complications and relieve anxiety,which may be useful in the clinical application.