Effects of hospital-family holistic care model on the health outcome of patients with permanent enterostomy based on the theory of 'Timing It Right'.
Timing It Right
ostomy complication
permanent enterostomy
quality of life
resilience
self-care agency
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
27
07
2019
revised:
29
11
2019
accepted:
10
01
2020
pubmed:
24
1
2020
medline:
21
10
2020
entrez:
24
1
2020
Statut:
ppublish
Résumé
To explore the effects of hospital-family holistic care model based on 'Timing It Right' on the health outcome of patients with permanent colostomy. Colorectal cancer is a common malignant tumour of digestive system, which seriously threatens human life and health. Colostomy is one of the main treatments for colorectal cancer, which effectively improves the 5-year survival rate of patients. However, the postoperative psychological and physiological rehabilitation nursing is still faced with great challenges due to the change of body image and defecation pathway caused by colostomy. A randomised controlled trial was conducted, and 119 patients with permanent enterostomy were randomly divided into two groups, with 60 cases in the intervention group and 59 cases in the control group. The intervention group received routine care follow-up and hospital-family holistic care intervention based on 'Timing It Right', while the control group received routine care and follow-up. The resilience, self-care ability, complications and life quality of patients with permanent enterostomy were compared between two groups before intervention, at discharge, 3 months and 6 months after discharge. CONSORT checklist was applied as the reporting guideline for this study (see Appendix S1). A total of 108 patients with permanent enterostomy completed the study (90.76%). At 3 months and 6 months after discharge, the resilience and quality of life in the intervention group were significantly better than those in the control group (t = 4.158 vs. 7.406, t = 4.933 vs. 8.611, p < .05), while the complications in the intervention group were significantly lower than that in the control group (25.5% vs. 41.51%, 14.45% vs. 30.19%; p < .05). The self-care ability of the intervention group was significantly better than that in the control group (t = 1.543 vs. 3.656 vs. 6.273, p < .05) at discharge, 3 months and 6 months after discharge. The interaction between time and grouping showed that the effect of time factor varied with the grouping. After intervention, there were significant differences in psychological resilience, self-care ability, complications and quality of life between the two groups at different observation points (p < .01). The three evaluation indices of intervention group increased with the migration of observation time points and were significantly better than those of control group, especially the quality of life (84.35 ± 4.25 vs. 60.45 ± 8.42, p < .01). The hospital-family holistic care model based on 'Timing It Right' can effectively improve the psychological resilience, self-care ability and quality of life; reduce complications; and improve the health outcomes of patients with permanent enterostomy. Patients with permanent enterostomy have different needs for nursing care at different stages of the disease, and they are dynamically changing. The hospital-family holistic care model based on 'Timing It Right' can effectively improve the health outcomes of patients with permanent enterostomy, which is worthy of clinical application.
Sections du résumé
AIMS AND OBJECTIVES
OBJECTIVE
To explore the effects of hospital-family holistic care model based on 'Timing It Right' on the health outcome of patients with permanent colostomy.
BACKGROUND
BACKGROUND
Colorectal cancer is a common malignant tumour of digestive system, which seriously threatens human life and health. Colostomy is one of the main treatments for colorectal cancer, which effectively improves the 5-year survival rate of patients. However, the postoperative psychological and physiological rehabilitation nursing is still faced with great challenges due to the change of body image and defecation pathway caused by colostomy.
METHODS
METHODS
A randomised controlled trial was conducted, and 119 patients with permanent enterostomy were randomly divided into two groups, with 60 cases in the intervention group and 59 cases in the control group. The intervention group received routine care follow-up and hospital-family holistic care intervention based on 'Timing It Right', while the control group received routine care and follow-up. The resilience, self-care ability, complications and life quality of patients with permanent enterostomy were compared between two groups before intervention, at discharge, 3 months and 6 months after discharge. CONSORT checklist was applied as the reporting guideline for this study (see Appendix S1).
RESULTS
RESULTS
A total of 108 patients with permanent enterostomy completed the study (90.76%). At 3 months and 6 months after discharge, the resilience and quality of life in the intervention group were significantly better than those in the control group (t = 4.158 vs. 7.406, t = 4.933 vs. 8.611, p < .05), while the complications in the intervention group were significantly lower than that in the control group (25.5% vs. 41.51%, 14.45% vs. 30.19%; p < .05). The self-care ability of the intervention group was significantly better than that in the control group (t = 1.543 vs. 3.656 vs. 6.273, p < .05) at discharge, 3 months and 6 months after discharge. The interaction between time and grouping showed that the effect of time factor varied with the grouping. After intervention, there were significant differences in psychological resilience, self-care ability, complications and quality of life between the two groups at different observation points (p < .01). The three evaluation indices of intervention group increased with the migration of observation time points and were significantly better than those of control group, especially the quality of life (84.35 ± 4.25 vs. 60.45 ± 8.42, p < .01).
