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评估一种新型数字造口术装置对渗漏事件、生活质量、心理健康和患者自我护理的影响:一项干预性多中心临床试验。

Evaluating the Effect of a Novel Digital Ostomy Device on Leakage Incidents, Quality of Life, Mental Well-Being, and Patient Self-Care: An Interventional, Multicentre Clinical Trial.

作者信息

Brady Richard R W, Sheard Diane, Alty Mandie, Vestergaard Martin, Boisen Esben Bo, Ainsworth Rachel, Hansen Helle Doré, Ajslev Teresa Adeltoft

机构信息

Newcastle Centre for Bowel Disease Research Hub, Newcastle Hospitals and Newcastle University, Newcastle upon Tyne NE1 4LP, UK.

Surgical Directorate, Lancashire Teaching Hospital, Royal Preston Hospital, Preston PR2 9HT, UK.

出版信息

J Clin Med. 2024 Sep 24;13(19):5673. doi: 10.3390/jcm13195673.

DOI:10.3390/jcm13195673
PMID:39407731
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11477101/
Abstract

Most people with a stoma worry about leakage, and a quarter experience leakage of stomal effluent outside the baseplate on a monthly basis. Leakage has additional physical and psychosocial consequences, for instance, peristomal skin complications, feeling unable to cope, and self-isolation. An interventional, single-arm, multi-centre study was undertaken in the United Kingdom to evaluate a novel digital leakage notification system for ostomy care, including a support service (=test product) for 12 weeks in patients with a recent stoma formation (≤9 months). Patients completed questionnaires at baseline and after 4, 6, 8, 10, and 12 weeks, evaluating leakage episodes, Ostomy Leak Impact (tool containing three domains), and patient self-management (by PAM-13). Additionally, mental well-being (by WHO-5) and health-related quality of life (QoL) (by EQ-5D-5L) were assessed. Outcomes between baseline and final evaluation were compared by generalised linear and linear mixed models. 92 patients (ITT population) with a mean age of 49.4 years (range 18-81 years) were recruited. Of these, 80% had an ileostomy, and 53% were female. After 12 weeks of using the test product, a significant decrease in mean episodes of leakage outside the baseplate (1.57 versus 0.93, < 0.046) was observed. Ostomy Leak Impact scores improved across all three domains ( < 0.001), indicating less embarrassment, increased engagement in social activities, and increased control. Patient self-management also improved significantly (PAM-13 score: ∆6.6, < 0.001), as did the WHO-5 well-being index (∆8.0, < 0.001). Lastly, EQ-5D-5L profile scores tended to improve ( = 0.075). A new digital leakage notification system demonstrated strong improvements to patients' stoma self-care, mental well-being, and QoL. Registration number on ClinicalTrials.gov: NCT05135754.

摘要

大多数造口患者担心渗漏问题,四分之一的患者每月都会出现造口排泄物从底盘外渗漏的情况。渗漏还会带来额外的身体和心理社会后果,例如,造口周围皮肤并发症、感觉无法应对以及自我隔离。在英国进行了一项干预性、单臂、多中心研究,以评估一种用于造口护理的新型数字渗漏通知系统,包括为近期造口形成(≤9个月)的患者提供为期12周的支持服务(即测试产品)。患者在基线时以及第4、6、8、10和12周后完成问卷调查,评估渗漏事件、造口渗漏影响(包含三个领域的工具)和患者自我管理(通过PAM-13)。此外,还评估了心理健康(通过WHO-5)和健康相关生活质量(QoL)(通过EQ-5D-5L)。通过广义线性模型和线性混合模型比较基线和最终评估之间的结果。招募了92名患者(意向性分析人群),平均年龄为49.4岁(范围18 - 81岁)。其中,80%为回肠造口患者,53%为女性。使用测试产品12周后,观察到底盘外平均渗漏事件显著减少(1.57对0.93,<0.046)。造口渗漏影响评分在所有三个领域均有所改善(<0.001),表明尴尬减少、社交活动参与度增加以及控制力增强。患者自我管理也显著改善(PAM-13评分:∆6.6,<0.001),WHO-5幸福感指数也是如此(∆8.0,<0.001)。最后,EQ-5D-5L简表评分有改善趋势(=0.075)。一种新型数字渗漏通知系统在患者的造口自我护理、心理健康和生活质量方面显示出显著改善。ClinicalTrials.gov注册号:NCT05135754。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/1a76eb3b72cc/jcm-13-05673-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/44fc11824a83/jcm-13-05673-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/77e9ad407136/jcm-13-05673-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/2c512f7963bf/jcm-13-05673-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/1a76eb3b72cc/jcm-13-05673-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/44fc11824a83/jcm-13-05673-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/77e9ad407136/jcm-13-05673-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/2c512f7963bf/jcm-13-05673-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11477101/1a76eb3b72cc/jcm-13-05673-g004.jpg

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本文引用的文献

1
A pilot study of a digital ostomy leakage notification system: impact on worry and quality of life.一项数字化造口漏液通知系统的初步研究:对担忧和生活质量的影响。
Br J Nurs. 2023 Mar 23;32(6):S4-S12. doi: 10.12968/bjon.2023.32.6.S4.
2
Leakage of stomal effluent outside the baseplate leads to rise in product usage and health professional interactions.造口底盘周围有排泄物渗漏会导致产品用量增加以及医护人员的介入。
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Prevalence of leakage and its negative impact on quality of life in people living with a stoma in the UK.
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造口术后第一年渗漏、造口周围皮肤并发症的发生率及其对生活质量的影响
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Br J Nurs. 2022 Sep 8;31(16):S24-S38. doi: 10.12968/bjon.2022.31.16.S24.
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Utilities associated with stoma-related complications: peristomal skin complications and leakages.与造口相关并发症相关的问题:造口周围皮肤并发症和渗漏。
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Challenges faced by people with a stoma: peristomal body profile risk factors and leakage.造口人面临的挑战:造口周围身体轮廓的风险因素和渗漏。
Br J Nurs. 2022 Apr 7;31(7):376-385. doi: 10.12968/bjon.2022.31.7.376.
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Impact of stoma leakage in everyday life: data from the Ostomy Life Study 2019.造口渗漏对日常生活的影响:来自2019年造口生活研究的数据。
Br J Nurs. 2022 Mar 24;31(6):S48-S58. doi: 10.12968/bjon.2022.31.6.S48.
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