The Effects Of Mobile Education On Ostomy Self-care And Adaptation Of Discharged Patients With Ileal Conduit

Objective1.To develop a personalized program and send to discharged patients with ileal conduit through Wechat platform regularly,providing a continuous nursing for their rehabilitation process2.To explore the effects of mobile education on ostomy self-care and adaptation of those patients3.To provide evidence for the exploration and improvement of continuous health management services on discharged patients with ileal conduitMethod1.Those who received ileal conduit because of bladder cancer in the urinary surgery department of the First Affiliated Hospital of Zhengzhou University was recruited from September,2016 to October,2017.The control group and intervention group assigned according to the odd-even number of operation.The control group were given routine care,patients in intervention group received 12 weeks of mobile education program on the basis of routine care.The outcome were evaluated from 1day before discharge to12 weeks after discharge.2.The questionnaires such as The Urostomy Education Scale,Ostomy Adjustment Inventory-23 were used to analysis the intervention outcomes.The complications were timely assessed during 12 weeks of follow-up,the self-care related knowledge,ability,adaptation level were evaluated at times of 1 day before discharge,4 weeks after discharge and 12 weeks after discharge.3.All the data was analyzed by SPSS18.0,descriptive analysis,t-test,Chi-square,repeated measurement analysis of variance were included as statistical methods.Result1.A total of 81 patients were enrolled in this study,40 cases in the intervention group and 41 cases in the control group.Among them,65 cases were male,16 cases female;youngest one was 45 years,oldest 79 years,the mean age was 65.02±8.18years;24.69%patients were divorced or widowed;58.02%patients received primary education;patients living in urban areas accounted for 76.54%;70.37%patients were retired;patients with hypertension and/or diabetes accounted for 76.54%;the minimum length of stay was 9,20 was maximum,the average length of stay was12.37±2.55.There was no statistical difference between two groups.2.The score of self-care related knowledge was no statistical difference between two groups at 1 day before discharge(Z=-1.112,P>0.05).12 weeks after discharge,the score of intervention group was 64.95±6.29,while the control group was 43.90±14.39,their difference was statistically significant(Z=-6.030,P<0.001).3.Repeated measurement analysis of variance indicated that the score of self-care ability was no statistical difference between two groups at 1 day before discharge(t=0.107,P>0.05);the score of intervention group at 4 weeks after discharge and 12 weeks after discharge were 9.98±2.68 and 15.65±2.37,which were statistically higher than the score of 8.12±3.41 at 4 weeks after discharge and 12.29±5.86 at 12weeks after discharge in control group(F=6.343,P<0.05);the scores of self-care ability in both group changed over time,without consideration of intervention factor(F=259.532,P<0.001);interaction between group effect and time effect was emerged(F=10.885,P<0.001).4.The differences between two groups in complications incidences at 1 day before discharge were no statistically significant(P>0.05);though the complications incidences were no statistical difference between two groups at 4 weeks after discharge,the complications incidence of the intervention group was lower than the control group(?~2=0.618,P>0.05);statistically significant were found between two groups at 12 weeks after discharge.The incidence of dermatitis caused by chemical irritation and urinary tract infection had the top two highest rate at 4 and 12 weeks after discharge(?~2=13.812,P<0.001).5.Repeated measurement analysis of variance indicated that the score of adaptation was no statistical difference between two groups at 1 day before discharge(t=2.915,P>0.05)and 4 weeks after discharge(t=1.795,P>0.05);the score of intervention group at 12 weeks after discharge were 58.25±9.36,which were statistically higher than the score of 43.17±11.62 in control group(t=41.277,P<0.001);the scores of adaptation in both group changed over time(F=27.033,P<0.001),without consideration of intervention factor;interaction between group effect and time effect was emerged(F=29.222,P<0.001).ConclusionThe application of mobile education through Wechat platform can enhance the self-care related knowledge and skills,decrease the incidence of complications,thus the ostomy self-care and adaptation level of discharged patients with ileal conduit can be effectively improved.