尿路造口患者自护能力现状及其影响因素分析

目的调查尿路造口患者出院后自护能力的现状并分析其影响因素,旨在为该类患者自护能力的干预性研究提供依据。方法于2019年6—9月选取门诊就诊的尿路造口患者为调查对象,采用一般资料调查表、造口自我护理量表-早期版（SSCS-ESV）、中文版造口接受度问卷、自尊量表、社会影响量表（SIS）进行调查。结果共收回有效问卷191份,有效回收率为90.95%（191/210）。自护情况:59例（30.89%）完全自己护理造口（完全自护组）,29例（15.18%）需要他人协助护理造口（协助自护组）,103例（53.93%）不是自己护理造口（非自护组）。完全自护、协助自护组造口自护得分分别为（34.71±2.12）分、（26.62±3.82）分,处于中等水平。有序Logistic回归分析显示,造口存在时间、术后开始自护时间、造口接受度、病耻感是影响患者自护情况的主要因素;多元逐步回归分析显示,造口存在时间、造口接受度、自尊水平、病耻感是影响患者出院后自护水平的主要因素。结论尿路造口患者的造口自护能力处于中等水平,以自护情况、自护水平及其影响因素作为干预的切入点,可提高患者造口的自护能力和生活质量。

Self-Care Ability of Patients with Urostomy and its Influencing Factors

Objective To investigate the current situation of self-care ability and its influencing factors in urostomy patients after discharge,and to provide a basis for the intervention research on self-care ability of urostomy patients.Methods Urostomy patients admitted to the outpatient department from June to September 2019 were surveyed using the general information questionnaire,early stage version of stoma self-care scale(SSCS-ESV),Chinese version of colostomy acceptance questionnaire,self-esteem scale,and social impact scale(SIS).Results A total of 191 valid questionnaires were collected,and the effective recovery rate was 90.95%(191/210).Among the 191 urostomy patients,59(30.89%)completed self-nursing(complete self-care group),29(15.18%)needed assistance(assisted self-care group),and 103(53.93%)did not performed self-nursing(non-self-care group).The score of self-care was 34.71±2.12 in complete self-care group,and 26.62±3.82 in assisted self-care group,which were in the middle level.The orderly logistic regression analysis showed that the main factors affecting complete self-care included stoma existence time,self-care start time,stoma acceptance and stigmatisation.Multiple stepwise regression analysis showed that stoma existence time,stoma acceptance,self-esteem and stigmatization were the main factors influencing the self-care ability of urostomy patients.Conclusion The self-care ability of urostomy patients is in the middle level.Interventions based on self-care situation,self-care level and their influencing factors can improve the self-care ability and quality of life of urostomy patients.