ABSTRACT
Objective:To investigate the status quo of spiritual nursing needs and its influencing factors of patients with permanent enterostomy, and analyze its correlation with disability acceptance and stigma, so as to provide a reference for the construction of targeted spiritual nursing intervention programs.Methods:A total of 351 patients with permanent enterostomy in Xiangya Hospital Central South University and Hunan Cancer Hospital were selected by convenience sampling from January 2021 to March 2022. A cross-section by using the self-made general information questionnaire, Nurse Spiritual Therapeutics Scale (NSTS), Acceptance of Disability Scale (ADS), and Stigma Scale for Chronic Illness (SSCI). And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs of patients with permanent enterostomy.Results:The total score of spiritual nursing needs of patients with permanent enterostomy was 30.15 ± 6.46, and the average score of items was 2.51 ± 0.78. Among the five dimensions, the highest average score was creating a good atmosphere 3.10 ± 0.98, and and the lowest was helping religious practice 1.65 ± 0.70. The total score of disability acceptance was 81.94 ± 13.86; the total score of stigma was 64.03 ± 14.28. The total scores of spiritual nursing needs were positively correlated with the total scores of disability acceptance ( r=0.703, P<0.01), and negatively correlated with the total scores of stigma ( r=-0.516, P<0.01). Multivariate linear regression analysis showed that religious beliefs, educational level, residence, course of disease, disability acceptance, and stigma were the main influencing factors for the spiritual nursing needs of patients with permanent enterostomy ( t values were -13.26-13.56, all P<0.01), accounting for 52.5% of the total variation. Conclusions:The spiritual nursing needs of patients with permanent enterostomy were moderate. It is suggested that nurses can develop targeted spiritual nursing measures according to the individualized characteristics of patients, improve their disability acceptance and reduce their stigma level, so as to meet their spiritual nursing needs and realize their spiritual safety.
ABSTRACT
Objective:To explore the correlation between self-efficacy and discharge readiness in patients with enterostomy.Methods:It was a cross-sectional study. Using the self-efficacy Scale and the Readiness for Discharge Scale as research tools, the patients who underwent enterostomy in the Department of General Surgery of Peking Union Medical College Hospital from December 2018 to December 2019 were conveniently selected for questionnaire survey. Statistical descriptive variables such as mean values, median values and frequency were used to investigate the current situation of self-efficacy and discharge readiness of patients with enterostomy. Pearson correlation analysis (or Spearman correlation analysis) was used to explore the correlation between self-efficacy and discharge readiness in these patients.Results:The total self-efficacy score of the 121 patients with enterostomy was (75.81±21.16) points, and the total discharge readiness score was (138.11±34.60) points. The total score of self-efficacy in the patients with enterostomy was positively correlated with the total score of readiness for hospital discharge ( r=0.379, P<0.01). No correlation was found between the self-condition dimension and the confidence and efficacy of sexual life ( r=0.125, P>0.05) and the confidence and efficacy of sexual life satisfaction ( r=0.062, P>0.05). The disease knowledge dimension was positively correlated with the following variables, self-efficacy score ( r=0.311, P<0.01), stoma care efficacy ( r=0.358, P<0.01), self-social efficacy ( r=0.227, P<0.05), diet choice efficacy ( r=0.221, P<0.05) and stoma self-care confidence efficacy ( r=0.249, P<0.01). The post-discharge coping ability dimension was positively correlated with the total score of self-efficacy ( r=0.428, P<0.01). Anticipatory social support dimension was positively correlated with self-efficacy ( r=0.218, P<0.05), self-social efficacy ( r=0.226, P<0.01), vitality confidence ( r=0.202, P<0.05) and stoma self-care confidence ( r=0.198, P<0.05). Conclusion:The self-efficacy level of patients with enterostomy can positively predict the level of readiness for discharge.
