Influences of continuous nursing on WeChat platform upon the nursing effects on patients with intestinal stoma / 中国实用护理杂志

Objective:To analyze the effects of continuous nursing intervention on patients with intestinal stoma using WeChat, China′s most popular messaging App.Methods:A total of 60 patients undergoing permanent intestinal stoma surgery, who were admitted to Dalian Third People′s Hospital from January 2018 to December 2019, were selected as the research objects. They were divided into the control group and the observation group with 30 cases each using random number table method. The control group adopted the traditional continuous nursing model while the observation group received both traditional continuous nursing model and continuous nursing interventions via WeChat. By using the Exercise of Self-Care Agency Scale (ESCA), City of Hope-Quality of Life-Ostomy Questionnaire Chinese Version (C-COH), and Ostomy Adjustment Inventory (OAI), the differences in self-care capability, quality of life, stoma adaptability, incidence of intestinal stoma complications, and patients′ satisfaction with the new nursing model in the two groups were compared before the intervention, 1 month and 3 months after the intervention, respectively.Results:Before intervention, there was no significant difference between the two groups in ESCA total score, C-COH score and OAI score ( P>0.05). After 1 month and 3 months of intervention, the observation group had the total ESCA scores of (91.50 ± 2.86) and (104.87 ± 3.45) points, which were higher than control group′s (81.37 ± 2.98) and (92.80 ± 2.91) points, respectively, and the differences between the two groups were statistically significant ( t=13.13, 14.38, both P<0.05); the observation group had the C-COH scores of (5.00 ± 1.13) and (6.37 ± 1.22) points, which were higher than the control group′s (3.90 ± 1.14) and (4.67 ± 1.04) points, respectively, and the differences between the two groups were statistically significant ( t=3.71, 5.69, both P<0.05); the observation group had the OAI scores of (48.13 ± 8.55) and (60.07 ± 7.43) points, which were higher than the control group′s (39.57 ± 7.43) and (43.47 ± 7.39) points, respectively, and the difference between the two groups was statistically significant ( t=4.07, 8.53, both P<0.05); after 3-month intervention, the observation group had a 16.7 % (5/30) incidence of stoma complications, which was lower than the control group′s 46.7% (14/30), and the difference between the two groups was statistically significant ( χ2=6.24, P<0.05); after 3-month intervention, the observation group had a score of (95.90 ± 1.66) points for the patient′s satisfaction with continuous care, which was higher than the control group′s (89.80 ± 2.44) points, and the difference between the two groups was statistically significant (t value was 11.13, P<0.05). Conclusions:Delivering the WeChat continuous nursing interventions for patients with intestinal stoma has improved the patients′ self-care capability, enhanced stoma adaptation level and quality of life, reduced the incidence of intestinal stoma complications, and improved patients′ satisfaction. Thereby, continuous nursing on WeChat is worthy of clinical application.

Analysis on current situation and influencing factors of health behavior among rectal cancer patients with intestine stoma afer neoadjuvant chemotherapy / 中国实用护理杂志

Objective To study current situation and influencing factors of health behavior among rectal cancer patients with intestine stoma after neoadjuvant chemotherapy. Methods Questionnaire investigation was conducted among 78 patients using health-promoting lifestyle profile-Ⅱ, general demographic data and related data of disease.And a statistical analysis was made on its investigation. Results The score of health behavior of rectal cancer patients with intestine stoma after neoadjuvant chemotherapy was 131.01 ± 24.47.The score ofeach dimensionin descending order were:nutrition, interpersonal relations, stress management, health responsibility, spiritual growth and physical activity. Multiple stepwise regression analysis indicates literacy, average mothly income, chemotherapy collateral injury and stoma complications were the significant factors of health behavior (P<0.05), which could explain 70％ of the variance in health behavior. Conclusion The level of health behavior of rectal cancer patients with intestine stoma afer neoadjuvant chemotherapy need to be improved. In the process of designing and implementing clinical nursing, great importance should be paid to the nursing of patients with chemotherapy collateral injury and stoma complications, to improve their health behavior, to help them establish and maintain a healthy lifestyle and to improve the quality of life.

