Study On The Current Situation Of Social Isolation And Intervention For Patients With Enterostomies

Objectives1.To understand the current situation and factors influencing social isolation in patients with enterostomies and to explore patients’ real experience of isolation.2.To investigate the effects of a health education program based on rational emotive behavior therapy on isolation,perception of discrimination,social participation and quality of social relationships in patients with enterostomies.MethodsThis study consists of two parts:1.Part I-the current situation of social isolation and the factors influencing it in patients with enterostomy: an explanatory time series design was used.(1)Quantitative research: 225 patients who underwent enterostomy surgery in a tertiary level A hospital in Zhenjiang City were selected for the survey using convenience sampling method.The General Information Questionnaire,General Isolation Scale(GSA)and Social Impact Scale(SIS)were used to understand the current situation of social isolation and the factors influencing social isolation in patients with enterostomy.(2)Qualitative research: With the purposive sampling method,convenience sampling and maximum difference method sampling,interview subjects from the quantitative research,semi-structured interviews were conducted with the 14 patients included,and thematic analysis was used to uncover the true feelings of daily life of patients with enterostomies to fully understand the patients’ experience of isolation.2.Part II-Construction and application of an intervention program for social alienation in patients with enterostomies.(1)Based on the results of the preliminary quantitative and qualitative studies,literature review and screening of appropriate intervention technology strategies,the group brainstormed to form the first draft of the intervention plan,and then formed the final intervention plan based on pre-experiments and discussions among the group members.(2)Using a class experimental study,70 patients attending the gastrointestinal surgery and wound stoma clinic of a tertiary care hospital in Zhenjiang City were selected for the study from January to June 2022,with 35 cases each in the control and experimental groups.Patients in both groups received conventional health education for patients with intestinal stoma,and the experimental group received an intervention program based on rational emotive behavior therapy on this basis.Changes in general isolation,perception of discrimination,social participation and quality of social relationships were compared between the two groups at baseline,1 month after the intervention and 3 months after the intervention,respectively.Results1.Current status of social isolation in patients with enterostomies and factors influencing it:(1)Quantitative research: 225 enterostomal patients were included,with isolation score(39.26±3.55),with a high degree of isolation;the differences in their isolation scores were statistically significant(P<0.05)among patients with different marital status,education level,occupational status and duration of stoma.(2)Qualitative research: In-depth interviews and comprehensive analysis of 14 patients with enterostomies to obtain the experience of isolation in social participation,interpersonal relationships and goal setting for patients with different levels of enterostomies.2.Construction and application of an intervention program for social isolation in patients with enterostomies:Rational emotional behavioral therapy was used as the framework of the intervention program,and individualized health education intervention strategies were implemented for patients with enterostomies.The two groups of patients were comparable at baseline before the intervention,and the comparison of general information was not statistically significant(P>0.05).At 1 month of intervention and3 months of intervention,the overall total score of isolation of patients in the test group improved,and the difference with the control group was statistical significance(P < 0.05);the total score of social influence of patients in the test group was higher,and the difference with the control group was statistically significant(P < 0.05);the dimensions of social participation and the total score of patients in the test group decreased,indicating that social participation was effective,and the differences of outdoor autonomous participation,social life and Social relationship and total score differences were statistically significant(P < 0.05),indoor autonomous participation and family role autonomous participation differences were not statistically significant(P > 0.05);the quality of social relationship in the test group improved significantly over time,and the differences with the control group were statistically significant(P <<0.05).Conclusions1.The issue of social isolation in patients with an intestinal stoma requires urgent clinical attention,and the experience of isolation varies among patients with different marital status,educational level,occupational status,and duration of stoma.Health care professionals should implement targeted measures to enhance social support,effectively alleviate their sense of isolation,and promote healthy patient outcomes.2.The intervention program based on rational emotive behavior therapy can help improve isolation,reduce the level of discrimination perception and improve the quality of social relationships in patients with enterostomies,but the effect on social participation needs to be further explored.