ABSTRACT
Objective:To explore the application effect of capacity, opportunity, motivation-behavior (COM-B) model based self-care health platform for colorectal cancer patients with enterostomy.Methods:A total of 84 patients with permanent enterostomy for colorectal cancer treated in our hospital from May 2020 to April 2021 were selected and divided into the intervention group and the control group by random number table method, 42 cases in each group. The control group was treated with routine nursing, and the intervention group was treated with a self-care health platform based on COM-B model. Patients′ self-care ability, self-efficacy level and the incidence of enterostomy-related complications were evaluated before and after the intervention.Results:Finally, 41 cases were included in the intervention group and 40 cases in the control group. Before intervention, there were no significant differences in self-concept, self-care skills, self-responsibility, health knowledge level and total score of self-care ability between the 2 groups ( P>0.05). After intervention, the total scores of self-concept, self-care skills, self-responsibility, health knowledge and self-care ability in the intervention group were (26.14 ± 1.13), (39.49 ± 2.13), (16.20 ± 2.08), (50.95 ± 5.56), (132.78 ± 6.47), which were higher than those in the control group (19.35 ± 2.07), (29.88 ± 3.52), (9.85 ± 3.25), (43.13 ± 6.71), (102.20 ± 11.47), the difference was statistically significant ( t values were 5.72-18.28, all P<0.05). Before intervention, there was no significant difference in self-efficacy scores between the 2 groups ( P>0.05). After intervention, the self-efficacy score of the intervention group (88.20 ± 6.90) was higher than that of the control group (74.63 ± 3.59), the difference was statistically significant ( t=11.14, P<0.05). After intervention, the incidence of enterostomy-related complications in the intervention group was 7.31%(3/41), lower than 27.50%(11/40) in the control group, the difference was statistically significant ( χ 2=5.36, P<0.05). Conclusion:The construction of self-care health platform for colorectal cancer patients with enterostomy based on COM-B model can effectively improve the self-care ability and self-efficacy of patients, and reduce the incidence of complications.
ABSTRACT
Objective:To analyze the application effect of "Internet+" early grading follow-up management mode after enterostomy for colorectal neoplasms.Methods:The 186 patients who underwent enterostomy for colorectal neoplasms in Lishui Central Hospital were selected as the research objects. The patients enrolled from January 2019 to February 2020 served as the control group, and the patients enrolled from March 2020 to April 2021 served as the observation group, with 93 patients in each group. Routine follow-up measures were taken in the control group, while "Internet+" was used in the observation group for early grading follow-up management of patients with enterostomy for colorectal neoplasms. The timely follow-up feedback, score of skin condition around stoma, incidence of stoma complications and nursing satisfaction during follow-up were compared between the two groups.Results:The two-day non feedback rate in the control group was 20.43% (19/93) and that in the observation group was 7.53% (7/93), the difference was statistically significant ( χ2 = 6.44, P<0.05) .The score of skin condition around stoma in the observation group was (2.53 ± 0.78) points 3 months after discharge, which was significantly better than that in the control group 4.02 ± 1.13, the difference was statistically significant ( t = 10.47, P<0.05). The incidence of stoma complications in the observation group was 9.68% (9/93) , which was lower than that in the control group 21.51% (20/93) , the difference was statistically significant ( χ2 = 4.94, P<0.05). The nursing satisfaction in the observation group was 98.92% (92/93) , which was significantly higher than that in the control group 91.40% (85/93) , the difference was statistically significant ( χ2 = 4.20, P<0.05). Conclusions:"Internet+" early grading follow-up management model can significantly improve the follow-up effect after enterostomy for colorectal neoplasms, improve the skin condition around stoma, reduce stoma complications and improve nursing satisfaction.
ABSTRACT
Objective:To explore the coping trajectory of primary caregivers in patients with permanent enterostomy, and to provide theoretical basis for clinical intervention.Methods:A semi-structured interview was conducted among 20 primary caregivers of patients with permanent enterostomy hospitalized in Qilu Hospital of Shandong University from May to July 2021. The data were analyzed by three-level coding and continuous comparison.Results:The coping trajectory of primary caregivers of permanent enterostomy patients experienced confusion and fatigue period, coping exploration period, acceptance and coexistence period, transformation and transcendence period.Conclusions:Medical staff should give corresponding health education and timely formulate effective intervention measures according to different stages. At the same time, we should effectively integrate external resources to promote the construction of "Hospital-Family-Community" tripartite care model to relieve the care pressure of caregivers.