Health locus of control, body image and self-esteem in individuals with intestinal stoma / Lócus de controle em saúde, imagem corporal e autoestima nos indivíduos com estoma intestinal

Abstract Objective To evaluate the health locus of control, self-esteem, and body image in patients with an intestinal stoma. Method A descriptive, cross-sectional, analytical study conducted at the pole of the ostomates of the city of Pouso Alegre. The study was approved by Research Ethics Committee of Universidade do Vale do Sapucaí. Opinion: 620,459. Patients: 44 patients with an intestinal stoma. Four instruments were used: a questionnaire with demographic and stomatologic data, the Health Locus of Control Scale, the Rosenberg Self-Esteem Scale/UNIFESP-EPM, and the Body Investment Scale. Statistics: Chi-square, Pearson, Mann-Whitney and Kruskal-Wallis tests. p < 0.05 was determined. Results The majority of patients were over 70 years, 16 (36.4%) were female, 30 (68.2%) were married, 31 (70.5%) were retirees, 31 (70.5%) had an income of 1-3 minimum wages, 32 (72.7%) did not practice physical activity, 18 (40.9%) had an incomplete elementary education, and 35 (79.5%) participated in a support or association group. 33 (75%) participants received the stoma because of a neoplasia; and 33 (75%) had a definitive stoma. In 36 (81.8%) participants, the type of stoma used was a colostomy, and 22 (50%) measured 20-40 mm in diameter; 32 (72.7%) participants used a two-piece device. With regard to complications, there were 29 (65.9%) cases of dermatitis. The mean total score for the Health Locus of Control Scale was 62.84; for the Rosenberg Self-Esteem Scale, 27.66; and for the Body Investment Scale, 39.48. The mean scores for the dimensions internal, powerful others, and chance of the Health Locus of Control Scale were 22.68, 20.68, and 19.50, respectively. With respect to the Body Investment Scale, for the dimensions body image, body care, and body touch, the mean scores were 11.64, 11.00, and 13.09, respectively. Conclusion In this study, the participants showed changes in self-esteem and body image and also showed negative feelings about their body. Ostomized individuals believe that they themselves control their state of health and do not believe that other persons or entities (physician, nurse, friends, family, god, etc.) can assist them in their improvement or cure and, in addition, believe that their health is controlled by chance, without personal or other people's interference.

Resumo Objetivo Avaliar o lócus de controle da saúde, autoestima e imagem corporal em portadores de estoma intestinal. Método Estudo descritivo, transversal, analítico; realizado no Polo de ostomizados da cidade de Pouso Alegre, aprovado pelo CEP da Universidade do Vale do Sapucaí. Parecer: 620.459. Casuística: 44 pacientes com estoma intestinal. Foram utilizados quatro instrumentos:questionário com dados demográficos e relacionados ao estoma, Escala de Lócus de Controle da Saúde, Escala de Autoestima de Rosenberg/UNIFESP-EPM e Body Investment Scale. Estatística: Testes do Qui-quadrado, Pearson, Mann-Whitney e de Kruskal-Wallis. Determinou-se p < 0,05. Resultados A maioria tinha idade acima de 70 anos, 16 (36,4%) eram do gênero feminino, 30 (68,2%) eram casados, 31 (70,5%) aposentados, 31 (70,5%) tinham renda de 1 a 3 salários mínimos, 32 (72,7%) não praticavam atividade física, 18 (40,9%) não completaram o ensino fundamental e 35 (79,5%) participavam de grupo de apoio ou associação. 33 (75%) das causas da confecção do estoma foram por neoplasia e em 33 (75%) o estoma era definitivo. Em 36 (81,8%) o estoma era do tipo colostomia, 22 (50%) mediam de 20 a 40 mm de diâmetro e 32 (72,7%) eram dispositivos duas peças. Com relação às complicações, 29 (65,9%) foram dermatite. A média do escore total da Escala para Locus de Controle da Saúde foi de 62,84; Escala de Autoestima de Rosenberg, 27,66; e Body Investment Scale, 39,48. Com relação à média do escore total das dimensões da Escala para Locus de Controle da Saúde, constatamos: Internalidade para saúde, 22,68; Externalidade "outros poderosos", 20,68; e Externalidade para saúde, 19,50. Com relação às dimensões da Body Investment Scale, constatamos: para Imagem corporal, média de 11,64; Cuidado corporal, média de 11,00; e Toque corporal, média de 13,09. Conclusão Os participantes do estudo apresentaram autoestima e imagem corporal alteradas e sentimentos negativos em relação ao corpo. Os ostomizados acreditam que eles próprios controlam o seu estado de saúde e não acreditam que outras pessoas ou entidades (médico, enfermeiro, amigos, familiares, Deus, etc.) possam ajuda-los em sua melhora ou cura e que sua saúde é controlada ao acaso, sem interferência própria ou de outras pessoas.

