Ercolano Elizabeth, Grant Marcia, McCorkle Ruth, Tallman Nancy J, Cobb Martha D, Wendel Christopher, Krouse Robert
Yale University.
Clin J Oncol Nurs. 2016 Jun 1;20(3):269-74. doi: 10.1188/16.CJON.20-03AP.
Living with an ostomy requires daily site and equipment care, lifestyle changes, emotional management, and social role adjustments. The Chronic Care Ostomy Self-Management Training Program (CCOSMTP) offers an ostomy self-management curriculum, emphasizing problem solving, self-efficacy, cognitive reframing, and goal setting.
The qualitative method of content analysis was employed to categorize self-reported goals of ostomates identified during a nurse-led feasibility trial testing the CCOSMTP.
Thirty-eight ostomates identified goals at three CCOSMTP sessions. The goals were classified according to the City of Hope Health-Related Qualify of Life Model, a validated multidimensional framework, describing physical, psychological, social, and spiritual ostomy-related effects. Nurse experts coded the goals independently and then collaborated to reach 100% consensus on the goals' classification.
A total of 118 goals were identified by 38 participants. Eighty-seven goals were physical, related to the care of the skin, placement of the pouch or bag, and management of leaks; 26 were social goals, which addressed engagement in social or recreational roles and daily activities; and 5 were psychological goals, which were related to confidence and controlling negative thinking. Although the goals of survivors of cancer with an ostomy are variable, physical goals are most common in self-management training.
造口患者的日常生活需要进行造口部位及设备护理、改变生活方式、进行情绪管理以及调整社会角色。慢性护理造口自我管理培训项目（CCOSMTP）提供了一套造口自我管理课程，强调问题解决、自我效能感、认知重构和目标设定。
采用内容分析的定性方法，对在一项由护士主导的、测试CCOSMTP的可行性试验中确定的造口患者自我报告的目标进行分类。
38名造口患者在CCOSMTP的三次课程中确定了目标。这些目标根据希望之城与健康相关的生活质量模型进行分类，该模型是一个经过验证的多维度框架，描述了与造口相关的身体、心理、社会和精神方面的影响。护士专家独立对目标进行编码，然后共同协作以在目标分类上达成100%的共识。
38名参与者共确定了118个目标。87个目标是身体方面的，与皮肤护理、造口袋放置和渗漏管理有关；26个是社会目标，涉及参与社会或娱乐角色及日常活动；5个是心理目标，与自信心和控制消极思维有关。尽管有造口的癌症幸存者的目标各不相同，但身体目标在自我管理培训中最为常见。