ABSTRACT
Objective:To investigate the intervention effects of nurse-led discharge planning on discharge readiness and ostomy psychological adaptation in patients with enterostomy.Methods:A total of 70 patients with enterostomy admitted from January 2019 to October 2020 in Jiangsu Province Hospital of Chinese Medicine were enrolled in the present study. They were assigned to experimental group and control group according to the admission time, there were 35 cases in each group. There was one case lost in the control group in the end. The control group received the routine care, while the experimental group implemented nurse-led discharge planning. The Chinese version of Readiness for Hospital Discharge Scale (RHDS) and Ostomy Adjustment Inventory (OAI) were adopted as indicators, the intervention effects was compared between the two groups.Results:On discharge, disease knowledge, coping ability, personal status and expected support dimension scores and total scores in RHDS were (58.06 ± 12.54) , (23.57 ± 3.73), (24.29 ± 3.48) , (30.40 ± 5.25), (136.31 ± 14.32) points in the experimental group, which were significantly higher than those in the control group (49.57 ± 13.28), (18.63 ± 4.97), (22.37 ± 4.28), (26.11 ± 5.66), (101.68 ± 13.04) points, and the differences were statistically significant ( t values were 2.05-4.91, all P<0.05) . On discharge and 1 month after discharge, the persistent worry, acceptance, positive attitude towards life dimension scores and total scores in OAI were (21.34 ± 2.72) , (13.29 ± 2.36), (15.26 ± 3.24), (49.89 ± 5.70) points and (22.03 ± 3.45), (12.49 ± 3.10), (15.09 ± 3.06), (49.60 ± 5.55) points in the experimental group, which were significantly higher than those in the control group (19.35 ± 2.98) , (11.56 ± 2.79), (13.26 ± 3.15), (44.18 ± 5.63) points and (19.91 ± 3.34), (10.76 ± 2.80), (12.24 ± 3.25), (42.91 ± 4.76) points, the differences were statistically significant ( t values were 2.42-5.36, all P<0.05). Conclusions:Nurse-led discharge planning can promote discharge readiness and ostomy psychological adaptation in patients with enterostomy.
ABSTRACT
Objective:To investigate the current situation with regard to a sense of coherence in major caregivers of enterostomy patients and analyze its relationship with self-efficacy and perceived social support.Methods:From July to December 2019, a total of 118 major caregivers of enterostomy patients were investigated using a general information questionnaire, a self-efficacy scale, and a perceived social support scale.Results:The score of sense of coherence in major caregivers of enterostomy patients was 58.40±9.17, and the average scores of all dimensions, from high to low, were “controllable sense，” “understandable sense，”and “meaningful sense.” Sense of coherence was positively correlated with self-efficacy and perceived social support ( r=0.457, P<0.01; r=0.369, P<0.01). Hierarchical multiple regression analysis showed that self-efficacy and perceived social support had a positive predictive effect on sense of coherence and explained 35.2% of the variance ( R′ 2=0.352, F=25.639, P<0.001). Conclusions:The main caregivers of enterostomy patients had a low level of sense of coherence. Self-efficacy and perceived social support have a positive effect on sense of coherence. Medical staff should take targeted measures to help caregivers improve their self-efficacy and social support system in order to improve their sense of coherence.
ABSTRACT
Objective:To explore benefit finding and its influencing factors among enterostomy patients.Methods:A total of 120 enterostomy patients were investigated with general information questionnaire, Benefit Finding Scale, Simplified Scale of Resilience and Perceived Social Support Scale.Results:The score of benefit finding among enterostomy patients was 49.44±5.86. Multiple regression analysis showed that education level, self-care, complications, resilience, perceived social support were influencing factors of benefit finding, and explained 51.1% of the variance.Conclusions:The benefit finding among enterostomy patients was grim. It is suggested that clinical staff pay more attention to the patients with low education, poor self-care and complications of stoma, and also pay more attention to the positive psychology and the social support system of patients, guide patients to pay attention to the positive significance of the disease, so as to improve the level of benefit finding.
