Pieper Barbara, Sieggreen Mary, Nordstrom Cheryl, Kulwicki Pauline, Freeland Barbara, Palleschi Maria-Teresa, Sidor Deborah, Bednarski Donna, Burns Jerry, Frattaroli Madelyn
Barbara Pieper, College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI 48202, USA.
Ostomy Wound Manage. 2006 Jun;52(6):48-52, 54, 56 passim.
Because it provides greater and more durable weight reduction than behavioral and pharmacological interventions for the morbidly obese, the number of bariatric surgeries is increasing - one such procedure is the Roux-en-Y gastric bypass. A cross-sectional study was conducted to examine incision care knowledge and discharge concerns of patients who had undergone this type of gastric bypass bariatric surgery. Participants (N = 31; 28 women, three men; mean age 45 years), recruited from a bariatric surgery center in a large, urban teaching hospital, had undergone a Roux-en-Y gastric bypass by either the open (n = 29) or laparoscopic (n = 2) method. Patients scheduled to be discharged home, 21 years of age or older, and able to understand and respond in English were eligible to participate. Participants completed questionnaires that included demographic information and rating scales regarding incision care knowledge, fears, and discharge concerns. Mean time from hospital admission to study participation was 1.1 days (SD = 3 days). Knowledge of incision care and amount of information received about incision care were rated low. The five most frequently mentioned postdischarge concerns included bowel trouble at home, wound pain at home, looking for wound complications, watching for wound infection, and activity limitations. The higher the amount of information received about incision care, the higher the patient's knowledge (r = .57, P <.001). Lower incision care knowledge scores were correlated with a higher fear of incision care (r = .46, P = .008) and patients reporting greater pain had more concerns about discharge (r = .49, P <.005). Little is known about preparing the bariatric surgery patient for discharge home. To improve outcomes, research that examines issues including discharge teaching methods, patient concerns, and information for persons undergoing bariatric surgery is needed.
由于与针对病态肥胖者的行为和药物干预相比,减肥手术能实现更大程度且更持久的体重减轻,减肥手术的数量正在增加——其中一种手术是Roux-en-Y胃旁路术。开展了一项横断面研究,以调查接受此类胃旁路减肥手术患者的切口护理知识和出院顾虑。研究对象(N = 31;28名女性,3名男性;平均年龄45岁)从一家大型城市教学医院的减肥手术中心招募,他们通过开放手术(n = 29)或腹腔镜手术(n = 2)接受了Roux-en-Y胃旁路术。计划出院回家、年龄在21岁及以上且能用英语理解并做出回应的患者有资格参与。研究对象完成了问卷,问卷内容包括人口统计学信息以及关于切口护理知识、恐惧和出院顾虑的评分量表。从入院到参与研究的平均时间为1.1天(标准差 = 3天)。切口护理知识以及所获得的关于切口护理的信息量评分较低。出院后最常提及的五个顾虑包括在家出现肠道问题、在家伤口疼痛、留意伤口并发症、留意伤口感染以及活动受限。所获得的关于切口护理的信息量越高,患者的知识水平越高(r = 0.57,P < 0.001)。切口护理知识得分较低与对切口护理的更高恐惧相关(r = 0.46,P = 0.008),报告疼痛更严重的患者对出院有更多顾虑(r = 0.49,P < 0.005)。对于让减肥手术患者为出院回家做准备的情况知之甚少。为改善治疗效果,需要开展研究来调查包括出院指导方法、患者顾虑以及减肥手术患者信息等问题。