| Objective: In this study,MDT-type continuous nursing was applied to patients with rectal cancer,and the effects of this model on resilience,self-care ability and psychological status of rectal cancer patients were observed.Methods: A analysis was conducted from August 2015 to October 2016 in a hospital in Yan'an City.Forty patients with rectal cancer colostomy in one of the top three hospitals met the inclusion criteria were treated as a control group.From October 2016 to January 2018,forty patients with rectal cancer colostomy who met the inclusion criteria were treated as an intervention group;the control group was given regular discharge guidance,and the observation group was given MDT continuous care on the basis of routine discharge guidance.Questionnaires were issued at discharge and three months after discharge,and the results of the questionnaires were analyzed.Results:There was no significant difference in the age,gender,education level,marital status,payment method,stoma type,duration of stoma indwelling time,and family relationship between the two groups(P>0.05).In terms of stoma adaptation,the scores of OAI-20 total scores and dimensions(positive emotions,negative emotions,and social life adaptation)were not statistically different between the two groups after one week of stoma opening(P>0.05).After 3 months,the scores of the OAI-20 total score and dimensions(positive emotions,negative emotions,and social life adaptation)of the intervention group were higher than those of the control group,and the difference was statistically significant(P<0.05).Before and after self-comparison,the OAI-20 total score of the control group and the intervention group were higher than that at 1 week after ostomy;and the scores of each dimension were higher than that at 1 week after ostomy,and the differences between the two groups were statistically significant(P<0.05).Three months after surgery compared to one week after surgery,the increase in adaptability was greater. Psychological conditions were easily compared in the two groups.(1)Depression: Before the intervention,the difference in SDS scores between the two groups was no significant difference(P>0.05).The score in the intervention group was(67.250 ±4.005)points,and the score in the control group was(67.025±2.213)points,the degree of depression was in the level of moderate to severe in both two groups.After the two groups were given different intervention measures,the SDS score in the intervention group was(40.275±2.926)points,and the control group score was(64.425±4.679).),the difference between the two was statistically significant(P<0.05).(2)Anxiety: There was no significant difference in SAS scores between the two groups before intervention(P>0.05).There was significant difference in SAS scores after intervention(P<0.05).Stoma opened 3 months Compared with stoma opened 1 week,the severity of anxiety decreased,and the difference was statistically significant(P<0.05).In terms of self-care ability,there was no significant difference in SAS scores between the two groups before intervention(P>0.05).There was a statistically significant difference in self-care ability scores between the two groups after intervention(P<0.05).The self-care ability of Intervention group and control group all increased after intervention,and the self-care ability of the intervention group increased more significantly,which had a greater impact on the patient's life.The incidence rate of stoma complications was apparently descending(P<0.05).Conclusions:MDT continuous nursing can more effectively improve the psychological adaptation of patients with stoma ability?the patient's psychological conditions ?patient's self-care ability more and decline the incidence rate of stoma complications effectively... |
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