ABSTRACT
Objective:To explore the strategy of selecting the second stage operation after neonatal enterostomy.Methods:Clinical data of 35 cases admitted to the Department of Pediatric Surgery of Henan Provincial People′s Hospital for enterostomy in neonatal period and radical operation in the second stage from May 2014 to December 2019 were subject to retrospective analysis.They were inquired about the medical history in detail before the operation, and received barium enema and colonoscopy, 24-hour delayed radiography, anorectal manometry and other examinations.During the operation, a multi-point intestinal biopsy and rapid frozen pathological examination were performed accor-ding to the individual′s condition, and the specific surgical method was determined in combination with intraoperative exploration.Postoperative observations were conducted for such complications as anastomotic leakage, intestinal obstruction, and abdominal infection, as well as such medium and long-term outcomes as intestinal function recovery, defecation, and nutritional status.Results:Nine cases were diagnosed with neonatal necrotizing enterocolitis (NEC) and received ostomy closure.Sixteen cases were diagnosed with NEC concomitant with intestinal stenosis and received the narrow bowel enterectomy and anastomosis combined with ostomy closure; 10 cases were diagnosed with Hirschsprung′s disease, including 5 cases of total colonic aganglionosis treated with Soave radical operation, 3 cases of long-segment Hirschsprung′s disease treated with subtotal colectomy, inverted ascending coloanal anastomosis with Deloyers method and second enterostomy, and 2 cases of normal-segment Hirschsprung′s disease treated with pull-through operation combined with ostomy closure.After the operation, 1 case had anastomotic leakage and septic shock, 1 case had incision dehiscence, 3 cases had adhesive intestinal obstruction and 1 case occurred left lung consolidation.During a follow-up period of 3-36 months, their recovery condition was acceptable.Conclusions:For those neonates receiving enterostomy, detailed medical history should be enquired before the second stage operation.The combination of barium enema and colonoscopy, 24-hour delayed radiography and multi-point intestinal biopsy with intraoperative exploration conduced to selecting appropriate individualized surgical schemes and reducing surgical complications, thus improving the long-term quality of life of children.
ABSTRACT
RESUMEN Fundamento: el cirujano general necesita conocer de las técnicas y procederes quirúrgicos frecuentes en cirugía del intestino delgado, los cirujanos de especialidades afines deben tener los conocimientos básicos necesarios. Este segmento del tubo digestivo es el sitio donde más aparece el ilio intestinal, no así el cáncer, sin embargo, los procederes quirúrgicos en malnutrición por exceso o defecto y las plastias, se incrementan en la actualidad. Objetivo: actualizar la técnica de los procederes quirúrgicos que no por conocidos pierden importancia. Métodos: se realizó una búsqueda sobre el tema a través de las bases de datos SciELO, LILACS, MEDLINE, PubMed, además en bibliotecas institucionales. Se analizaron los resultados antes de redactar el manuscrito. Resultados: se conceptúan todos los procederes y se expone como extraer un cuerpo extraño del intestino insistiendo en los tipos de bezoar. Se alude a las enterorrafias, su técnica, materiales de sutura y agujas en las ostomías, se brinda información sobre yeyuno e ileostomía y en enteroanastomosis, como hacerlas y sus preceptos. Se revisa sobre enterectomías, enteroptiquia, enteroplastia se ilioentectropia. Conclusiones: todos los procederes se relacionan en forma detallada respondiendo a los objetivos que se propuso el autor.
ABSTRACT Background: the general surgeon needs to know about the techniques and frequent surgical procedure actions on the small intestine; other relation surgeons should have basic necessary knowledge. This segment of the digestive tract is the place where the intestinal Ilium appears most, but not the cancer; however, the procedures in malnutrition due to excess or defect and the plasties are currently increasing. Objective: to update this important surgical procedure technique. Methods: aspects of the subject in question are reviewed by conducting a search through the web site SciELO, LILACS, MEDLINE, PubMed, as well as institutional libraries. The results were criticall y analyzed before writing the manuscript. Results: all procedures are conceptualized. It is exposed how to extract a foreign body from the intestine insisting on the types of bezoar. It refers to the enterorrafias, their technique, suture materials and needles; in ostomies, we provide information about jejunum and ileostomy and enteroanastomosis, how to do them and their precepts. It is reviewed on enterectomies, enteroptiquia, enteroplastias and ilioentectropia. Conclusions: all procedures are listed in detail corresponding to the objectives of the review.
