Aims: To evaluate the effectiveness of the hospital-family holistic care model based on the theory of 'Timing It Right' in caregivers of patients with permanent enterostomy.
Design: A prospective randomized controlled trial.
Methods: One hundred and twenty-five caregivers of patients with permanent enterostomy were recruited from 1 May 2017-31 August 2019. They were randomized into either intervention group (N = 62) or control group (N = 63). The control group received routine care and follow-up, while the intervention group received routine care, follow-up, and hospital-family holistic care intervention based on 'Timing It Right'. The care ability, psychological distress, and life quality of the caregivers were evaluated between the groups before the intervention, at discharge, and 3 and 6 months after discharge.
Results: One hundred and eleven caregivers completed the study (88.8%). At 3 and 6 months after discharge, the care ability and life quality in the intervention group were significantly better than those in the control group (t = 8.506/9.783, t = 22.652/26.179, p < 0.05) based on the t tests, and the psychological distress was lower than that in the control group. The ostomy adaptability of the control group was significantly lower than that in the intervention group (p < 0.001) based on the t tests, and the χ2 test showed that ostomy complication was more than that in the intervention group (23.81% vs. 12.90% and 34.92% vs. 19.35%; p < 0.05) at 3 and 6 months after discharge. The interaction between time and group showed that the effect of time factor varied with the group and the four evaluation indexes in the intervention group gradually improved with the extension of the observation time and were better than those in the control group based on generalized estimating equation model.
Conclusion: The hospital-family holistic care model based on 'Timing It Right' can effectively improve the care ability of caregivers of patients with permanent enterostomy, reduce psychological distress, and improve the quality of life.
Impact: The caregivers of patients with permanent enterostomy showed dynamic changes in their care experience and needs at different stages of the disease. The hospital-family holistic care intervention strategy based on 'Timing It Right' can effectively improve the caregiver's care ability, alleviate psychological distress, and improve the quality of life. Additionally, improving the patients' stoma adaptability and reducing the incidence of complications related to ostomy.
目的: 评价基于“适时”理论的医院--家庭整体护理模式对肠造口患者护理人员的有效性。 设计: 一项前瞻性随机对照试验。 方法: 2017年5月1日至2019年8月31日期限, 共计招募125名永久性肠造口患者护理人员。此类护理人员被随机分为干预组 (N=62) 和对照组 (N=63) 。对照组接受常规护理和随访, 而干预组将接受常规护理、随访和基于“适时”理论的医院--家庭整体护理干预。应分别在干预前、出院时、出院后3个月和出院后6个月对两组护理人员的护理能力、心理压力和生活质量进行评估。 结果: 共计111名护理人员完成本项研究 (88.8%) , 分别在出院后3个月和6个月进行t试验, 试验结果表明, 干预组的护理能力和生活质量明显优于对照组 (t=8.506/9.783,t=22.652/26.179,p<0.05) , 且心理压力明显低于对照组。t试验结果表明, 对照组的造口适应性明显低于干预组 (p<0.001) , 而χ2 试验结果表明, 术后3个月和6个月, 对照组的造口并发症明显多于干预组 (23.81%对比12.90%,34.92%对比19.35%;p<0.05) 。时间与组间的交互作用表明, 时间因素的影响因组而异, 干预组的四项评价指标随观察时间的延长而逐渐改善, 并且根据广义评价方程模型, 治疗组优于对照组。。 结论: 基于“适时”理论的医院--家庭整体护理模式能够有效地提高肠造口患者护理人员的护理能力, 缓解其心理压力, 并提高其生活质量。 影响: 不同患病阶段, 永久性肠造口患者护理人员的护理经验和需要呈动态变化。基于“适时”理论的医院--家庭整体护理干预策略能够有效地提高护理人员的护理能力, 缓解其心理压力, 并提高其生活质量。此外, 可通过上述干预策略提高患者造口的适应能力, 并减少造口相关并发症的发生。.
Keywords: care ability; caregivers; hospital-family care; nursing; permanent enterostomy; psychological distress; quality of life; timing it right.
© 2021 John Wiley & Sons Ltd.