Hospital - Community - Family Integration Nursing Model Applied To Permanent Colostomy Patients

Objective By investigating the permanent patients underwent colostomy discharged the same day,1 month and 3months after discharge, The stoma complications occurrence and quality of life, discussion Hospital- Community- Home Integration care interventionshow to affect patients interventions for how colostomy patient transferred from hospital to community and home and summarized the theoretical basis.Methods Using controlled clinical studies, in order to facilitate sampling method to extract January 2014-June due to colorectal cancer in Yantai Yuhuangding Hospital abdominal perineal resection of 100 patients were divided into experimental and control groups, the control group to carry out routine perioperative care(include former surgery missionary, postoperative health education, nursing knowledge, the psychological intervention, discharge education, etc.);the experimental group was implemented the hospital-community-family nursing care model, the intervention time line from certain colostomy before surgery to 3 months after discharge. Two groups of patients with colostomy complications, EORTC determination of quality of life scale(Chinese version) score as the main evaluation index, evaluation of the patient was discharged the same day, a month after discharge and 3 months after discharge,complications and their differences in the quality of life will collect data for statistical analysis.Results 1、 The results of two groups of patients, colostomy complications survey show: Discharged on the same day there was no significant difference(P> 0.05) between control patients and the experimental group in stoma complications and severity; a month after the intervention, the experimental group and the control group of patients with skin problems around the stoma, stoma mucocutaneous separation generation and the degree of separation has significant difference(P <0.05); 3 months after the intervention, the difference of the surrounding stoma skin complications,stoma stenosis and the severity between the experimental group and the control group was statistically significant(P <0.05); And mouth mucosa prolapse, incision hernia, colostomy retraction occurred within three months of observation time was no significant difference(P> 0.05). 2、The results of two groups of patients’ quality of life survey show: Discharged the same day the experimental group and the control group the quality of lifein each dimension score was no significant difference(P> 0.05); When discharged a month, the experimental group and control group patients’ quality of life score on the overall health and mood function、cognitive function、social function of four dimensions no statistically significant difference(P > 0.05),there were significant differences on the other 11 dimensions(P <0.05); when two groups of patients discharged from hospital three months all dimensions of quality of life were significantly different(P <0.05).Conclusion In the whole process of nursing intervention and psychological support, colostomy nursing and daily life health education after discharge, the community and family care as the core of the hospital-community-family nursing care model in the early can effectively reduce the colostomy patients after discharge the colostomy surrounding skin complications、skin mucous membrane separation, colostomy stenosis occurrence and severity,at the same time of improving patients, comfort, can also reduce the patients’ medical expenses for dealing with colostomy complications. Through integrated model of care interventions, ostomy patient quality of life after discharge early can get significantly improved, so that patients with a positive attitude positive return to society, thus Hospital- Community- Family Integrated care model is widely used in the stoma continuation of patient care.