ABSTRACT
Background: The use of T tube enterostomy (TTES) as an alternative option for stoma in neonatal emergency is known long time ago.Methods: We introduced T-tube ileostomy as technical innovation in our institution as a way of treatment for intestinal perforation in low birth weight premature neonates.Results: In this study 14 neonates underwent TTES procedures at university-based pediatric surgery and neonatology department. 11 (78.6%) patients treated with TTES, discharged home. Three babies (22.4%) died in postoperative course. One of them developed recurrent severe fulminant NEC ileostomy was created and kept on TPN but died after 2 weeks due to septicaemia. The two others were dysmorphic with metabolic diseases.Conclusions: T tube is effective in selected cases of necrotizing enterocolitis (NEC) because of its simplicity in application and removal. But it could not replace the formal stoma in general, its advantages are saving one more time exposure to surgery in those risky patients, Author recommend the use it in cases of post NEC intestinal perforation and extreme low birth weight neonates.
ABSTRACT
Objective@#To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy.@*Methods@#Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis.@*Results@#Exploratory factor analysis identified four principal factors which explained 52.584%, and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926.@*Conclusion@#The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
ABSTRACT
Objective@#To investigate the effects of family-integrated care (FIC) on postoperative outcomes in children with enterostomy and their caregivers.@*Methods@#From August 2017 to August 2018, 50 children with enterostomy and 50 family members of the Children′s Hospital of Hunan Province were selected as subjects. According to the random number table, the children and their families were divided into control group and the observation group, each group was 25 cases. The control group was given a routine nursing mode to intervene, and the observation group was given an FIC mode for intervention. Postoperative outcomes were evaluated using the incidence of ostomy complications and readmission rates. The pre-intervention and outpatient follow-up were used to assess the psychological status of the family members using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), and to assess the postoperative care of the family's intestines using the postoperative evaluation of the postoperative intestines. The level of knowledge mastery. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to assess the psychological state of the family members, and the postoperative care knowledge evaluation form for the postpartum was used to evaluate the postoperative care of the family.@*Results@#The incidence of ostomy complications in the observation group was 8.70% (2/23), which was lower than that in the control group (34.78% (8/23) (P<0.05). The readmission rate of the observation group was 0(0/23), which was lower than the control group 17.39% (4/23) (P<0.05). After intervention, the SAS scores and SDS scores of the families of the two groups were lower than those before the intervention, and the SAS scores and SDS scores of the observation group were lower than the control group(P<0.05). Before discharge and 3months of follow-up, the scores of postoperative care knowledge evaluation scores of the observation group were higher than those of the control group(P<0.05).@*Conclusions@#FIC mode can effectively reduce the incidence of complications and readmission rate in children with enterostomy. It has positive significance for improving the negative emotions of children′s family members and improving the mastery of postoperative care.
ABSTRACT
Objective@#To investigate the sleep quality at home and the influencing factors in patients with colorectal tumor after enterostomy.@*Methods@#Using convenience sampling method, during March 2016 to December 2017 in Anhui Provincial Cancer Hospital wound and stoma outpatient, choose 276 patients with enterostomy (including temporary enterostomy and permanent enterostomy), using self-made general questionnaire ostomy, Pittsburgh Sleep Quality Index (PSQI) and self nursing competence scale to investigate them.@*Results@#The total PSQI score of enterostomy patients was 6.39±4.07, among which 150 patients (57.0%) had poor sleep (PSQI>7). The score of the 7 dimensions of PSQI from high to low was sleep time (1.22±1.05), sleep time (1.12±0.98), subjective sleep quality (1.00 ±0.92), sleep disorder (1.02±0.95), sleep efficiency (0.95±0.43), daytime dysfunction (0.83±0.76), hypnotic drugs (0.25±0.24).There were statistically significant differences in sleep quality among patients with different ages (Z=-2.937), duration of stoma (t=3.450-3.896), types of stoma (t=3.998-4.011), whether or not they had a history of leakage within 1 month (t=3.454-6.774), whether or not they had bloating bags (t=3.230-4.001), stoma complications (t=2.976-3.582), enterostomy self-care knowledge (Z=-3.202, t=3.971) and nursing skills (t=3.061)(P<0.05).@*Conclusions@#The present study shows that the sleep quality of patients with enterostomy is generally poor, and targeted measures should be taken to reduce its incidence or to intervene in time.