Research progress of family caregivers of patients with permanent colostomy / 中国实用护理杂志

Enterostomy are a common surgical procedure in the treatment of rectal cancer, has more than 100000 each year in our country requires enterostomy patients, whereas patients with postoperative rehabilitation and nursing leave the family caregivers, the study found that with baseline levels of care for people, and increased mortality 63% of caregivers within five years, attaches great importance to the caregivers of patients with life can avoid the occurrence of another patient, at the same time also can improve the quality of family care, reduce the demand for medical and waste. Therefore, this article will from the permanent patients underwent colostomy care burden of family caregivers, health education needs, psychological burden to understand colostomy caregivers are faced with the problem of our country, explore the mental and physical health of the caregivers related factors, provide the basis for effective follow disease intervention.

Health locus of control, spirituality and hope for healing in individuals with intestinal stoma / Locus de controle em saúde, Espiritualidade e Esperança de cura nos indivíduos com estoma intestinal

Objective: To assess the health locus of control, spirituality and hope of cure in patients with intestinal stoma. Methods: This study was conducted at the Polo of Ostomized People in the city of Pouso Alegre, Minas Gerais. Participants were 52 patients with intestinal stoma. Three questionnaires were applied for data collection: a questionnaire on demographic and stoma-related data; the Scale for Health Locus of Control; the Herth Hope Scale, and the Self-rating Scale for Spirituality. Results: Most ostomized subjects were women aged over 61 years, married and retired. As to the stoma, in the majority of cases these operations were definitive and were carried out due to a diagnosis of neoplasia. Most ostomized subjects had a 20- to 40-mm diameter colostomy, 27 showed dermatitis as a complication, and 39 (75%) used a two-part device. The mean total score for the Scale for Health Locus of Control, the Herth Hope Scale, and the Self-rating Scale for Spirituality were 62.42, 38.27, and 23.67, respectively. Regarding the dimensions of the Scale for Health Locus of Control, the dimension "completeness of health" = 22.48, dimension "externality-powerful others" = 22.48, and dimension "health externality" = 19.48. Conclusion: Ostomized patients participating in the study believe they can control their health and that caregivers and individuals involved in their rehabilitation can contribute to their improvement. The cure or improvement has a divine influence through religious practices or beliefs.

Objetivo: Verificar o locus de controle da saúde, espiritualidade e esperança de cura em indivíduos ostomizados. Métodos: Este estudo foi realizado no Polo dos ostomizados da cidade de Pouso Alegre, Minas Gerais. Fizeram parte do estudo 52 pacientes com estoma intestinal. Foram utilizados para coleta de dados três questionários: questionário sobre os dados demográficos e relacionados ao estoma; Escala para Locus de controle da saúde; Escala de Esperança de Herth e Escala de auto-classificação para Espiritualidade. Resultados: A maioria dos ostomizados era do gênero feminino com idade acima de 61 anos, casados e aposentados. Com relação ao estoma, a maioria desses dispositivos era definitiva e as causas para a sua confecção do dispositivo foram, em sua maioria, um diagnóstico de neoplasia. A maioria dos ostomizados tinha uma colostomia com diâmetro de 20 a 40 mm e apresentavam dermatite como complicação; e 39 (75%) utilizavam dispositivos de duas peças. A média do escore total da escala para Locus de controle da saúde, Escala de Esperança de Herth, e Escala de Auto-classificação para Espiritualidade foi de, respectivamente, 62,42, 38,27 e 23,67. Com relação às dimensões da Escala para Locus de Ccontrole da Saúde, foram obtidos os seguintes valores: dimensão integralidade "saúde" = 22,48, dimensão externalidade "outros poderosos" = 20,48 e dimensão externalidade "saúde" = 19,48. Conclusão: Os pacientes ostomizados que participaram do estudo acreditam que podem controlar sua saúde, e que as pessoas envolvidas no cuidado e em sua reabilitação podem contribuir para sua melhora. A cura ou melhora tem influência divina por meio das práticas ou crenças religiosas.

