基于互联网平台的4C延续性护理模式在肠造口患者中的应用

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摘要目的探讨基于互联网平台的4C延续性护理模式在肠造口患者中的应用效果。方法选取2019年12月至2020年8月昆明医科大学第三附属医院结直肠外科、胃与小肠外科收治的96例肠造口患者，按照随机数字表法将其分为对照组和实验组，每组48例。对照组给予常规护理，实验组在此基础上给予基于互联网平台的4C延续性护理模式，比较两组出院前，出院1、3个月的生活质量、自我护理能力、造口并发症发生率。结果整体分析发现：两组出院前，出院1、3个月生活质量评分组间比较、时间点比较及交互作用，差异均有统计学意义（P ＜ 0.05）。进一步两两比较，组内比较：对照组出院3个月除社会健康外，生理、心理、精神健康评分及总分均高于出院前，且出院3个月的心理健康及总分高于出院1个月，出院1个月高于出院前，差异有统计学意义（P ＜ 0.05）。实验组出院1、3个月的生活质量评分高于出院前，且出院3个月心理、社会、精神健康评分高于出院1个月，差异均有统计学意义（P ＜ 0.05）；组间比较：除出院1个月精神健康评分，实验组出院1、3个月其余维度评分与总分均高于同期对照组，差异均有统计学意义（P ＜ 0.05）。两组自我护理能力的评分时间、组间、交互作用比较，差异有统计学意义（P ＜ 0.05）。进一步两两比较，组内比较：对照组各时间点比较，差异均无统计学意义（P ＞ 0.05）；实验组除出院1个月自我护理技能，自我护理概念、自我护理责任感、自我护理技能、健康知识水平评分及总分均高于出院前，差异均有统计学意义（P ＜ 0.05）；组间比较：两组出院前比较，差异无统计学意义（P ＞ 0.05），实验组除出院1个月自我护理责任感及自我护理技能，其余各维度评分及总分高于同期对照组，差异均有统计学意义（P ＜ 0.05）。实验组出院1、3个月造口并发症的总发生率低于对照组，差异有统计学意义（P ＜ 0.05）。结论基于互联网平台的4C延续性护理模式有助于提高肠造口患者自我护理能力，减少造口并发症，提升生活质量。

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	王帅颖1 刘琴1 栾涛2 王庆喜3 肖梅玉3 韩媛1

关键词 ：肠造口, 延续性护理, 互联网, 个案管理, 家庭随访

Abstract：Objective To explore the application effect of 4C continuous nursing model based on internet platform in patients with enterostomy. Methods A total of 96 patients with enterostomy admitted to the Department of Colorectal Surgery and the Department of Gastroenterology and Intestinal Surgery in the Third Affiliated Hospital of Kunming Medical University from December 2019 to August 2020 were selected, according to the random number table method, they were divided into control group and experimental group, with 48 cases in each group. The control group was given routine care, and the experimental group was given 4C continuous nursing model based on the internet platform, the quality of life, self-care ability, and the incidence of ostomy complications were compared between the two groups before discharge, one month and three months after discharge. Results Overall analysis showed that there were statistically significant differences between groups, time points and interaction of quality of life evaluation at one and three months after discharge before discharge (P ＜ 0.05). In addition to social health, the scores and total scores of physical, psychological and mental health of the control group were all higher than before discharge three months after discharge, and the scores of mental health and total scores of three months after discharge were higher than that of one month after discharge, and the scores of one month after discharge were higher than that of before discharge, the differences were statistically significant (P ＜ 0.05). The scores of quality of life in the experimental group one and three months after discharge were higher than those before discharge, and the scores of psychological, social and mental health at three months after discharge were higher than those at one month after discharge, with statistical significance (P ＜ 0.05), comparison between groups: except the mental health score one month after discharge, the other dimensions and total scores of the experimental group were higher than those of the control group one and three months after discharge, and the differences were statistically significant (P ＜ 0.05). There were statistically significant differences in the scoring time, inter-group and interaction of self-care ability between the two groups (P ＜ 0.05), further pairwise comparison and intra-group comparison: there was no statistically significant difference at each time point in the control group (P ＞ 0.05). In the experimental group, the scores of self-care concept, self-care responsibility, self-care skills, health knowledge level and total score were all higher than those before discharge, with statistical significance (P ＜ 0.05). Comparison between groups: there was no significant difference between the two groups before discharge (P ＞ 0.05). The scores and total scores of the experimental group were higher than those of the control group in the same period except for self-care responsibility and self-care skills one month after discharge (P ＜ 0.05). The incidence of total ostomy complications in the experimental group was lower than that in the control group one month and three morehs after discharge, the difference was statistically significant (P ＜ 0.05). Conclusion The 4C continuous nursing model based on the internet platform is helpful to improve the self-care ability of enterostomy patients, reduce the complications of enterostomy, and improve the quality of life.

Key words： Enterostomy Continuous care Internet Case management Home follow-up

基金资助:云南省教育厅科学研究基金项目（2020Y0132）。

通讯作者: 刘琴（1973.12-），女，硕士，昆明医科大学第三附属医院胃与小肠外科护士长，副主任护师；研究方向：护理管理。

作者简介: 王帅颖（1994.12-），女，昆明医科大学第三附属医院2018级护理学在读硕士研究生；研究方向：肿瘤护理。

引用本文:

王帅颖1 刘琴1 栾涛2 王庆喜3 肖梅玉3 韩媛1. 基于互联网平台的4C延续性护理模式在肠造口患者中的应用[J]. 中国医药导报, 2021, 18(26): 165-169.
WANG Shuaiying1 LIU Qin1 LUAN Tao2 WANG Qingxi3 XIAO Meiyu3 HAN Yuan1. Application of 4C continuous nursing model based on internet platform in patients with enterostomy. 中国医药导报, 2021, 18(26): 165-169.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I26/165

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