ABSTRACT
Objective@#To explore the clinical safety and feasibility of enterostomy using running suture of dermis and seromuscular layer in laparoscopic-assisted radical resection for rectal carcinoma.@*Methods@#From May 1, 2017 to May 1, 2018, 46 patients who underwent laparoscopic-assisted radical resection for rectal carcinoma with enterostomy using running suture of dermis and seromuscular layer in Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively enrolled in this study. Data regarding clinicopathologic characteristics, operation and postoperative outcomes, stoma-related complications and functions of stoma were collected and analyzed.@*Results@#All of the 46 patients successfully underwent this operation. Among them, 30 patients underwent laparoscopic-assisted abdominoperineal resection for rectal cancer with sigmoidostomy and 16 patients underwent laparoscopic-assisted low anterior resection for rectal cancer with loop ileostomy. The mean operation time was 115.3 minutes and intraoperative blood loss was 86.1 ml. The mean time for enterostomy was 14.1 minutes. The average time to flatus, time to fluid diet intake and length of hospital stay were 1.8 days, 2.9 days and 6.5 days, respectively. During the follow-up period, three patients suffered from stomal edema, two patients suffered from parastomal hernia, and two patients suffered from skin inflammation surrounding stoma. None of re-operation related stoma and severe mobility such as stomal stenosis, stomal necrosis, stomal prolapse, stomal retraction and stomal mucocutaneous separation occurred. Thirty-five patients recovered with satisfactory stomal function, two with middle function and one with poor function.@*Conclusion@#Enterostomy using running suture of dermis and seromuscular layer in laparoscopic-assisted radical resection for rectal carcinoma is a safe and feasible procedure with a satisfactory short-term effect.
ABSTRACT
Objective To investigate the effects of family-integrated care (FIC) on postoperative outcomes in children with enterostomy and their caregivers. Methods From August 2017 to August 2018, 50 children with enterostomy and 50 family members of the Children′s Hospital of Hunan Province were selected as subjects. According to the random number table, the children and their families were divided into control group and the observation group, each group was 25 cases. The control group was given a routine nursing mode to intervene, and the observation group was given an FIC mode for intervention. Postoperative outcomes were evaluated using the incidence of ostomy complications and readmission rates. The pre-intervention and outpatient follow-up were used to assess the psychological status of the family members using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), and to assess the postoperative care of the family's intestines using the postoperative evaluation of the postoperative intestines. The level of knowledge mastery. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to assess the psychological state of the family members, and the postoperative care knowledge evaluation form for the postpartum was used to evaluate the postoperative care of the family. Results The incidence of ostomy complications in the observation group was 8.70% (2/23), which was lower than that in the control group (34.78% (8/23) (P<0.05). The readmission rate of the observation group was 0(0/23), which was lower than the control group 17.39% (4/23) (P<0.05). After intervention, the SAS scores and SDS scores of the families of the two groups were lower than those before the intervention, and the SAS scores and SDS scores of the observation group were lower than the control group(P<0.05). Before discharge and 3months of follow- up, the scores of postoperative care knowledge evaluation scores of the observation group were higher than those of the control group(P<0.05). Conclusions FIC mode can effectively reduce the incidence of complications and readmission rate in children with enterostomy. It has positive significance for improving the negative emotions of children′s family members and improving the mastery of postoperative care.
ABSTRACT
Objective To investigate the sleep quality at home and the influencing factors in patients with colorectal tumor after enterostomy. Methods Using convenience sampling method, during March 2016 to December 2017 in Anhui Provincial Cancer Hospital wound and stoma outpatient, choose 276 patients with enterostomy (including temporary enterostomy and permanent enterostomy), using self-made general questionnaire ostomy, Pittsburgh Sleep Quality Index (PSQI) and self nursing competence scale to investigate them. Results The total PSQI score of enterostomy patients was 6.39±4.07, among which 150 patients (57.0%) had poor sleep (PSQI>7). The score of the 7 dimensions of PSQI from high to low was sleep time (1.22 ± 1.05), sleep time (1.12 ± 0.98), subjective sleep quality (1.00 ± 0.92), sleep disorder (1.02±0.95), sleep efficiency (0.95±0.43), daytime dysfunction (0.83±0.76), hypnotic drugs (0.25± 0.24).There were statistically significant differences in sleep quality among patients with different ages (Z=-2.937), duration of stoma (t=3.450-3.896), types of stoma (t=3.998-4.011), whether or not they had a history of leakage within 1 month (t=3.454-6.774), whether or not they had bloating bags (t=3.230-4.001), stoma complications (t=2.976-3.582), enterostomy self-care knowledge (Z=-3.202,t=3.971) and nursing skills (t=3.061)(P<0.05). Conclusions The present study shows that the sleep quality of patients with enterostomy is generally poor, and targeted measures should be taken to reduce its incidence or to intervene in time.
