摘要
目的分析尿路造口患者在不同时间点症状群纵向变化,为临床医务人员采取前瞻性干预措施提供理论依据。方法选取2018年12月至2019年6月于昆明医科大学第二附属医院行根治性全膀胱切除术造口术患者,在患者术后1周、1个月、3个月使用中文版安德森症状评估量表的第一部分内容调查其症状群。结果完成有效调查的患者共59例,在三个时间点,每个症状群内有特定的症状。探索性因子分析后患者术后1周呈现出4个症状群集,方差累计贡献率57.75%,包括造口相关症状群、疼痛相关症状群、胃肠道症状群、躯体症状群;术后1月呈现出3个症状群集,方差累计贡献率55.45%,包括造口相关症状群、疼痛相关症状群、躯体症状群;术后3月的分析结果呈现出3个症状群集,方差累计贡献率59.24%,包括造口相关症状群、疼痛相关症状群、躯体症状群,症状群最严重为术后1月造口相关症状群,得分为(6.27±1.41)分,除胃肠道症状群外各症状群在三个时间节点均有差异(P<0.05)。结论护理人员对膀胱全切尿路造口患者应该持续关注,尤其在患者出院至术后1月该时间段,对尿路造口患者的症状管理首先应着重于造口护理的管理,教会患者识别可能出现的造口护理症状并教会患者处理可能出现的情况。
Objective To analyze the longitudinal changes of symptom groups in patients with urinary ureterostomy at different time points, and provide a theoretical basis for clinical medical staff to take prospective intervention measures. Methods Patients who underwent radical total urinary ureterostomy at the Second Affiliated Hospital of Kunming Medical University from December 2018 to June 2019 were selected and the first part of the Chinese version of M.D.Anderson Symptom Inventory(MDASI) was used to assess their symptom clusters at 1 week, 1 month and 3 months after the operation. Results A total of 59 patients completed the effective investigation. At three time points, each symptom group had specific symptoms. After exploratory factor analysis,the patient presented 4 symptom clusters 1 week after surgery, with a cumulative variance contribution rate of57.75%, including ostomy-related symptom cluster, pain-related symptom cluster, gastrointestinal symptom cluster,and somatic symptom cluster;1 month after surgery 3 symptom clusters were presented, with a cumulative variance contribution rate of 55.45%, including stoma-related symptom cluster,pain-related symptom cluster,and somatic symptom cluster. Analysis results at 3 months after surgery showed 3 symptom clusters with a cumulative variance contribution rate of 59.24%,including ostomy-related symptomcluster, pain-related symptom cluster,and somatic symptom cluster, among which the most severe symptom cluster was the ostomy-related symptom 1 month after surgery,with a score of 6.27±1.41.Except for the gastrointestinal symptom group, each symptom group has differences at three time nodes(P < 0.05). Conclusion Nursing staff should keep paying attention to patients with urinary tract ostomy,especially during the period from the patient’s discharge to 1 month after surgery. Symptom management of urinary tract ostomy patients should first focus on the management of ostomy care and teach patients identify possible ostomy symptoms and teach patients to deal with possibl
作者
钱阳凤
杨明莹
王俊
余力锐
赵喜娟
陶诗琪
QIAN Yang-feng;YANG Ming-ying;WANG Jun;YU Li-rui;ZHAO Xi-juan;TAO Shi-qi(Dept.of Nursing,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China;Dept.of Urology,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)
出处
《昆明医科大学学报》
CAS
2020年第8期176-180,共5页
Journal of Kunming Medical University
基金
云南省教育厅科学研究基金资助项目(2020J0179)。
关键词
尿路造口
症状群
探索性因子分析
Urethral stoma
Symptom cluster
Exploratory factor analysis
