探索直肠癌保肛术病人低位前切除综合症的科学管理:一款症状管理平台的构建与评定
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">春日恰如许</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">阅读正当时</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">前 言</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">随着手术技术的进步、新辅助治疗的开展和<span style="color: black;">病人</span>的<span style="color: black;">剧烈</span>意愿,保肛手术已<span style="color: black;">作为</span>直肠癌切除的首选术式,<span style="color: black;">病人</span>可<span style="color: black;">保存</span>其原有肛门,避免永久性造口带来的身体形象改变及生活<span style="color: black;">不方便</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">然则</span>保肛术后70%~90%的<span style="color: black;">病人</span>会<span style="color: black;">显现</span>排便频率<span style="color: black;">增多</span>、排便紧迫感、排空<span style="color: black;">阻碍</span>、气体和大便失禁等症状,<span style="color: black;">乃至</span>有<span style="color: black;">病人</span>经历了大便从干硬到糊状的周期性肠道症状,<span style="color: black;">叫作</span>之为低位前切除<span style="color: black;">综合症</span>,在术后6个月内最为严重,<span style="color: black;">也</span>有<span style="color: black;">病人</span>在术后7~16年仍存在症状,<span style="color: black;">病人</span>感觉受制于自己的肠道症状并“被绑在了马桶上”,生理、心理及经济<span style="color: black;">包袱</span>均较重。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q5.itc.cn/q_70/images03/20240514/279df00648894aaeb14a580713b11535.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">保肛术后肠道症状的改善很大程度上依赖于<span style="color: black;">病人</span>自我管理。部分<span style="color: black;">病人</span><span style="color: black;">经过</span><span style="color: black;">吃下</span><span style="color: black;">药品</span>、<span style="color: black;">调节</span><span style="color: black;">膳食</span>、排便功能训练、<span style="color: black;">运用</span>卫生垫、提前<span style="color: black;">认识</span>出行地点<span style="color: black;">周边</span>厕所的位置等,可避免或减少肠道症状对其<span style="color: black;">平常</span>生活<span style="color: black;">导致</span>的影响。然而,出院之后大部分<span style="color: black;">病人</span>得到的支持性护理不足且肠道症状<span style="color: black;">拥有</span>个体差异性和不可预测性,<span style="color: black;">引起</span><span style="color: black;">病人</span>自我管理症状效果<span style="color: black;">不良</span>。随着信息技术的快速发展,移动医疗<span style="color: black;">作为</span><span style="color: black;">病人</span>健康管理的<span style="color: black;">要紧</span>手段,<span style="color: black;">能够</span>促进<span style="color: black;">病人</span><span style="color: black;">即时</span><span style="color: black;">得到</span>症状管理的<span style="color: black;">办法</span>,减轻症状<span style="color: black;">包袱</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">那要<span style="color: black;">怎样</span>搭建针对直肠癌保肛术<span style="color: black;">病人</span>的症状管理平台,以<span style="color: black;">加强</span><span style="color: black;">病人</span>管理肠道症状的便利性和有效性?本<span style="color: black;">科研</span>团队以症状管理理论为<span style="color: black;">指点</span>构建平台,<span style="color: black;">经过</span>医护人员和<span style="color: black;">病人</span>试用<span style="color: black;">持续</span>优化平台,以<span style="color: black;">供给</span>专业性、针对性<span style="color: black;">指点</span>,<span style="color: black;">病人</span>总体满意度较高。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">READING </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">方 法</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">1.成立<span style="color: black;">科研</span>团队</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">组建<span style="color: black;">科研</span>团队,<span style="color: black;">包含</span>科<span style="color: black;">专家</span>、护士长负责全面沟通协调,并审核平台设计<span style="color: black;">方法</span>及<span style="color: black;">颁布</span>内容;专科医护人员负责拟定平台设计<span style="color: black;">方法</span>,编写平台<span style="color: black;">颁布</span>内容;软件<span style="color: black;">开发</span>人员负责<span style="color: black;">根据</span>平台设计<span style="color: black;">方法</span>进行<span style="color: black;">开发</span>;信息工程师负责对平台功能进行测试及<span style="color: black;">守护</span>;<span style="color: black;">科研</span>生负责检索文献并<span style="color: black;">帮助</span>平台设计<span style="color: black;">方法</span>拟定、平台<span style="color: black;">颁布</span>内容编写、可用性测试。