ABSTRACT
Objective To compare the prognosis of different surgical procedures and to find the relatively safe and effective treatment for severe jejunoileal atresia(sJA).Method From January 2007 to June 2018,children with sJA receiving different surgical procedures in our hospital were retrospectively reviewed.Their clinical data were analyzed,including the survival rate,complication rate,unplanned re-operation rate and postoperative nutritional status.Result A total of 130 patients were enrolled in this study.According to the different types of surgical procedures,the patients were assigned into primary anastomosis group (58 cases,44.6％),Mikulicz double barrel ileostomy group (17 cases,13.1％) and Bishop-Koop anastomosis group (55 cases,42.3％).The overall mortality rate was 6.2％ (8/130).No significant differences existed in mortality rates among the three groups (P＞0.05).The incidences of gastrointestinal complications in primary anastomosis group (70.6％,12/17) and Mikulicz group (70.6％,12/17) were both higher Bishop-Koop group (34.5％,19/55),the differences were statistically significant (P＜0.05).The unplanned re-operation rates were 34.5％ (20/58) in the primary anastomosis group and 17.6％ (3/17) in the Mikulicz group,both higher than the Bishop-Koop group (3.6％,2/55),the differences were also statistically significant (P＜0.05).Multivariate analysis showed that the risk of complications in the primary anastomosis group (OR=3.434,95％CI 1.392～8.471) and Mikulicz group (OR=5.933,95％CI 1.467～23.991) were higher than the Bishop-Koop group.The risk of unplanned re-operation in the primary anastomosis group was 12.422 times as the Bishop-Koop group (95％CI 2.535～60.877).No significant differences existed between the Mikulicz group and the Bishop-Koop group in the risk of unplanned re-operation (P＞0.05).The weight for age (Z-score) in the Bishop-Koop group (-1.4,95％CI-2.0～-0.8) at the stoma closure time was better than the Mikulicz group (-3.2,95％CI-4.4～-2.0),the difference was statistically significant (P＜0.01).Conclusion Bishop-Koop anastomosis has lower complication rate and lower unplanned re-operation rate in the treatment of sJA.The nutritional status of children who received Bishop-Koop anastomosis is better than Mikulicz double barrel ileostomy at the stoma closure time.Bishop-Koop anastomosis is relatively safe and effective for sJA patients.
ABSTRACT
Objective To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy. Methods Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis. Results Exploratory factor analysis identified four principal factors which explained 52.584% , and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926. Conclusion The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
ABSTRACT
Objective To investigate the occurrence of moisture-associated skin damage (MASD) around the stoma in patients with colorectal tumor after enterostomy. Methods Using convenience sampling method, during March 2016 to December 2017 in Anhui Provincial Cancer Hospital wound and stoma outpatient, choose 276 patients with enterostomy (including temporary enterostomy and permanent enterostomy), using self-made general questionnaire and ostomy self nursing competence scale to investigate them. Results Totally 276 cases of enterostomy patients, including 119 cases (43.1％) underwent colostomy, 157 cases ileum ileostomy (56.9％). There were 92 cases (33.3％)of patients with MASD , the binary classification Logistic regression analysis showed that enterostomy time (P = 0.004), the type of enterostomy (P=0.009), height of enterostomy (P=0.001), enterostomy self-care knowledge (P=0.012) and nursing skills (P=0.002) were MASD influence factors. Conclusion The present study shows that MASD is widespread in patients with enterostomy, and targeted measures should be taken to reduce its incidence or to intervene in time.