Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taiwan.
Cancer Nurs. 2011 Jan-Feb;34(1):E1-9. doi: 10.1097/NCC.0b013e3181e3ca21.
Diarrhea is common after colorectal surgery, but its severity and self-care methods have not been examined in depth.
To understand changes in and factors influencing diarrhea distress and self-care strategies of patients 1 week and 1, 2, and 3 months after colorectal cancer surgery.
For this descriptive, longitudinal study, 35 cancer patients were recruited from a teaching hospital in northern Taiwan. Data were collected in structured, one-on-one interviews at 1 week and 1, 2, and 3 months after surgery. Variance and effects of diarrhea distress and number of self-care strategies were analyzed by repeated-measures analysis of variance and generalized estimating equation. Effectiveness scores for self-care strategies were analyzed by Wilcoxon signed rank test.
Participants' overall level of diarrhea symptom distress was low. Distress level was highest 1 week after surgery, but gradually decreased thereafter. Over time after surgery, patients' frequency of using self-care strategies did not differ, but self-care strategies changed. Dietary modification and exercise were rated as the most effective strategies. Self-care information for hospitalized patients was primarily provided by medical personnel. The major factor affecting diarrhea distress was defecation frequency, and the major factors affecting self-care strategies were age, cancer stage, defecation frequency, and diarrhea distress.
Diarrhea distress level gradually decreased, and self-care strategies changed with time after colorectal cancer surgery.
Because health care personnel were the primary source of self-care information for hospitalized patients after colorectal cancer surgery, nurses should use these findings to provide supportive treatment and educate patients and their family members about the cause and severity of diarrhea. Such education should include treatment-induced adverse effects as the basis for treating diarrhea.
结直肠手术后常发生腹泻，但腹泻的严重程度及其自我护理方法尚未深入研究。
了解结直肠癌手术后 1 周、1、2、3 个月患者腹泻困扰及自我护理策略的变化及其影响因素。
本研究采用描述性、纵向设计，从台湾北部一所教学医院招募了 35 名癌症患者。在手术后 1 周和 1、2、3 个月时，通过结构化的一对一访谈收集数据。采用重复测量方差分析和广义估计方程分析腹泻困扰和自我护理策略数量的方差和效应。采用 Wilcoxon 符号秩检验分析自我护理策略的有效性评分。
参与者的腹泻症状困扰总体水平较低。术后 1 周时困扰程度最高，但此后逐渐降低。术后时间推移，患者使用自我护理策略的频率没有差异，但自我护理策略发生了变化。饮食调整和运动被评为最有效的策略。住院患者的自我护理信息主要由医务人员提供。影响腹泻困扰的主要因素是排便频率，影响自我护理策略的主要因素是年龄、癌症分期、排便频率和腹泻困扰。
结直肠癌手术后，腹泻困扰水平逐渐降低，自我护理策略随时间而变化。
由于结直肠癌手术后住院患者的自我护理信息主要来源于医护人员，护士应利用这些发现为患者提供支持性治疗，并对患者及其家属进行有关腹泻原因和严重程度的教育。这种教育应包括治疗引起的不良反应，作为治疗腹泻的基础。
