中国普外基础与临床杂志

中国普外基础与临床杂志

加速康复外科模式下结直肠癌患者出院准备度护患评估异性分析

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目的 比较加速康复外科模式下结直肠癌患者及其责任护士对出院准备度评估的差异性。 方法 横断面选取四川大学华西医院胃肠外科收治的 130 例结直肠癌患者及其住院期间的责任护士为研究对象,同时采用护评版出院准备度量表和患者版出院准备度量表进行调查。所有患者围手术期管理均按照加速康复外科流程进行。比较护患对结直肠癌患者出院准备度评估的差异。 结果 本研究共调查了结直肠癌患者 130 例,责任护士 40 位。护士对结直肠癌患者出院准备度的评分为(162.86±27.95)分,患者自评评分为(149.86±33.65)分。护患就“患者是否为出院回家作好准备”的评估结果的一致性较弱(κ=0.365,P<0.001)。患者自评出院准备度 4 个维度条目均分从高到低分别是:可获得社会支持、出院后应对能力、疾病知识和自身状况;护评结果条目均分由高到低分别是:可获得社会支持、疾病知识、出院后应对能力和自身状况。除“可获得的社会支持”维度外,其他维度的护评得分均明显高于患评得分(P<0.05)。 结论 护患关于加速康复外科模式下结直肠癌患者出院准备度的评估存在差异,护士高估了患者的出院准备度水平。

Objective To compare the differences in evaluating readiness for hospital discharge between nurses and colorectal cancer patients following enhanced recovery after surgery (ERAS) pathway. Methods A cross-sectional survey was conducted in Department of Gastrointestinal Surgery, West China Hospital, Sichuan University. Patient-reported Readiness for Hospital Discharge Scale (RHDS) and nurse-reported RHDS were delivered to 130 colorectal cancer (CRC) patients and 40 nurses respectively. All patients were followed ERAS pathway during perioperative periods. The differences were compared in evaluating readiness for hospital discharge between nurses and CRC patients. Results This study investigated 130 CRC patients and 40 responsible nurses. The scores of RHDS from nurses and patients were 162.86±27.95 and 149.86±33.65 respectively. 【XXXXXXXXXXXXXXXX(κ=0.365, P<0.001)】. Items in patients’RHDS scoring ranking from high to low were expected support, coping Ability, knowledge and personal status. Items in nurses’RHDS scoring ranking from high to low were expected support, knowledge, coping Ability, and personal status. Besides the" social support” dimension, the scores of other dimensions from nurses were significantly higher than those from patients (P<0.05). Conclusion There is a gap between the assessment of RHDS from nurses and patients, nurses overestimated patients’discharge readiness level.

关键词: 加速康复外科; 结直肠癌; 出院准备度; 差异分析

Key words: enhanced recovery after surgery; colorectal cancer; readiness for hospital discharge; difference analysis

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