ISSN 2097-6054(网络) ISSN 1672-9234(印刷) CN 11-5289/R
主管:中国科学技术协会 主办:中华护理学会
出版:中华护理杂志社
收录:中国科学引文数据库(CSCD)来源期刊
   中国期刊全文数据库
   中国核心期刊(遴选)数据库
   Scopus
健康教育与健康促进

直肠癌预防性回肠造口高排量健康教育效果评价指标体系的构建研究

  • 张思苑 ,
  • 高欢玲 ,
  • 刘利红 ,
  • 李红梅 ,
  • 马彩虹 ,
  • 崔彩彩 ,
  • 吕旭晶 ,
  • 陈薇镜 ,
  • 杜晓龙
展开
  • 032200 山西省汾阳市 山西医科大学汾阳学院(张思苑,高欢玲,李红梅,马彩虹,崔彩彩,吕旭晶,陈薇镜,杜晓龙);山西省汾阳医院胃肠肛门外科(刘利红)
张思苑,女,本科(硕士在读),护士,E-mail:18236038269@163.com

收稿日期: 2024-05-13

  网络出版日期: 2025-03-21

基金资助

吕梁市科技计划项目(2024SHFZ41);山西省研究生实践创新项目(2024SJ222)

Establishment of an evaluation index system of high output health education for patients with rectal cancer undergoing preventive ileostomy

  • Siyuan ZHANG ,
  • Huanling GAO ,
  • Lihong LIU ,
  • Hongmei LI ,
  • Caihong MA ,
  • Caicai CUI ,
  • Xujing Lü ,
  • Weijing CHEN ,
  • Xiaolong DU
Expand

Received date: 2024-05-13

  Online published: 2025-03-21

摘要

目的 构建适用于直肠癌预防性回肠造口术后患者的高排量健康教育效果评价指标体系,为临床护理人员评估患者健康教育效果,开展针对性的健康教育和指导提供依据。 方法 以知信行理论为指导,通过文献研究、半结构式访谈法、德尔菲法及层次分析法,确定直肠癌预防性回肠造口高排量健康教育效果评价指标体系及各指标权重。 结果 2轮专家函询的有效问卷回收率分别为75%(15/20)和87%(13/15),专家判断依据系数为0.873、0.969,专家熟悉程度为0.920、0.938,专家权威程度为0.897、0.954,2轮函询各级指标的肯德尔和谐系数分别为0.267~0.338、0.377~0.397(P<0.05)。最终构建的直肠癌预防性回肠造口高排量健康教育效果评价指标体系包括3个一级指标、13个二级指标和63个三级指标。 结论 构建的直肠癌预防性回肠造口高排量健康教育效果评价指标体系能够为临床护理人员进行全面、高效的健康教育效果评价提供参考。

本文引用格式

张思苑 , 高欢玲 , 刘利红 , 李红梅 , 马彩虹 , 崔彩彩 , 吕旭晶 , 陈薇镜 , 杜晓龙 . 直肠癌预防性回肠造口高排量健康教育效果评价指标体系的构建研究[J]. 中华护理教育, 2025 , 22(3) : 348 -354 . DOI: 10.3761/j.issn.1672-9234.2025.03.015

Abstract

Objective To establish an evaluation index system for health education among high output stoma patients with low anterior resection of rectal cancer and preventive ileostomy so as to provide reference for clinical nurses to carry out targeted health education and guidance for prophylactic ileostomy patients with high output stoma. Methods Literature review,semi-structured interviews,as well as the Delphi method and Multi-dimensional Analytic Hierarchy Process were used to establish a framework of the evaluation index system based on the theory of Knowledge-Belief-Practice and set weighted value for each evaluation index. Results The response rates of the two rounds of expert consultations was 75% and 87%,respectively. The expert authority coefficients was 0.873 and 0.969,respectively. The total Kendall harmony coefficients of the two rounds of expert consultations were 0.267-0.338 and 0.377-0.397(P<0.05). As a result,an evaluation index system of health education was developed which comprised three first-level indexes,13 second-level indexes and 63 third-level indexes for high output stoma patients with low anterior resection of rectal cancer and preventive ileostomy. Conclusion The evaluation index system can provide evidence and a practice tool for clinical nurses in conducting a comprehensive and efficient evaluation of health education among high output stoma patients with low anterior resection of rectal cancer and preventive ileostomy.

