Effects of hospital-family holistic care model on the health outcome of patients with permanent enterostomy based on the theory of 'Timing It Right'.

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.

Zhang X ，Gao R ，Lin JL ，Chen N ，Lin Q ，Huang GF ，Wang L ，Chen XH ，Xue FQ ，Li H ... -  《-》

Application of the hospital-family holistic care model in caregivers of patients with permanent enterostomy: A randomized controlled trial.

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. A prospective randomized controlled trial. 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. 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. 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. 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.

Zhang X ，Lin JL ，Gao R ，Chen N ，Huang GF ，Wang L ，Gao H ，Zhuo HZ ，Chen LQ ，Chen XH ，Li H ... -  《-》

Impact of Discharge Planning Combined with "Internet Home Ostomy Care Platform'' in Patients with Permanent Colostomy after Rectal Cancer Surgery.

Li M ，Yu K ，Zhang Y ，Mao A ，Dong L ... -  《-》

The effect of online training-based continuous nursing care for rectal cancer-patients undergoing permanent colostomy.

The study explored and analyzed the effects of online training based continuous nursing care on the health-related life quality and self-care ability of rectal cancer patients undergoing permanent colostomy. A total of 119 patients who were hospitalized and underwent permanent colostomy due to rectal cancer from January 2018 to December 2019 were collected as research subjects and were divided into the control group (n=57) and the observation group (n=62) based on their admission time. The control group received routine nursing, while the observation group was treated with online training based continuous nursing care in addition to routine nursing. Both groups' self-efficacy, self-care ability, quality of life, psychological status and complications within 6 months after discharge were compared. Both groups had increased scores in self-efficacy, and their dimensional scores and total scores of self-care ability after intervention were higher compared with pre-intervention (P<0.05), and the indexes of the observation group after intervention were significantly higher than that of the control group (P<0.05). The two groups had remarkably increased SF-36 scores of each dimension after intervention compared with pre-intervention (P<0.05), and the observation group had apparently higher SF-36 scores than the control group after intervention (P<0.05). The two groups had increased SAS and SDS grades in post-intervention compared with pre-intervention (P<0.05), and the observation group had notably higher SAS and SDS scores than the control group (P<0.05). The complication rate within 6 months after discharge in the observation group was obviously lower than which in the control group (P<0.05). An online training based continuous caring model can effectively improve the self-care ability and self-efficacy of rectal cancer patients with permanent enterostomy, thus promoting better life quality and psychological states, and effectively reducing the incidence of complications after discharge.

Huang Q ，Zhuang Y ，Ye X ，Li M ，Liu Z ，Li J ，Pan Z ... -  《American Journal of Translational Research》

Effect of Orem's self-care model on discharge readiness of patients undergoing enterostomy: A randomized controlled trial.

To evaluate the effectiveness of Orem's self-care model in preparing hospitals for the discharge of patients with colorectal cancer who undergo enterostomy. 92 patients with enterostomy were recruited between February 2022 and February 2023 from a general tertiary hospital. The participants were assigned to either the intervention group or the control group randomly. The intervention group received Orem's self-care program and a three-month follow-up, whereas the control group received only routine care and a three-month follow-up. Discharge readiness, self-care ability, and stoma-quality-of-life data were collected at hospital discharge (T1), 30 days (T2), and 90 days (T3) after discharge. The intervention group had substantially higher discharge readiness (knowledge, p < 0.001; coping ability, p = 0.006; personal status, p = 0.001; expected support, p = 0.021; total score, p < 0.001), better self-care ability at T1 (self-care knowledge, p < 0.001; self-care skills, p = 0.010), better total quality of life (QoL) at T1, T2, and T3 (p < 0.001; p = 0.006; p = 0.014); better stoma management and daily routine at T1 (p = 0.004; p < 0.001); and better daily routine at T2 (p = 0.009) than the control group. The designed discharge readiness program based on Orem's self-care could promote effective patient discharge readiness, self-care knowledge, self-care skills, and QoL. The trial number ChiCTR2200056302 registered on ClinicalTrials.gov.

Li SQ ，Luo CL ，Qiu H ，Liu YX ，Chen JM ... -  《-》