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">2.搭建平台技术框架</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">以症状管理理论为<span style="color: black;">指点</span>结合<span style="color: black;">日前</span>大数据<span style="color: black;">制品</span>的架构构建平台技术框架。用户应用层分为医护端和<span style="color: black;">病人</span>端,平台<span style="color: black;">按照</span>用户类型展示不同内容,实现不同操作。业务服务层:针对医护人员和<span style="color: black;">病人</span>不同的<span style="color: black;">运用</span>需求,设计不同的功能和模块。数据资源层:收集和储存平台的基本数据。用户应用层<span style="color: black;">经过</span><span style="color: black;">拜访</span>业务服务层来实现数据资源的前后台数据交互。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q3.itc.cn/q_70/images03/20240514/083ec5d09e4d4c629164e3bf13d36793.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">3.设计功能模块</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">(1)构建症状体验功能模块</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">病人</span>可在平台肠道症状体验日记模块记录肠道症状性质、特点,及其带来的感受和对生活的影响,并可<span style="color: black;">经过</span>肠道测评模块<span style="color: black;">评定</span>肠道症状的严重程度。<span style="color: black;">同期</span><span style="color: black;">亦</span>鼓励<span style="color: black;">病人</span>将其所经历的症状、体验、自我管理经验等以故事的形式在<span style="color: black;">病友</span>故事模块<span style="color: black;">颁布</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q3.itc.cn/q_70/images03/20240514/a33ae79e9a0d490e8c98e4890869199d.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">(2)构建症状管理策略功能模块</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">症状管理策略方面能实现平台与医院HIS系统对接,自动匹配责任护士与住院<span style="color: black;">大夫</span><span style="color: black;">做为</span><span style="color: black;">干涉</span>人员;设计符合肠道症状<span style="color: black;">出现</span>与<span style="color: black;">恢复</span>规律的<span style="color: black;">干涉</span>次数与随访提醒。设计肠道管理模块为<span style="color: black;">病人</span><span style="color: black;">供给</span><span style="color: black;">关联</span><span style="color: black;">疾患</span>信息和自我管理策略,<span style="color: black;">包含</span>临床表现、<span style="color: black;">出现</span>机制、影响<span style="color: black;">原因</span>、治疗<span style="color: black;">办法</span>等,<span style="color: black;">仔细</span>讲解<span style="color: black;">膳食</span>与营养、运动、用药、工作与社交等方面知识,盆底肌<span style="color: black;">熬炼</span>采用视频、动画的形式,并<span style="color: black;">需求</span><span style="color: black;">病人</span>每日完成盆底肌<span style="color: black;">熬炼</span>打卡。<span style="color: black;">同期</span>平台<span style="color: black;">供给</span>在线咨询模块,医护人员<span style="color: black;">按照</span><span style="color: black;">病人</span>的症状体验和<span style="color: black;">评定</span>结果以确定症状管理的重点,给予专业性、个性化<span style="color: black;">指点</span>。<span style="color: black;">另外</span>,设计<span style="color: black;">病友</span>交流模块以加强同伴支持。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q5.itc.cn/q_70/images03/20240514/b0fd2da8edf649a0b5f2e3687d757d0b.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">(3)构建症状管理效果<span style="color: black;">评估</span>功能模块</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">经过</span>构建平台以<span style="color: black;">创立</span>强大的用户数据库,<span style="color: black;">经过</span><span style="color: black;">病人</span>自我报告和客观指标<span style="color: black;">评估</span>症状管理效果。