The Systematic Health Education To Patients With Cystectomy And Orthotopic Neobladder

Objective (s):Systematic education is a effective education covering the entire details of treatment, combining a variety of education method,such as verbal education, patients’ brochure, multimedia teaching and individual participation and practice, guliding as PDCA circle and nursing process, making education at the correct time. Focus on the defect of general education of patients with radical cystectomy and orthotopic neobladder, system health education was used to these kinds of patients. In order to meet the patients’ demand of different period of disease, to make sure that patients and their family member understand the correct way of neobladder function reconstruction and keep they all patience and confidence with the difficult, painful and lengthy recovery. By conducting systematic education system, expect to prevent or reduce the complications, accelerate the neobladder function recovery and finally, improve the quality of life.Methods:92 patients consulted in urological department of the second affiliated hospital of kunming medical university from may,2014 to November,2015 was eligible. Depend on different ward area they were divided into control group(n=44) and intervention group(n=48). Control group received general education and intervention group received systematic education, which consisting of insufficient discussions of these topics:preoperative health education about urinary diversion options and their side-effects, self-care, recovery process, medical insurance, and also psychological needs related to depression and worries about changes in body image; Postoperative health education about dietary guidance of bowel function recovery, neobladder function recruction and management; and discharge telephone follow-up. Two groups based on similar condition, they backed to hospital 3 months after operation to evaluation the intervention effect by residual urine volume(B ultrasonic), neobladder volume(B ultrasonic), incontinence(ICI-Q-SF), early complication rate and quality of life(QLICP-GM, QLICP-BL).Results:Fellowed-up 3 months, Water project, urinary diary, neobladder exercise and pelvic muscle training in intervention group were much better than control group(P<0.05), excepted usage of protective equipment (P>0.05). The different of neobladder function was significant:patients in of intervention group had less residual urine and more neobladder volume than control (265.0±45.64ml vs 165.0±150.52ml, 20.0±15.33ml vs 65.0±45.79ml, P<0.05), however the different of incontinence(ICI-Q-SF) of two group was not obvious (10.36±3.01 vs 9.71±2.97, P >0.05).it was arresting that the rate of early complication like infection and bowel dysfunction in intervention group were low, and the quality of life in these group was better(P<0.05).Conclusion(s):Systematic education could meet the patients’demand in different period of disease, prevent or reduce the rate of infection and bowel dysfunction. And the use of teaching patients and their family member the correct way of neobladder exercises, which result in promote neobladder function recovery was obvious, also, systematic education is a powerful, useful way to improve life quality, and help patients achieve the psycho-physical complete recovery.