Qin fen Song, MS, RN, Nursing Department, Dalian University Affiliated Xinhua Hospital, Dalian, China.
Guangxiao Yin, MS, RN, SICU, Dalian University Affiliated Zhongshan Hospital, Dalian, China.
J Wound Ostomy Continence Nurs. 2021;48(4):311-317. doi: 10.1097/WON.0000000000000779.
We constructed a self-management program for rectal cancer survivors with colostomies and evaluated the effect of the program on self-efficacy, self-management ability, and incidence of stomal and peristomal complications.
A prospective, nonrandomized clinical trial.
Participants were recruited from 4 proctology departments in a tertiary hospital in northeast China. Fifty-five were assigned to the intervention group and 56 were assigned to the control group; 26 were lost to follow-up. Therefore, data analysis was based on 43 participants in the intervention group and 42 in the control group.
Control group patients received the standard care where guidance and stoma care manuals were given the day before hospital discharge, and regular telephone follow-up twice a month for 3 months. Participants in the experimental group received, in addition to standard care, a self-management program delivered via a multimedia messaging app initiated after discharge available over a 6-week period. Primary outcomes were self-efficacy and self-management ability; we also analyzed the incidence of stomal and peristomal complications as a secondary outcome. Between-groups outcomes were analyzed via a repeated-measures analysis of variance.
Analysis indicated intervention group participants had higher levels of self-efficacy and self-management of their colostomies than did control group participants. Analysis also revealed intervention group participants had a lower incidence of peristomal complications; no differences in the incidence of stomal complications were found.
Study findings suggest that use of the multimedia messaging app-based self-management program enhanced self-efficacy and self-management, while reducing the incidence of peristomal complications in rectal cancer survivors with colostomies.
我们为直肠癌结肠造口术后患者构建了自我管理方案，并评估了该方案对自我效能、自我管理能力和造口及造口周围并发症发生率的影响。
前瞻性、非随机临床试验。
参与者从中国东北部一家三级医院的 4 个直肠科招募。55 名患者被分配到干预组，56 名患者被分配到对照组；26 名患者失访。因此，数据分析基于干预组的 43 名患者和对照组的 42 名患者。
对照组患者在出院前一天接受标准护理，提供指导和造口护理手册，并在出院后 3 个月内每月进行 2 次电话随访。实验组患者除接受标准护理外，还在出院后通过多媒体消息应用程序接受自我管理方案，为期 6 周。主要结局是自我效能和自我管理能力；我们还分析了造口和造口周围并发症的发生率作为次要结局。采用重复测量方差分析对组间结局进行分析。
分析表明，干预组患者的自我效能和结肠造口自我管理水平高于对照组患者。分析还显示，干预组患者造口周围并发症的发生率较低；两组患者造口并发症的发生率无差异。
研究结果表明，使用基于多媒体消息应用程序的自我管理方案可提高直肠癌结肠造口术后患者的自我效能和自我管理能力，同时降低造口周围并发症的发生率。
