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直肠癌造口患者支持性护理需求的纵向轨迹及影响因素分析

Analysis of Longitudinal Trajectory and Influencing Factors of Supportive Care Needs in Colorectal Cancer Patients With Enterostomy.

作者信息

Zhou Lu, Li Hui, Zhang Zhengyang, Wang Ling

机构信息

Department of Nursing, Peking University People's Hospital, Beijing, China.

School of Nursing, Peking University, Beijing, China.

出版信息

J Clin Nurs. 2025 Jun;34(6):2276-2287. doi: 10.1111/jocn.17426. Epub 2024 Oct 11.

Abstract

AIMS

The aim of this study was to understand the dynamic changes in the needs of patients with enterostomy during the 3 months after discharge and its possible influencing factors.

DESIGN

A prospective observational design.

METHODS

This study investigated the supportive care needs of patients who underwent colorectal cancer surgery with colostomy in three Chinese hospitals from May 2023 to October 2023 during the 3 months following discharge from the hospital. The growth mix model was used to describe the needs trajectory and analyse the heterogeneity of the trajectory. Univariate analysis was used to find the factors that might affect the heterogeneity of needs trajectory of patients with enterostomy, and then logistic regression analysis was used to determine the influencing factors of the heterogeneity of needs trajectory of patients with enterostomy. The reporting of this study adhered to the STROBE checklist.

RESULTS

A total of 232 patients with enterostomy completed follow-up. There was heterogeneity in the developmental trajectories of supportive care needs of enterostomy patients and the trajectories of the five dimensions of supportive care needs. The heterogeneity factors affecting the trajectory of supportive care needs included the enterostomy patient's psychosocial adjustment score, type of enterostomy, and educational background and the heterogeneity factors affecting the five dimensions trajectory of supportive care needs include psychosocial adjustment score, tumour staging, type of enterostomy, smoking, chemotherapy and enterostomy self-care knowledge score.

CONCLUSIONS

The needs of patients with enterostomy within 3 months after discharge were dynamic. Identifying and meeting the unmet needs of patients with enterostomy was crucial to improving the health-related quality of life of patients with enterostomy.

PATIENT OR PUBLIC CONTRIBUTION

None.

RELEVANCE TO CLINICAL PRACTICE

The needs of patients with enterostomy were dynamic, with the needs of most patients with enterostomy decreasing within 3 months of discharge, but some patients with enterostomy continued to have high needs at 3 months after discharge, and clinical nurses were expected to pay special attention to these patients.

摘要

目的

本研究旨在了解肠造口患者出院后3个月内需求的动态变化及其可能的影响因素。

设计

前瞻性观察性设计。

方法

本研究调查了2023年5月至2023年10月期间在中国三家医院接受结直肠癌手术并进行结肠造口的患者在出院后3个月内的支持性护理需求。采用生长混合模型描述需求轨迹并分析轨迹的异质性。单因素分析用于找出可能影响肠造口患者需求轨迹异质性的因素,然后采用逻辑回归分析确定肠造口患者需求轨迹异质性的影响因素。本研究的报告遵循STROBE清单。

结果

共有232例肠造口患者完成随访。肠造口患者支持性护理需求的发展轨迹以及支持性护理需求五个维度的轨迹存在异质性。影响支持性护理需求轨迹的异质性因素包括肠造口患者的心理社会适应得分、肠造口类型、教育背景;影响支持性护理需求五个维度轨迹的异质性因素包括心理社会适应得分、肿瘤分期、肠造口类型、吸烟、化疗以及肠造口自我护理知识得分。

结论

肠造口患者出院后3个月内的需求是动态变化的。识别并满足肠造口患者未满足的需求对于提高肠造口患者的健康相关生活质量至关重要。

患者或公众贡献

无。

与临床实践的相关性

肠造口患者的需求是动态变化的,大多数肠造口患者在出院后3个月内需求下降,但一些肠造口患者在出院后3个月仍有较高需求,临床护士应特别关注这些患者。

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