CONCLUSIONS
CONCLUSIONS
The hospital-family holistic care model based on 'Timing It Right' can effectively improve the psychological resilience, self-care ability and quality of life; reduce complications; and improve the health outcomes of patients with permanent enterostomy.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
Patients with permanent enterostomy have different needs for nursing care at different stages of the disease, and they are dynamically changing. The hospital-family holistic care model based on 'Timing It Right' can effectively improve the health outcomes of patients with permanent enterostomy, which is worthy of clinical application.
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Pagination
2196-2208Subventions
Organisme : Dreyfus Health Founding (US)
ID : 230712 (606077)
Organisme : National Key Clinical Specialty Discipline Construction Program of China
ID : [2010]313
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Angott, A. M., Comerford, D. A., & Ubel, P. A. (2013). Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust? Patient Education & Counseling, 91, 113-119. https://doi.org/10.1016/j.pec.2012.10.015
Aoki, K., & Ishiguro, M. (2014). People with stomas - Issues and responses in critical periods. Gan to Kagaku Ryoho Cancer & Chemotherapy, 41(1), 11-14.
Armitage, P., Berry, G., & Matthews, J. N. S. (2008). Statistical methods in medical research (4th ed.). https://doi.org/10.1002/9780470773666.ch17
Beaver, K., Latif, S., Williamson, S., Procter, D., Sheridan, J., Heath, J., … Luker, K. (2010). An exploratory study of the follow-up care needs of patients treated for colorectal cancer. Journal of Clinical Nursing, 19, 3291-3300. https://doi.org/10.1111/j.1365-2702.2010.03407.x
Black, P. (2009). Stoma care nursing management: Cost implications in community care. British Journal of Community Nursing, 14, 350-352. https://doi.org/10.12968/bjcn.2009.14.8.43515
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185countries. CA: A Cancer Journal for Clinicians, 68, 394-424. https://doi.org/10.3322/caac.21492
Burch, J. (2013). The pre- and postoperative nursing care for patients with a stoma. British Journal of Nursing, 14, 310-318. https://doi.org/10.12968/bjon.2005.14.6.17799
Cameron, J. I., & Gignac, M. A. M. (2008). “Timing It Right”: A conceptual framework for addressing the support needs of family caregivers to stroke survivors from the hospital to the home. Patient Education and Counseling, 70, 305-314. https://doi.org/10.1016/j.pec.2007.10.020
Cameron, J. I., Naglie, G., Gignac, M. A., Bayley, M., Warner, G., Green, T., … Cheung, A. M. (2014). Randomized clinical trial of the timing it right stroke family support program: Research protocol. BMC Health Services Research, 14, 18. https://doi.org/10.1186/1472-6963-14-18..
Chen, W., Zheng, R., Baade, P. D., Zhang, S., Zeng, H., Bray, F., … He, J. (2016). Cancer statistics in China. CA: A Cancer Journal for Clinicians, 66, 115-132. https://doi.org/10.3322/caac.21338
Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety, 18, 78-82. https://doi.org/10.1002/da.10113
Finan, P., & Haboubi, N. (2012). The Miles operation extralevator abdominoperineal excision. Colorectal Disease, 14, 1171-1172. https://doi.org/10.1111/j.1463-1318.03191.x
Frigiola, A., Bull, C., & Wray, J. (2014). Exercise capacity, quality of life, and resilience after repair of tetralogy of Fallot: A cross-sectional study of patients operated between 1964-2009. Cardiology in the Young, 24, 79-86. https://doi.org/10.1017/S1047951112002296
Geng, Z., Howell, D., Xu, H., & Yuan, C. (2017). Quality of life in Chinese persons living with an ostomy: Amultisite cross-sectional study. Journal of Wound, Ostomy and Continence Nursing, 44, 249-256. https://doi.org/10.1097/WON.0000000000000323
Ginger, D. S. (2013). The incidence of stoma and peristomal complications during the first 3 months after ostomy creation. Journal of Wound, Ostomy and Continence Nursing, 40, 400-406. https://doi.org/10.1097/WON.0b013e318295a12b
Haraldsdottir, S., Einarsdottir, H. M., Smaradottir, A., Gunnlaugsson, A., & Halfdanarson, T. R. (2014). Colorectal cancer - Review. Laeknabladid, 100, 75-82.
