The Impact Of Group Visits On Self-efficacy, Adaptation Level And The Quality Of Life Of Postoperative Patients With Colostomy

Objective1 To explore whether it is feasible that group visits was applied to postoperative patients with colostomy; 2 To explore the impact of group visits on self-efficacy,adaptation level and the quality of life of postoperative patients with colostomy; 3 To lay the foundation of the database of patients with colostomy.Methods1 78 subjects were collected from November, 2013 to June, 2014. They successfully completed the enterostomy in gastrointestinal surgery and anorectal surgery of The First Affiliated Hospital of Zhengzhou University.Gastrointestinal ward 1 and anorectal ward 1 were the interventional group, gastrointestinal ward 2 and anorectal ward 2 were the control group. 39 patients included the criteria were selected for each group. Interventional group were given the educational model of group visits, whereas control group routine management. The treatment group was management with group visits.2 Questionnaires used in this study included a self-designed General information questionnaire. The Stoma Self-Efficacy Scale(SSES) of which Cronbach’s α was 0.97,Ostomy Adjustment Inventory(OAI) of which content validity(CVI) and Cronbach’s α were 0.68, 0.87 respectively, City of Hope-Quality of life–Ostomy Questionnaire–Chinese Version(COH-QOL-OQ) of which Cronbach’s α was 0.95. Stoma complications was collected as data of discharged.There were two options of “ Yes ” and “ No ” for stoma complications, and those who chose Yes should provide the type of complications at the same time. 3 The patients should fill the questionnaire at 3 and 6 months after enterostomy.Results1 The valid sample finally contained 70 patients in the survey, each group 35. According to the patient’s general information, patients’ average age was 52.21±13.39 years old, sigmoid stoma were 74.3%, ileostomy were 11.4%. 2 At 3 months postoperatively, the self-efficacy score of treatment group and control group was 71.40±4.42, 62.97±3.82; the adaption level score of treatment group and control group was 41.34±4.97, 37.63±2.74; the difference of self-efficacy score and the adaption level score between two groups was statistically significant(P<0.05). 3 At 6 months postoperatively, the self-efficacy score of 7 treatment group and control group was 87.43±6.80, 76.37±3.61; the adaption level score of 7 treatment group and control group was 54.43±5.29, 46.43±3.35; the difference of self-efficacy score and the adaption level score between two groups was statistically significant(P<0.05). 4 ANOVA for repeated measurement used to test the self-efficacy score and the quality of life score between two groups indicated the difference of score was statistically significant at different time and intervention types respectively(P<0.05), and there was interaction effect(P<0.05); ANOVA for repeated measurement used to test the adaption level score between two groups indicated the score of adaption level,continuing concern dimension, acceptance dimension, positive attitude towards life dimensions was significantly different at different time and intervention methods respectively(P<0.05), and there was interaction effect(P<0.05).5 At 3 months postoperatively, the incidence rate of stoma complication in treatment group was lower than control group.Conclusions1 compared with the conventional management, group visits can enhance the self-efficacy, adaptation level and the quality of life at 3 and 6 months after enterostomy respectively. 2 group visits can reduce the incidence rate of stoma complications at 3 and 6 months after enterostomy respectively.