Study On Health Outcome Among Clostomy Patients With Colorectal Cancer Based On Implementation Sience Theory:Amixed Method Reasearch

Objective: Follow the implementation of scientific theories,construct a scientific nursing intervention plan for patients with colorectal cancer enterostomy,and provide a theoretical basis for the study of health outcomes of patients with colorectal cancer enterostomy.Methods: This research adopts the exploratory mixed research method of "quality +quantity + quantity" sequence.1.Qualitative study of postoperative life experience of patients with colorectal cancer enterostomy.Using the Colaizzi phenomenological data analysis method and the principle of information saturation as the sampling standard,according to the proposed interview outline,the semi-structured interview method was adopted to conduct face-to-face interviews with 12 interviewers to understand their real life experiences and discover the patients' potential nursing needs.2.Sinicization and cross-cultural adaptation of the Self-care Ability Scale for Enterostomy Patients(CAESPO).Obtain the permission to use the original version of CAESPO,follow the Brislin translation model to complete the Chinese version translation;invite 15 experts to conduct cultural adjustments through two rounds of Delphi expert consultation to test the reliability and validity of the scale.3.The effect of scientific nursing intervention in patients with colorectal cancer enterostomy.A similar experimental study was adopted to facilitate sample extraction in sections.A total of 160 patients who underwent colorectal cancer enterostomy in a tertiary hospital in Jilin Province from April 2019 to August 2020 were divided into control group and observation group.control group received routine care,observation group received scientific nursing intervention.On the day of discharge,1 month after discharge,and 3 months after discharge,the health outcome indicators of enterostomy patients were collected,including quality of life,health literacy,self-care ability,enterostomy complications,and patient satisfaction with nursing intervention,repeated measurement analysis of variance and chi-square test were performed in the two groups and applied statistics Software SPSS22.0 for analysis.Results:1.Qualitative study of postoperative life experience of patients with colorectal cancer enterostomyThrough the analysis of the interview content of patients with colorectal cancer and enterostomy,five major themes are summarized: low self-care ability,negative emotion performance,decreased quality of sexual life,high economic pressure,and hope for post-traumatic growth.Poor self-care ability includes low self-care skills,lack of knowledge about self-care,and changes in self-concept;manifestations of negative emotions include emotional out-of-control,loneliness and escape,and stigma;decreased quality of sexual life includes changes in sexual life,and information on sexual health Under-acquisition,negative sexual behavior.The sources of economic pressure include the purchase of ostomy products,post-operative radiotherapy and chemotherapy,and expenditures caused by ostomy complications.Post-traumatic growth is manifested in striving to participate in social activities,enhancing self-worth and hoping to obtain social support.2.Sinicization and cross-cultural adaptation of the Self-care Ability Scale for Enterostomy Patients(CAESPO).After two consultations with Delphi experts,8 items with similar content were integrated into 4 items,1 item was modified,2 items were added and 4 items were deleted,and finally 52 items were formed.The return rate of the two questionnaires of experts is>90%,and the coefficient of expert authority is>0.8.The coordination degree of experts is tested by Kendall harmony coefficient.The difference between the two rounds of results is statistically significant(P<0.001),indicating that the expert's positive coefficient,authority coefficient,The consistency of the scores is high,and the consultation results are more reliable.The importance score of each item is 4.333-5.00 points,and the coefficient of variation CV is 0.00-0.136,further verifying the reliability of the Chinese version of the CAESPO Intestinal Stoma Patient Self-Care Ability Scale.3.The effect of scientific nursing intervention in patients with colorectal cancer enterostomy.(1)Based on the above research,the implementation of the scientific nursing intervention plan includes five intervention themes: implementation of integrated medical and nursing management,preparation of a bilingual version of "Colorectal Cancer Enterostomy Health Literacy Manual",development of multidisciplinary nursing cooperation model,establishment of patients Self-assessment mechanism and improve the connotation of extended nursing services.(2)The two groups of general sociodemographic data were analyzed by chi-square test and independent sample t-test,and the results were not statistically different(P>0.05),and they were comparable.(3)Repeated measures analysis of variance for the total score of quality of life,time effect(F=795.56,P<0.05),treatment effect(F=160.88,P<0.05),interaction effect between the two(F=42.62,P<0.05)),are statistically significant.(4)Repeated measures analysis of variance for the total score of self-care ability,time effect(F=795.56,P<0.05),treatment effect(F=160.88,P<0.05),interaction effect between the two(F=42.62,P<0.05)0.05),all have statistical significance.(5)Repeated measurement analysis of variance for the total score of health literacy,time effect(F=1158.82,P < 0.05),treatment effect(F=161.14,P < 0.05),interaction effect between the two(F=316.16,P<0.05)),are statistically significant.(6)Chi-square test analysis of the incidence of intestinal stoma complications.On the day of discharge,the incidence of complications in the two groups was not statistically significant(F=0.074,P=0.786);at 1 month after discharge,the incidence of complications in the two groups was not statistically significant.(F=7.656,P=0.006);3 months after discharge,the complication rate of the two groups of patients(F=6.632,P=0.010)was statistically significant.(7)Comparing the total scores of patient satisfaction,the average of the control group was(7.42±0.79)and the average of the observation group was(8.55±0.54),there was a significant statistical difference between the two(P<0.001).Conclusion:1.Carry out qualitative research on patients with colorectal cancer and enterostomy,analyze the theme,further understand the real needs of patients,and provide a basis for formulating and implementing scientific nursing interventions.2.The Chinese version of the CAESPO scale is suitable for Chinese culture and has good practicability and scientificity.From the three aspects of knowledge,skills and attitude,it fully embodies the life,activities,social communication,self-growth and special nursing abilities of patients with enterostomy.3.The implementation of scientific nursing intervention can effectively improve the patient's quality of life,self-care ability and health literacy,reduce the occurrence of intestinal stoma complications,increase patient satisfaction,and ultimately improve health outcomes.