Association of sociodemographic and clinical factors with spirituality and hope for cure of ostomized people / Associação dos fatores sociodemográficos e clínicos com a espiritualidade e esperança de cura dos ostomizados

Abstract Objective To evaluate the sociodemographic and clinical factors related to patients with intestinal stoma and correlate them to the health locus of control, spirituality and hope for a cure. Method This study was conducted at the Polo of Ostomized Patients of the city of Pouso Alegre, Minas Gerais. Participants were 52 patients with intestinal stoma. The scale for Health Locus of Control, the Herth Hope Scale, and the Self-rating Scale for Spirituality were used for data collection. Results The patients were aged up to 50 years, with the following means: Herth Hope Scale: 17.53; Self-rating Scale for Spirituality: 19.33. With regard to marital status, single people had a mean of 21.00 for the Herth Hope Scale. Retired ostomized patients had a mean of 20.53 for the Herth Hope Scale, of 10.38 for the Self-rating Scale for Spirituality, and of Scale for Health Locus of Control, of 18.79. The patients whose cause of making the stoma was neoplasia attained a mean of 19.43 for the Self-rating Scale for Spirituality. Regarding the character of the stoma, the mean for the Herth Hope Scale was 18.40. In the ostomized individuals who lived with the stoma for less than four years the means for the Herth Hope Scale, Self-rating Scale for Spirituality, and Scale for Health Locus of Control were 17.39, 20.35, and 23.09, respectively. Patients who did not participate of an association or support had means for the Herth Hope Scale, Self-rating Scale for Spirituality, and Scale for Health Locus of Control of 19.08, 17.25, and 20.63 respectively. Conclusion Ostomized patients believe they can control their health and that those involved in their care and rehabilitation can contribute to their improvement.

Resumo Objetivo Avaliar os fatores sociodemográficos e clínicos relativos aos pacientes com estoma intestinal e correlacioná-los ao locus de controle da saúde, espiritualidade e esperança de cura. Métodos Este estudo foi realizado no Polo dos Ostomizados da cidade de Pouso Alegre, Minas Gerais. Fizeram parte do estudo 52 pacientes com estoma intestinal. Foram utilizados para coleta de dados a Escala para Locus de Controle da Saúde; Escala de Esperança de Herth, e Self-rating Scale for Spirituality. Resultados Os pacientes na faixa etária até 50 anos tiveram as seguintes médias: Herth Hope Scale: 17,53; Self-rating Scale for Spirituality: 19,33. No que concerne ao estado civil, as pessoas solteiras tiveram a média de 21,00 para a Escala de Esperança de Herth. Os ostomizados aposentados atingiram as seguintes médias para as escalas: Escala de Esperança de Herth: 20,53; Self-rating Scale for Spirituality: 10,38 e Escala para Locus de Controle da Saúde: 18,79. Os pacientes cuja causa da confecção do estoma foi neoplasia tiveram a média de 19,43 para a Self-rating Scale for Spirituality. Com relação ao caráter do estoma, a média da Escala de Esperança de Herth foi 18,40. Nos ostomizados que conviviam com o estoma havia menos de 4 anos as médias das Escalas de Esperança de Herth, Self-rating Scale for Spirituality, e Escala para Locus de Controle da Saúde foram de 17,39, 20,35, e 23,09, respectivamente. Conclusão os pacientes ostomizados acreditam que podem controlar sua saúde e que as pessoas envolvidas no cuidado e na sua reabilitação podem contribuir para sua melhora.

A clinical study of intestinal stomas: its indications and complications.

Background: Intestinal stoma is an opening for fecal diversion. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Methods: This is a prospective study was carried out in a surgical unit of Hamidia Hospital, Gandhi Medical College, Bhopal from January, 2012 to December,2012. Data was collected by meticulous history taking including age, gender, indication, type of stoma, type of surgery, careful clinical examination, appropriate operative findings and follow up of the cases. The results were collected, analyzed and compared with other studies. Results: A total of 100 patients were evaluated age ranged between 12- 85 years (50.5 ± 29.01 years) Male to female ratio was 7:3. Of the 100 patients 97 were admitted in emergency while 3 in out-patient department. The most common type of stoma made was loop ileostomy (64%) followed by sigmoid colostomy (11%) and transverse loop colostomy (9%). Main indication for a stoma formation was enteric perforation (38%) followed by Koch’s abdomen (18%). Of the various complications encountered with intestinal stoma, peristomal skin irritation (36%) was the most consistent complication followed by laparotomy wound infection (13%). Conclusions: Inspite of vast exposure of general surgeons towards stoma formation the complications are inevitable. Early detection of complication and its timely management is the keystone.