Research On The Boundles Of Care For The Rehabilitation Process Of Patients After Radical Hysterectomy

Research purposes：1.By surveying the clinical data of radical hysterectomy patient,analyzing thefactors affecting rehabilitation process of the cervical cancer patients after surgery,and provide a scientific basis for the development and implementation of cervicalcancer postoperative care measures.2.Through studying the postoperative rehabilitation application of bundles of carefor the patients, evaluate whether it can achieve the popurse of reducingcomplications, shortering hospital stays, improving the quality of life of patients,provide a theoretical basis for the bundle of care,s futher improvement.Research Methods：The study is divided into two partsPart I:Collecting from December2012to September2013period, a clear diagnosis inpatients with radical hysterectomy for cervical cancer in parallel for the study of118cases (met the inclusion criteria), granted questionnaires, tracked and collecteddata.The impact of the first postoperative flatus, complications occur, hospital staysare compared respectively from three dimensions:individual factors, tumor-relatedfactors, treatment and care factors, thereby analyzed the postoperative rehabilitationprocess factors. Research tools include basic data collection sheet, anxiety ratingscale and general self-efficacy scale. Using SPSS17.0to entry and analysis data. Byunivariate analysis and multivariate stepwise regression analysis, definite theaffacting factors of Postoperative rehabilitation of the patients undergoing Radicalhysterectomy. Part II:120patients with radical hysterectomy in our laboratory were selected fromDecember2013to October2014period,and were randomly divided into two groupsof60cases, including the implementation of bundles of care as the experimentalgroup, another implementation of routine care group as the control group. UsingSPSS17.0to entry and analysis data. Count data used χ2test, measurement data usedt test, the first Flatus time,accur of the complications, hospital stays were compared.The results:1.Analysis factors affecting inpatientdays:age,anxiety,self-efficacy,clinicalstage,whether nurses attending the standardized training,P<0.05, significantdifference; Medicare insurance,pathological type,operative time,type P>0.05, notstatistically significant; Stepwise multiple regression analysis, whether nursesattending the standardized training, patient age, cancer stage, and anxiety final fourvariables into the regression equation, and correlation.2.Analysis the factors affecting the complications: age, anxiety,cancer sta-ging,whether nurses attending the standardizedtraining,P<0.05,significant,differe-nce;Medicaretype,self-efficacy,pathological type,operative time, P>0.05, not stat-istically significant; Logistic regression analysis showed that age, anxiety, nur-ses attending the standardized training and tumor stage are independent factorsaffecting the occur of complications.3. Analysis the factors affecting the first exhaust time: age,anxiety, selfef-ficacy,cancer staging,nurses attending the standardized training,P<0.05, significa-nt difference; Medicare type,pathological type,operative time,P>0.05, not stati-stically significant; Stepwise multiple regression analysis, nurses attending thestandardized training, histological type, cancer stage, and anxiety finally entered into the regression equation.4. The results of the study showed that thet test of exhaust time and hos-pital stays of two groups, P<0.05, indicates that there are differences betweenthe exhaust time and hospital stays of two groups; χ2test of abdominal infe- ction，rinary retention，occurrence of urinary retention and urinary tract infecti-on,P<0.05, shows differences between two groups,postoperative abdominal inf-ection，rinary retention，occurrence of urinary retention and urinary tract inf-ection;and systemic infection χ2test，P>0.05, the two groups showed no signi-ficant difference in systemic infection.Conclusions:1.Age, preoperative anxiety, cancer stage, nurses attending the standardizedtraining are the independent factors for hospital stays.2.Age, preoperative anxiety, cancer stage, nurses attending the standardizedtraining are the independent factors of complications in patients.the degree ofinfluence in descending order of anxiety, age, whether to participate in thesystematic training, cancer staging.3.Nurses attending the standardized training, preoperative anxiety, histologicaltype, tumor stage was an independent factor for postoperative first flatus time.4.The Boundles of care we have made got the significant effection, improve thequality of life of patients, provide a theoretical basis for the bundle of care,s futherimprovement.