| ObjectiveThe comprehensive geriatric assessment(CGA)was applied to the clinical nursing of elderly patients undergoing total urinary bypass surgery,discovering the potential elderly problems in time,and discussing the effects of CGA-based nursing intervention on postoperative bladder function,complication rate,quality of life,physical health,daily living ability,length of hospital stay and patient satisfaction.MethodsProspective study design was used to select 80 patients with myenteric invasive bladder cancer who underwent total cystectomy and urinary diversion in a urological department of a third-grade hospital in Yantai from June 2017 to April 2018.Patients were randomly divided into observation group and control group by 40 cases.The control group received routine evaluation and bladder cancer specialist care at the time of admission,and the intervention group performed systematic CGA nursing intervention on the basis of routine treatment of bladder cancer.The research tools use the World Health Organization Quality of Life Measurement Scale(WHOQOL-100),Functional Status Rating Standard(KPS),Daily Living Activity Score Sheet(ADL),and the International Incontinence Advisory Committee Questionnaire(ICI-Q-SF).The bladder function,complication rate,survival quality,physical health status and daily living ability of the two groups were evaluated 6 months after operation,and the hospitalization days and patient satisfaction of the two groups were compared.And compare the differences between the two groups of patients.Statistical analysis and analysis were performed using SPSS 23.0 software.The measurement data were analyzed by t test,expressed as (?)±s,and the count data were analyzed by x~2 test.P<0.05 was considered statistically significant.Results1.There was significant difference in the volume of new bladder between the two groups(t=2.580,P=0.012).The volume of new bladder in the observation group was greater than that in the control group.There was significant difference in bladder residual urine volume between the two groups(t=3.652,P<0.001).The residual urine volume of the bladder in the observation group was lower than that in the control group.The difference of postoperative urinary incontinence scores between the two groups was statistically significant(t=3.373,P=0.001).The postoperative urinary incontinence score of the observation group was lower than that of the control group;2.There were significant differences in the incidence of complications related to digestive system,wounds,infection,peripheral blood vessels and urethra in the two groups(x~2=3.914~15.312,P=0.001,P=0.025,P<0.001,P=0.048,P=0.043),the incidence of various common complications in the observation group was lower than that in the control group;3.There was no significant difference in postoperative mental/religious/faith and physiological status between the two groups(t=0.985~1.661,P=0.328,P=0.101).There were statistically significant differences in psychology,independence,social relations and environment(t=2.060~2.740,P =0.008,P=0.027,P=0.010,P=0.043),the overall quality of life of the observation group was higher than that of the control group(t=2.017,P=0.047);4.There was significant difference in postoperative KPS score between the two groups(t=2.951,P=0.004).The postoperative functional status of the observation group was improved compared with the control group.5.The difference of ADL scores between the observation group and the preoperative group was statistically significant(t=2.380,P=0.020).The postoperative life ability of the observation group was higher than that of the preoperative group.There was no significant difference in the ADL score between the control group and the preoperative group.(t=0.512,P=0.610),the difference of postoperative ADL scores between the two groups was statistically significant(t=3.031,P=0.003),and the postoperative ability of the observation group was higher than that of the control group.6.There was a statistically significant difference in the average length of hospital stay between the two groups(t=3.005,P=0.004).The average length of hospital stay in the observation group was lower than that in the control group.There was a statistically significant difference in the satisfaction of nursing work(x~2=7.440,P=0.006).The difficulty of nursing work is higher than that of the control group.ConclusionThrough CGA assessment,individualized nursing intervention for elderly patients with full-thickness urinary diversion in the bladder can more comprehensively identify potential elderly problems in elderly patients,take active measures to control various risk factors,improve bladder function in patients with bladder cancer after total bladder resection and urinary diversion,reduce the incidence of postoperative complications,improve the quality of life,physical health and daily living ability,improve the satisfaction of patients with bladder cancer,and reduce hospital stay and the incidence of complications. |
PDF Full Text Request