Effect Of Health Belief On Early Post-Hospital Nursing Of Patients With Enterostomy From The Perspective Of Family Health Care

Objective: Understanding the significance of family health care in self-care of enterostomy patients,analyzing the needs of health management during hospital-to-family transition in enterostomy patients and the development status of post-discharge support programs,exploring the effects of health belief intervention on postoperative early psychosocial adaptation and quality of life in patients with enterostomy,and providing practical guidance and nursing strategies for promoting early postoperative psychosocial adaptation in patients with enterostomy.Methods: This study was divided into two parts.(1)Qualitative research: Using the method of purpose sampling,and 12 cases of enterostomy patients from the ostomy clinic of a top-third hospital in Zhenjiang from November 2016 to April 2017 were selected as subjects.The interview was conducted by two nursing graduate students in a private and quiet space using semi-structured interviews.In-depth face-to-face interviews with patients were conducted in the form of on-the-spot recording and recording.Each interview lasted about 25 to 40 minutes.Interpretative phenomenological analysis is used to understand the health management needs of post-hospital family health care in patients with enterostomy.The number of interviewees is based on the saturation of data.(2)Intervention study: Using a convenient sampling method,a total of 110 patients with colostomy or ileostomy for colorectal cancer were selected from a top-third hospital in Zhenjiang.They were randomly divided into the control group and the experimental group,of which 55 cases were in the control group and 55 cases in the experimental group.The patients in the control group were given routine stoma care.The patients in the experimental group were enrolled in the health belief model on the basis of routine stoma care.The intervention period was 3 months.The intervention mode mainly forms self-health beliefs by improving the ability of post-operative information detection,skill learning,and need for perception.It is guided by health goals,corrects bad habits,and promotes the generation of positive attitudes to form healthy behaviors.Demographic and clinical characteristics data were collected from patients with enterostomy using aself-designed general information questionnaire.The patients of the two groups were investigated on the first day after surgery,at the time of discharge,and at the end of 3months after discharge,using the Chinese version of the Ostomy Adjustment Inventory-20 Scale(OAI-20)and the Chinese version of the Self-administration Formal-36 scales(SF-36).The psychosocial adaptation level and quality of life of patients with enterostomy were evaluated separately.Statistical analysis was performed using SPSS 22.0 software.The statistical methods used included descriptive analysis,two independent sample t-tests,one-way ANOVA,and four-square table chi-square test.Results:1.Qualitative research results:During the transitional period of enterostomy,the problems of body image,daily and social life activities,education of stoma management,family and social support are prominent,and nursing needs are obvious.2.Intervention study results:(1)There were no significant differences in gender,age,type of stoma,educational level,marital status,and family monthly income between the two groups(P>0.05).(2)The t-test results of two independent samples showed that: Before the intervention,the total score of postoperative psychosocial adaptation in the experimental group was 28.49±11.09,and the total score of the control group was27.00±12.07.The patients were generally at low adaptation level.At the time of discharge and 3 months after discharge,the total scores of psychosocial adaptation,positive emotion score,negative emotion score,and social life adaptation score of the experimental group were significantly higher than the control group(P<0.05).The results of paired t-test showed that: At the time of discharge and 3 months after discharge,the total scores of postoperative psychosocial adaptation,positive emotion score,negative emotion score,and social life adaptation were higher in the experimental group than before intervention(P<0.05).(3)Before the nursing intervention,there was no significant difference in scoresof quality of life between the two groups(P>0.05).At the time of discharge and 3months after discharge,the scores of quality of life in the experimental group were significantly higher than those in the control group(P<0.05).At the time of discharge,the scores of all dimensions of QOL of the experimental group were higher than those before the intervention(P<0.05).Three months after discharge,the scores of each dimension of quality of life of the two groups were higher than those before intervention(P<0.05).(4)Repeated measurement analysis of variance showed that: The total scores of psychosocial adaptation and scores of each dimension,the scores of each dimension of quality of life in the two groups had interactive effects(P<0.05).(5)After the nursing intervention,the total incidence of ostomy complications in the experimental group was 16.36%,and the total incidence of ostomy complications in the control group was 32.73%.The four-square table chi-square test results show:The total incidence of ostomy complications in the two groups was statistically significant(P<0.05).Among them,2 patients in the experimental group developed peristomal dermatitis,and 8 patients in the control group developed peristomal dermatitis.The incidence of peristomal dermatitis in the two groups was statistically significant(P<0.05).Conclusion:1.The early postoperative home health management needs of patients with enterostomy are urgent.2.Health beliefs can improve the level of early psychosocial adaptation and quality of life in patients with enterostomy.3.The post-discharge support programs for patients with enterostomy need to be improved.