Cheng Fang, Meng Ai-feng, Yang Li-Fang, Zhang Yi-nan
Jiang Su Cancer Hospital, Nanjing, PR China.
Ostomy Wound Manage. 2013 Jul;59(7):35-8.
A colostomy can have a negative impact on patient quality of life. Research suggests that psychosocial adaptation is positively associated with quality of life, but few reports address this adaptation and its related factors in patients with a permanent colostomy. A 4-month, descriptive study was conducted to assess the impact of ostomy knowledge and ability to self-care on the psychosocial adjustment of 54 Chinese outpatients (47 men, 14 participants 40 to 50 years old, 40 participants 50 to 70 years old) with a permanent colostomy to investigate the correlation between stoma knowledge, self-care ability, and psychosocial adjustment. Assessment instruments included a sociodemographic data questionnaire and a Chinese translation of the Ostomy Adjustment Inventory-23 that comprises 20 items in three domains (positive emotions, negative emotions, and social life). Participants rated statements on a scale from 0 (totally disagree) to 4 (totally agree); a score of 40 indicates a low level of psychosocial adjustment. Participants also completed the Stoma-related Knowledge Scale, comprising 14 5-point Likert scale questions where low scores indicate low knowledge, and they answered one question regarding self-care ability. Data were analyzed using statistical software for social science. The average stoma-related knowledge score suggested moderate levels of knowledge (45.112 ± 13.358). Twenty (20) participants managed all stoma care aspects independently, 30 required some assistance, and four (4) required care by someone else. The three domains of psychosocial adjustment scores (positive emotions, negative emotions, and social life) were 17.60 ± 4.093,12.92 ± 3.440, and 19.15 ± 6.316, respectively. Knowledge and the three domains of psychosocial adjustment were positively correlated with positive emotion (r = .610, P = 0.001), negative emotion (r = .696, P = 0.000), and social life adjustment (r = .617, P = 0.001). A significant difference in psychosocial adjustment scores was found between persons who did (57.37 ± 9.81) and those that did not (47.83 ± 8.18) independently care for their own stoma (P = 0.005). Persons with high levels of knowledge and independence had a high level of psychosocial adjustment. Providing knowledge and emphasizing/teaching self-care may help persons with a colostomy make the necessary daily and social life adaptations.
结肠造口术可能会对患者的生活质量产生负面影响。研究表明,心理社会适应与生活质量呈正相关,但很少有报告涉及永久性结肠造口术患者的这种适应情况及其相关因素。本研究进行了为期4个月的描述性研究,以评估造口知识和自我护理能力对54名患有永久性结肠造口术的中国门诊患者(47名男性,14名年龄在40至50岁之间,40名年龄在50至70岁之间)心理社会调适的影响,以调查造口知识、自我护理能力与心理社会调适之间的相关性。评估工具包括一份社会人口统计学数据问卷和一份《造口适应量表-23》的中文译本,该量表由三个领域(积极情绪、消极情绪和社会生活)的20个项目组成。参与者对各项陈述按从0(完全不同意)到4(完全同意)的量表进行评分;得分40表明心理社会调适水平较低。参与者还完成了造口相关知识量表,该量表由14个5点李克特量表问题组成,得分低表明知识水平低,并且他们回答了一个关于自我护理能力的问题。使用社会科学统计软件对数据进行分析。造口相关知识的平均得分表明知识水平中等(45.112±13.358)。20名参与者能够独立处理造口护理的所有方面,30名需要一些帮助,4名需要他人护理。心理社会调适得分的三个领域(积极情绪、消极情绪和社会生活)分别为17.60±4.093、12.92±3.440和19.15±6.316。知识以及心理社会调适的三个领域与积极情绪(r=.610,P=0.001)、消极情绪(r=.696,P=0.000)和社会生活调适(r=.617,P=0.001)呈正相关。在能够独立护理自己造口的患者(57.37±9.81)和不能独立护理自己造口的患者(47.83±8.18)之间,心理社会调适得分存在显著差异(P=0.005)。知识水平高且独立性强的患者心理社会调适水平高。提供知识并强调/教授自我护理可能有助于结肠造口术患者进行必要的日常生活和社会生活适应。