肠造口患者初期不同阶段生活质量调查及影响因素分析

目的 探讨肠造口患者初期生活质量的变化及各阶段生活质量的影响因素.方法 选取2009年12月-2010年10月确诊为直肠癌行Miles术肠造口患者60例,采用欧洲癌症研究与治疗组织的生活质量核心量表（EORTC QLQ-C30）第3版分别对肠造口患者出院时、出院1个月、出院3个月生活质量进行调查,并进行多因素分析.结果 出院时、出院1个月、出院3个月生活质量总分分别为（6.68±1.490）,（9.12±1.474）,（10.80±1.695）分,差异有统计学意义（F=106.100,P＜0.01）;功能量表、症状量表、症状子量表得分3个阶段比较差异均有统计学意义（F值分别为90.941,7.612,3.619,P＜0.05）;症状及子症状于出院1个月时加重,3个月时有所恢复.生活质量量表多元逐步回归分析结果显示,出院时,年龄和文化程度为生活质量的主要影响因素;出院1个月时,文化程度、造口护理者、排便情况、治疗和并发症5个因素为生活质量的主要影响因素;出院3个月时,年龄、收入、医保、造口护理者、治疗和并发症6个因素为生活质量的主要影响因素.结论 通过本研究为护理人员寻求有针对性及时调整的干预方案,为最大限度地提高造口患者的生活质量提供科学依据.

Investigation and influencing factors of life quality of patients with colostomy at early different stages

Objective To explore the change and influencing factors of life quality of patients with colostomy at early different stages.Methods Sixty rectum cancer patients with Miles colostomy from December 2009 to October 2010 were chosen.The life quality of patients were surveyed by European organization for research and treatment of cancer （EORTC QLQ-C30） at the time of discharge,the first and third month after the discharge,and the data were analyzed by multivariate analysis.Results The total scores of life quality were respectively （6.68 ± 1.490）,（9.12 ± 1.474）,（10.80 ± 1.695） at the time of discharge,the first and third month after the discharge,and the difference was statistically significant （F =106.100,P 〈 0.01）.The differences were found in the scores of the function scale,symptom scale and symptom subscale at three stages,and the differences were statistically significant （F =90.941,7.612,3.619,respectively; P 〈 0.05）.The symptom and mild symptom were aggravated at the time of discharge and the first month after the discharge,and were recovery on the third month after the discharge.Multiple regression analysis of quality of life showed that the main influencing factors on the life quality of patients were age and education at the time of discharge,and were education,stoma nurses,defecation,treatment and complication on the first month after the discharge,and were age,income,medical insurance,stoma nurses,treatment and complication on the third month after the discharge.Conclusions This study provides scientific evidence for nurses to seek the targeted and timely intervention programs and improve the life quality of patients with colostomy to the utmost extent.