The Influence Of Peer Education Model On The Early Quality Of Life Of Patients With Stoma After Operation

Objective:Local resection of low rectal cancer,and pull a section of intestine out of the abdominal cavity,enterostomy on the abdominal wall;total cystectomy for bladder cancer,Ureterostomy or ileostomy is needed to replace bladder.Although stoma can effectively treat patients’ diseases and prolong their lives,however,urination and defecation are not controlled by the patient’s self-consciousness and are accompanied by the patient for life,It leads to patients’ fear of facing stoma,psychological anxiety,inferiority and other negative emotions.The purpose of this paper is to explore the influence of peer education model on the quality of life of patients with stoma after operation,improve the details of peer education model,and analyze the effect of peer education model.Method:The subjects of the study were the patients who received the first stoma from July 2018 to June 2019 in a third class a hospital in Nanjing.According to the source of the disease area,the patients with urostomy in the first area of urology were treated as the control group,and the patients in the second area of urology were treated as the experimental group.Patients with enterostomy were divided into two groups according to time.The experimental group was from July 2018 to December 2018,and the control group was from January 2019 to June 2019.The control group was given routine nursing: the nurse guided the patients and their families to know the knowledge of stoma nursing,issued the stoma nursing package and informed the usage of it,guided the patients to receive the outpatient follow-up on time.In addition to routine nursing,the patients in the experimental group were also given peer education for 3 months.The quality of life and self-efficacy of stoma scale(SSEs)were used to screen out the peer education volunteers,who were trained and assessed,qualified to become peer education volunteers,and implemented interventions.Two groups of patients in the day before discharge,one month after discharge and three months after discharge were assessed by the quality of life scale of patients with stoma,self-efficacy scale of stoma,and adaptation scale of patients with stoma,and collected data to analyze the impact of peer education mode on the quality of life of patients with stoma.Results:1.Before the intervention,the baseline data of the two groups showed that 105 patients participated in the study,51 in the experimental group and 54 in the control group.Among them,89.90% were men and 10.10% were women.There was no significant difference in general data such as gender,weight,height,BMI index,education level,marital status,occupation,income and living status between the experimental group and the control group,and there was significant difference in age(P=0.0003),working status(P=0.0066)and medical insurance type(P=0.0207).2.The covariance analysis of the quality of life score table of the patients with stoma in the control group and the intervention group showed that there was no significant difference between the two groups in the influence of pocket making on the patients,the relationship with family members and friends one day before discharge and one month after discharge,and there was significant difference between the two groups three months after discharge.There was significant difference between the two groups in social interaction one day before discharge(P=0.0263)and three month after discharge(P=0.0011),and there was no significant difference between the two groups one months after discharge.There was no significant difference between the two groups in physical and mental condition one day before discharge,one month after discharge.There was significant difference between the two groups in physical and mental condition three months after discharge(P=0.0078).3.For the control group and the intervention group,there was no statistical difference in stoma care,social function,diet choice,sexual life and sexual life satisfaction between the two groups.The difference of self-care efficiency of stoma between the two groups was statistically significant at the day three months after discharge(P=0.0083).4.The results of covariance analysis showed that there was no significant difference between the two groups in ostomy reception one day before discharge,one month after discharge and three months after discharge.There was significant difference in the life attitude of the patients and stoma adaptation one day before discharge,one month after discharge and three months after discharge.Conclusion:1.Peer education intervention can improve the social interaction of patients with stoma.It has positive significance in the influence of stoma bag on patients and the relationship with family members and friends,so as to improve the quality of life of patients with stoma.2.Peer education intervention can improve the positive emotion,reduce the negative emotion and improve the stoma adaptation of patients with stoma.