<span style="color: black;">病人</span><span style="color: black;">定时</span>在自我健康测评模块<span style="color: black;">经过</span>自我<span style="color: black;">评估</span>的方式,将其肠道症状、营养<span style="color: black;">情况</span>、自我管理<span style="color: black;">行径</span>及有效性、生活质量、复查结果等上传至该平台,<span style="color: black;">病人</span>可得到系统预设的<span style="color: black;">即时</span>反馈,医护人员在比较<span style="color: black;">病人</span>不同<span style="color: black;">恢复</span>时期健康<span style="color: black;">情况</span>后给予<span style="color: black;">评定</span>反馈并进行针对性的<span style="color: black;">指点</span>,以<span style="color: black;">帮忙</span><span style="color: black;">病人</span>和医护人员切实<span style="color: black;">把握</span><span style="color: black;">恢复</span>效果。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q3.itc.cn/q_70/images03/20240514/a7709300f686450b9177e02811831af7.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">READING </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">结 果</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">经过</span>访谈<span style="color: black;">发掘</span>试用对象认为该平台界面清楚友好、结构<span style="color: black;">恰当</span>、图文并茂,<span style="color: black;">拥有</span>较高的可用性,与定量调查结果相一致,医护人员和<span style="color: black;">病人</span>可用性<span style="color: black;">评估</span>的有用性、信息质量、界面质量和总体满意度均值均>4分。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q9.itc.cn/q_70/images03/20240514/6f822c62e250461f8c8feb5221c344ef.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">READING </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">结 论</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">直肠癌保肛术后肠道症状<span style="color: black;">出现</span>率较高,其症状多变,<span style="color: black;">连续</span>时间长,使得<span style="color: black;">病人</span>护理和管理需求频繁。<span style="color: black;">因此呢</span><span style="color: black;">经过</span>构建直肠癌保肛术<span style="color: black;">病人</span>肠道症状管理平台旨在为<span style="color: black;">病人</span><span style="color: black;">供给</span><span style="color: black;">疾患</span>和自我管理<span style="color: black;">关联</span>知识,以<span style="color: black;">帮忙</span><span style="color: black;">病人</span>尽快适应,<span style="color: black;">同期</span>术后<span style="color: black;">定时</span>进行肠道症状<span style="color: black;">评定</span>,以便<span style="color: black;">即时</span>对<span style="color: black;">病人</span>症状进行筛查和个性化<span style="color: black;">指点</span>,从而满足<span style="color: black;">病人</span>需求,改善健康<span style="color: black;">结果</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">READING </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">END</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">文案</span>作者:<span style="color: black;"><span style="color: black;"><span style="color: black;"><span style="color: black;"><span style="color: black;"><span style="color: black;"><span style="color: black;"><span style="color: black;">庞雪滢 胡少华 李慧 尹丹乔 王婷 符敏 俞士卉 </span></span></span></span></span></span></span></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">作者单位:安徽医科大学<span style="color: black;">第1</span><span style="color: black;">附庸</span>医院安徽医科大学护理学院</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">本文刊登于《中国护理管理》2022年第3期:</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">庞雪滢,胡少华,李慧,等.直肠癌<span style="color: black;">病人</span>低位前切除<span style="color: black;">综合症</span>症状管理平台的<span style="color: black;">研发</span>及可用性<span style="color: black;">评估</span>.中国护理管理,2022(3):445-449.</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">本刊将于5月16日15:00推出云作课直播:</span></strong><strong style="color: blue;"><span style="color: black;"><span style="color: black;">病痛</span>护理管理(一)</span></strong><strong style="color: blue;"><span style="color: black;">,欢迎广大投稿作者及审稿专家观看,直播链接:</span></strong><a style="color: black;"><span style="color: black;">返回<span style="color: black;">外链论坛:http://www.fok120.com/</span>,查看<span style="color: black;">更加多</span></span></a></p>
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