| Objective(s):This study aimed to compare the quality of life,self-care ability,psychological state and complication of the two groups of bladder cancer patients with bladder cancer urinary diversion abdominal stoma,and to explore the effect of continuation nursing on patients with bladder cancer urinary diversion abdominal stoma.And to provide a new basis for the further study and development of patients with bladder cancer urinary diversion abdominal stoma,and to provide reference for the establishment of long-term extended nursing model for the patients undergoing bladder cancer urinary diversion abdominal stoma.Methods:This study is a prospective study of intervention.From August 2015 to December 2016,84 patientsthe were diagnosed as bladder cancer and receive to radical cystectomy and urinary diversion abdominal stoma in the Second Affiliated Hospital of Kunming Medical University,divided intervention group and control group,43 patients were admitted to the control group,received routine nursing care of bladder cancer,health education and hospital discharge care,41 patients was treated as intervention group were cared by the conventional care model.On the basis of discharge routine nursing receive health education and hospital discharge follow-up,the team members by a variety of forms of intervention in the discharge of patients for example telephone follow-up,family visits,outpatient follow-up,Sunshine Forum,Ostomy Fraternities,network online platform guide,stoma visit group,nurses give psychological support,answer the questions to the patients accordin to the gactual situation,review reminders,stomatal care guidance,respectively 1month and 3 month after surgery evaluation quality of life(life Quality scale QLICP-BL),urinary obstruction self-care ability(Kristensen urinary obstruction self-care scale),anxiety and depression(SAS,SDS scale),The incidence of complications for two groups.Results:There was no significant difference between the two groups in demographic data,basic quality of life,data of bladder cancer and anxiety and depression(P>0.05).Quality of life:1 month and 3 months after surgery,the intervention group was significantly better than the control group(P<0.05),1 month after surgery the intervention group with psychological function(PSD)and social function(SOD)were better than the control group(P<0.05).3 month after surgery the intervention group in psychological function(PSD),urinary tract function(UTS),specific psychological response(SPR)and urinary bag problem(UBP)were significantly better than the control group(P<0.05),specific physical symptoms(SPS),urine bag problems(UBP)and sexual function problems(SEP)were not statistically significant(P>0.05).Psychological anxiety and depression:1 month and 3 months after surgery,the ntervention group Self rating Anxiety Scale(SAS)and self-rating depression(SDS)scores were significantly better than the control group(P<0.05);1 month after surgery,the anxiety self-rating scale(SAS),depression self-rating scale(SAS)scores of the two groups lower than preoperative scores,3 month after surgery,the anxiety self-rating scale(SAS),depression self-rating scale(SAS)scores was lower than the 1 month after surgery(P<0.05).The ostomy self-care ability:1 month after surgery,the intervention group was better than the control group in stoma self-care ability(Including the remove the stoma device,the side of the two stove diameter,trim the size of the appropriate chassis,the installation of wearing a new stoma care device)(P<0.05),but there was no significant difference between the two groups in Ostomy self-care willingness(knowledge of stoma)ostomy around the skin care,and emptying the process(P>0.05).3 months after surgery,The intervention group was better than the control group in the willingness to self care(knowledge of stoma)and self-care skills(remove the stoma device,the side of the two stove diameter,trim the size of the appropriate chassis,the care of the skin around the stoma,the installation of wearing a new stoma care device)(P<0.05).There was no significant difference between the two groups in the evacuation process of self-care skills(P<0.05).Complications:This study shows that the most common early complications are stoma-related complications,urinary tract infection and digestive system complications,the incidence was 46.4%,34.5%and 29.8%.At 1 month after surgery,the ostoma related,urinary system and digestive system complications in the intervention group were lower than the control group(P<0.05),but there was no significant difference in stomatal correlation,cardiovascular system,respiratory system,incisionand peripheral blood vessels.At 3 months after surgery,the most common complications were complications associated with ostoma related,urinary tract infections and digestive complications,respectively with a rate of 38.1%,17.9%and 11.9%,the complications of the intervention group were significantly lower than the control group(P<0.05).Compared with 1 months after surgery,the number of complications was significantly reduced,and there were no significant difference in cardiovascular system,respiratory system and peripheral blood vessels(P>0.05).Conclusion(s):with routine discharge telephone follow-up comparison continued nursing mode can improve ladder cancer urinary diversion abdominal stoma patients'quality of life,self-care ability and psychological state of anxiety and depression,reduce incidence of complications.Continuation of nursing model is worth promoting... |
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