Hou, W. K., Law, C. C., Yin, J., & Fu, Y. T. (2010). Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: A growth mixture modeling approach. Health Psychology, 29, 484-495. https://doi.org/10.1037/a0020809
Hu, A., Pan, Y., Zhang, M., Zhang, J., Zheng, M., Huang, M., … Wu, X. (2014). Factors influencing adjustment to a colostomy in Chinese patients: A cross-sectional study. Journal of Wound, Ostomy and Continence Nursing, 41, 455-459. https://doi.org/10.1097/WON.0000000000000053
Jakobsson, J., Idvall, E., & Kumlien, C. (2017). The lived experience of recovery during the first six months after colorectal cancer surgery. Journal of Clinical Nursing, 26, 4498-4505. https://doi.org/10.1111/jocn.13780
Lee, C. M., Herridge, M. S., Matte, A., & Cameron, J. I. (2009). Education and support needs during recovery in acute respiratory distress syndrome survivors. Critical Care, 13(5), R153. https://doi.org/10.1186/cc8053
Lim, S. H., Chan, S. W., & He, H. G. (2015). Patients' experiences of performing self-care of stomas in the initial postoperative period. Cancer Nursing, 38, 185-193. https://doi.org/10.1097/NCC.0000000000000158
Lim, S. H., Chan, S. W., Lai, J. H., & He, H. G. (2015). A randomized controlled trial examining the effectiveness of a STOMA psychosocial intervention programme on the outcomes of colorectal patients with a stoma: Study protocol. Journal of Advanced Nursing, 71, 1310-1323. https://doi.org/10.1111/jan.12595
Luo, S., Luo, S., & Liao, Q. (2014). Study on colostomy lavage and defecation regularity of patients with permanent colostomy. China Medical Herald, 11, 122-125.
Lyu, L., Zheng, M., & Huang, M. (2015). Quality of life and its influencing factors among permanent colostomy patients. Chinese Journal of Practice Nursing, 31, 2359-2364. https://doi.org/10.3760/cma.j.issn.1672-7088.2015.31.005
McCorkle, R., Ercolano, E., Lazenby, M., Schulman-Green, D., Schilling, L. S., Lorig, K., & Wagner, E. H. (2011). Empowering patients living with cancer as a chronic illness. CA: A Cancer Journal for Clinicians, 61, 50-62. https://doi.org/10.3322/caac.20093
Millan, M., Tegido, M., & Biondo, S. (2010). Preoperative stoma siting and education by stomatherapists of colorectal cancer patients a descriptive study in twelve Spain colorectal surgical units. Colorectal Disease, 17, 88-92. https://doi.org/10.1111/j.1463-1318.2009.01942.x
Min, J. A., Jung, Y. E., Kim, D. J., Yim, H. W., Kim, J. J., Kim, T. S., … Chae, J. H. (2013). Characteristics associated with low resilience in patients with depression and/or anxiety disorders. Quality of Life Research, 22, 231-241. https://doi.org/10.1007/s11136-012-0153-3
Murre, J. M., & Dros, J. (2015). Replication and analysis of Ebbinghaus' forgetting curve. PLoS ONE, 10, 1-23. https://doi.org/10.1371/journal.pone.0120644
Nichols, T. R. (2015). Health-related quality of life in community-dwelling persons with ostomies: The physical functioning domain. Journal of Wound, Ostomy and Continence Nursing, 42, 374-377. https://doi.org/10.1097/WON.0000000000000
Person, B., Ifargan, R., Lachter, J., Duek, S. D., Kluger, Y., & Assalia, A. (2012). The impact of preoperative stoma site marking on the incidence of complications, quality of life, and patient's independence. Diseases of the Colon & Rectum, 55, 783-787. https://doi.org/10.1097/DCR.0b013e31825763f0
Prieto, L., Thorsen, H., & Kristian, J. (2005). Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy. Health and Quality of Life Outcomes, 3, 62-71.
Santos, V. L., Augusto, F. S., & Gomboski, G. (2016). Health-related quality of life in persons with ostomies managed in an outpatient care setting. Journal of Wound, Ostomy and Continence Nursing, 43, 158-164. https://doi.org/10.1097/WON.0000000000000210
Siegel, R. L., Miller, K. D., Fedewa, S. A., Ahnen, D. J., Meester, R. G. S., Barzi, A., & Jemal, A. (2017). Colorectal cancer statistics. CA: A Cancer Journal for Clinicians, 67, 177-193. https://doi.org/10.3322/caac.21395
Tao, H., Songwathana, P., Isaramalai, S.-A., & Wang, Q. (2014). Taking good care of myself: A qualitative study on self-care behavior among Chinese persons with a permanent colostomy. Nursing & Health Sciences, 16, 483-489. https://doi.org/10.1111/nhs.12166
Wang, H. H., & Laffrey, S. C. (2001). Preliminary development and testing of instruments to measure self-care agency and social support of women in Taiwan. Kaohsiung Journal of Medical Sciences, 16, 459-467.
Wu, X., Jin, X.-Y., & Shang, S.-M. (2011). Reliability and validity of the Chinese version of the Stoma-QOL questionnaire. Chinese Nursing Management, 11, 23-25.
Yamashita, M. (1998). The exercise of self-care agency scale. Western Journal of Nursing Research, 20, 370-381. https://doi.org/10.1177/019394599802000308
Yu, X. N., Zhang, J. X., & Yu, X. N. (2007). Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale (CD-RISC) with Chinese people. Social Behavior and Personality, 12, 19-30. https://doi.org/10.2224/sbp.2007.35.1.19
Zhang, Y., Xian, H., Yang, Y., Zhang, X., & Wang, X. (2019). Relationship between psychosocial adaptation and health-related quality of life of patients with stoma: A descriptive, cross-sectional study. Journal of Clinical Nursing, 28, 2880-2888. https://doi.org/10.1111/jocn.14876