Wound, Ostomy, Continence Department, Spectrum Health, Grand Rapids, Michigan 49503, USA. debra.crawford.spectrumhealth.org
J Wound Ostomy Continence Nurs. 2012 Sep-Oct;39(5):529-37. doi: 10.1097/WON.0b013e3182659ca3.
This randomized controlled trial compared 2 methods of ostomy care instruction to determine their effect on patients' knowledge, skills, and confidence related to postoperative ostomy care.
Eighty-eight adults with newly created ostomies were randomly assigned to 1 of 2 groups. Of the 88 enrolled patients, 68 completed the study: 10 patients were discharged from the hospital prior to completion of the study interventions; 10 others were withdrawn because they no longer met study inclusion criteria. The remaining subjects, who were equally split between men and women, ranged in age from 23 to 84 years. There were 23 colostomy and 45 ileostomy patients in our sample. The study setting was 2 acute care hospitals within a large tertiary health care system in the midwestern United States.
We used a posttest-only experimental design to compare 2 methods of postoperative ostomy education. Traditional education comprised 3 WOC nurse-led instruction sessions and the experimental intervention comprised 2 nurse-led instruction sessions plus DVD instruction that could be accessed in between nurse-led sessions. All patients received one-on-one instruction from certified WOC nurse at their bedside. Patients completed a written test of ostomy knowledge, a self-care skills demonstration, and a Visual Analog Scale rating their confidence with ostomy self-care.
There were no significant differences between the 2 teaching methods or type of ostomy with regard to knowledge of ostomy care (F3,64 5 1.308, P 5 0.28), ostomy care skills (F3,64 5 0.163, P 5 0.92), or confidence in performing ostomy self-care (F3,64 5 0.629, P 5 0.59). Differences between the study groups' self-reported learning style, education level, age, room type, and gender also did not significantly impact their knowledge, skills, or confidence.
When teaching first-time ostomy patients postoperative self-care, a Nurse Instruction plus DVD method is as effective as Nurse Instruction alone.
本随机对照试验比较了 2 种造口护理指导方法，以确定它们对患者术后造口护理相关知识、技能和信心的影响。
88 例新造口的成年人被随机分配到 2 组中的 1 组。在纳入的 88 例患者中，有 68 例完成了研究：10 例患者在完成研究干预措施之前出院；另外 10 例因不再符合研究纳入标准而退出。其余的受试者，男女各占一半，年龄在 23 岁至 84 岁之间。我们的样本中有 23 例结肠造口术和 45 例回肠造口术患者。研究地点是美国中西部一家大型三级医疗保健系统内的 2 家急性护理医院。
我们使用了一种仅进行后测的实验设计来比较 2 种术后造口教育方法。传统教育包括 3 次 WOC 护士主导的指导课程，而实验干预包括 2 次护士主导的指导课程加可在护士主导课程之间访问的 DVD 指导。所有患者都在床边接受了经过认证的 WOC 护士的一对一指导。患者完成了一份造口护理知识的书面测试、一项自我护理技能演示和一份视觉模拟量表，以评估他们对造口自我护理的信心。
在造口护理知识（F3,64=5.138，P=0.28）、造口护理技能（F3,64=0.163，P=0.92）或进行造口自我护理的信心（F3,64=0.629，P=0.59）方面，两种教学方法或造口类型之间没有显著差异。研究组之间的自我报告学习风格、教育水平、年龄、房间类型和性别差异也没有显著影响他们的知识、技能或信心。
在教授首次接受造口术的患者术后自我护理时，护士指导加 DVD 方法与护士指导单独使用一样有效。
