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基于Snyder希望理论的护理模式在直肠癌根治术后永久性肠造口护理中的应用价值

Application value of nursing mode based on Snyder's hope theory in permanent enterostomy nursing after radical rectal cancer surgery

    摘要
  • 摘要:
    目的 探讨基于Snyder希望理论的护理模式在直肠癌根治术后永久性肠造口患者中的应用价值。
    方法 将100例直肠癌根治术后永久性肠造口患者随机分为对照组和研究组，每组50例。对照组采用常规护理模式; 研究组采用基于Snyder希望理论的护理模式，根据目标、路径思维、动力思维的理论框架设置并实施围术期护理内容。于护理干预前(入院当日)、护理干预后(出院当日)应用焦虑自评量表(SAS)、Herth希望量表(HHI)、自我护理能力测量表(ESCA)、医学应对方式问卷(MCMQ，包括面对、回避、屈服3个维度)分别评价2组患者的焦虑状态、希望水平、自我护理能力、医学应对方式，并于护理干预前(入院当日)、护理干预后(出院随访1个月时)应用生命质量核心量表(QLQ-C30)评价2组患者的生命质量(功能领域、症状领域、总体健康状况领域)。
    结果 护理干预后, 2组SAS评分、回避评分、屈服评分、症状领域评分均低于护理干预前，HHI评分、ESCA评分、面对评分、功能领域评分、总体健康状况领域评分均高于护理干预前，差异有统计学意义(P < 0.05)。护理干预后，研究组SAS评分、回避评分、屈服评分、症状领域评分依次为(53.36±5.22)、(13.51±1.22)、(11.05±1.01)、(490.55±37.33)分，分别低于对照组的(57.82±3.42)、(18.85±1.65)、(15.74±1.40)、(543.33±32.33)分，差异有统计学意义(P < 0.05); 护理干预后，研究组HHI评分、ESCA评分、面对评分、功能领域评分、总体健康状况领域评分依次为(42.26±2.28)、(123.00±8.10)、(23.22±2.01)、(336.67±41.33)、(92.33±9.55)分，分别高于对照组的(36.78±2.74)、(105.00±7.18)、(16.58±1.46)、(300.11±37.66)、(80.33±5.83)分，差异有统计学意义(P < 0.05)。
    结论 对直肠癌根治术后永久性肠造口患者实施基于Snyder希望理论的护理模式，能够有效减轻患者焦虑心理，提升其希望水平和自我护理能力，对患者生存质量的改善和积极应对方式的建立具有重要意义。

     

    Abstract:
    Objective To explore the application value of nursing model based on Snyder's hope theory in patients with permanent enterostomy after radical rectal cancer surgery.
    Methods A total of 100 patients with permanent enterostomy after radical resection of rectal cancer were randomly divided into control group and study group, with 50 patients in each group. Control group received routine nursing mode, and the study group received nursing mode based on Snyder's hope theory, and the perioperative nursing content was set and implemented according to the theoretical framework of goal, path thinking and dynamic thinking. The anxiety state, hope level, self-care ability and medical coping style were evaluated by self-rating Anxiety Scale (SAS), Herth Hope Scale (HHI), self-care ability Scale (ESCA) and Medical Coping Style Questionnaire (MCMQ) before nursing intervention (admission day) and after nursing intervention (discharge day). The quality of life scale (QLQ-C30) was used to evaluate the quality of life (functional domain, symptom domain and general health status domain) of patients in the two groups before nursing intervention (the day of admission) and after nursing intervention (at 1 month of follow-up after discharge).
    Results After nursing intervention, SAS, avoidance and yield scores and symptom domain score were significantly lower than those before nursing intervention, HHI, ESCA, face score and functional domain score and general health domain score were significantly higher than those before nursing intervention (P < 0.05). After nursing intervention, the scores of SAS, avoidance, yield score and symptom domain score in the study group were (53.36±5.22), (13.51±1.22), (11.05±1.01) and (490.55±37.33), which were significantly lower than (57.82±3.42), (18.85±1.65), (15.74±1.40) and (543.33±32.33) in the control group (P < 0.05). The scores of HHI, ESCA, face and functional domain and general health status domain were (42.26±2.28), (123.00±8.10), (23.22±2.01), (336.67±41.33) and (92.33±9.55), which were significantly higher than (36.78±2.74), (105.00±7.18), (16.58±1.46), (300.11±37.66) and (80.33±5.83)in the control group (P < 0.05).
    Conclusion Nursing mode based on Snyder's hope theory can effectively relieve patients'anxiety, improve their hope level and self-care ability in patients with permanent enterostomy after radical rectal cancer surgery, which is of significance to the improvement of patients' quality of life and the establishment of positive medical coping styles.

     

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