参考文献

[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249.
[2] Mohammed S, Anaya DA, Awad SS, et al. Sphincter preservation rates after radical resection for rectal cancer in the United States Veteran population:opportunity for improvement in early disease[J]. Ann Surg Oncol, 2015, 22(1):216-223.
[3] 张卫. 《中低位直肠癌手术预防性肠造口中国专家共识(2022版)》解读[J]. 中华胃肠外科杂志, 2022, 25(6):479-481.
[3] Zhang W. Interpretation of Chinese expert consensus on protective ostomy for mid-low rectal cancer in China (version 2022)[J]. Chin J Gastrointest Surg, 2022, 25(6):479-481.
[4] Pisarska M, Gajewska N, Ma?czak P, et al. Defunctioning ileosto-my reduces leakage rate in rectal cancer surgery - systematic review and meta-analysis[J]. Oncotarget, 2018, 9(29):20816-20825.
[5] Lightner AL, Pemberton JH. The role of temporary fecal diversion[J]. Clin Colon Rectal Surg, 2017, 30(3):178-183.
[6] Takeda M, Takahashi H, Haraguchi N, et al. Factors predictive of high-output ileostomy:a retrospective single-center compara-tive study[J]. Surg Today, 2019, 49(6):482-487.
[7] Nissinen MJ, Gylling H, Jarvinen HJ, et al. Ileal pouch-anal anastomosis,conventional ileostomy and ileorectal anastomosis modify cholesterol metabolism[J]. Dig Dis Sci, 2004, 49(9):1444-1453.
[8] 楼征. 肠造口手术治疗学[M]. 上海: 上海科学技术出版社, 2019.
[9] Nightingale J. How to manage a high-output stoma[J]. Frontline Gastroenterol, 2022, 13(2):140-151.
[10] Fielding A, Woods R, Moosvi SR, et al. Renal impairment after ileostomy formation:a frequent event with long-term conse-quences[J]. Colorectal Dis, 2020, 22(3):269-278.
[11] Borucki JP, Schlaeger S, Crane J, et al. Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy. A systematic review and meta-analysis[J]. Colorectal Dis, 2021, 23(7):1721-1732.
[12] Lederhuber H, Massey LH, Kantola VE, et al. Clinical mana-gement of high-output stoma:a systematic literature review and meta-analysis[J]. Tech Coloproctol, 2023, 27(12):1139-1154.
[13] Nagle D, Pare T, Keenan E, et al. Ileostomy pathway virtually eliminates readmissions for dehydration in new ostomates[J]. Dis Colon Rectum, 2012, 55(12):1266-1272.
[14] Vanloon YT, Poylin VY, Nagle D, et al. Effectiveness of the ileostomy pathway in reducing readmissions for dehydration:does it stand the test of time?[J]. Dis Colon Rectum, 2020, 63(8):1151-1155.
[15] Gonella F, Valenti A, Massucco P, et al. A novel patient-cen-tered protocol to reduce hospital readmissions for dehydration after ileostomy[J]. Updates Surg, 2019, 71(3):515-521.
[16] Zhang Q, Sun JN, Wang DX, et al. Knowledge,attitudes,prac-tices and associated factors regarding high output stoma of ileostomy among colorectal surgical nurses:a multicentre cross-sectional study[J]. Support Care Cancer, 2023, 32(1):12.
[17] 赵泽英, 邓颖辉, 丁妮, 等. 肠造口高排量的研究进展[J]. 护理研究, 2020, 34(2):291-294.
[18] Iqbal A, Raza A, Huang E, et al. Cost Effectiveness of a novel attempt to reduce readmission after ileostomy creation[J]. JSLS, 2017, 21(1).
[19] 林鸿缘, 陈璟, 刘颖洁, 等. 直肠癌预防性回肠造口患者的营养教育[J]. 护理学杂志, 2022, 37(10):10-14.
[19] Lin HY, Chen J, Liu YJ, et al. Nutrition education for patients with rectal cancer undergoing prophylactic ileostomy[J]. J Nurs Sci, 2022, 37(10):10-14.
[20] 黄敬亨. 健康教育学[M]. 上海: 复旦大学出版社, 2003.
[21] 郭秀花. 医学现场调查技术与统计分析[M]. 北京: 人民卫生出版社, 2009.
[22] 卢佳美, 李维, 廖金莲, 等. 鼻咽癌放化疗患者健康教育效果评价指标体系的构建[J]. 中华护理杂志, 2022, 57(8):942-950.
[22] Lu JM, Li W, Liao JL, et al. Establishment of an evaluation index system for health education among nasopharyngeal carcinoma patients with radio-chemotherapy[J]. Chin J Nurs, 2022, 57(8):942-950.
[23] Migdanis A, Migdanis I, Koukoulis GD. Nutritional considera-tions in colorectal surgery in diverting ileostomy patients:a review[J]. Cureus, 2023, 15(11):e48102.
[24] 董玲, 欧玉兰, 颜媛媛. 成人回肠造口病人营养管理的研究进展[J]. 全科护理, 2024, 22(7):1240-1244.
[24] Dong L, Ou YL, Yan YY. Research progress on nutritional management of adult ileostomy patients[J]. Chin Gen Pract Nurs, 2024, 22(7):1240-1244.
[25] Fish DR, Mancuso CA, Garcia-Aguilar JE, et al. Readmission after ileostomy creation:retrospective review of a common and significant event[J]. Ann Surg, 2017, 265(2):379-387.
文章导航

/