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门诊护理环境中造口患者的健康相关生活质量

Health-Related Quality of Life in Persons With Ostomies Managed in an Outpatient Care Setting.

作者信息

Santos Vera Lucia Conceição de Gouveia, Augusto Fabiana da Silva, Gomboski Gustavo

机构信息

Vera Lucia Conceição de Gouveia Santos, PhD, MSN, BSN, CETN (TiSOBEST), Department of Medical-Surgical Nursing, University of São Paulo School of Nursing, São Paulo, SP, Brazil. Fabiana da Silva Augusto, BSN, ETN, University of São Paulo School of Nursing, São Paulo, SP, Brazil. Gustavo Gomboski, MSN, BSN, ETN, University of São Paulo School of Nursing, São Paulo, SP, Brazil.

出版信息

J Wound Ostomy Continence Nurs. 2016 Mar-Apr;43(2):158-64. doi: 10.1097/WON.0000000000000210.

Abstract

PURPOSE

We examined health-related quality of life (HRQOL) in persons with ostomies receiving outpatient care. We also analyzed relationships among HRQOL, demographic, and pertinent clinical factors.

DESIGN

We used a descriptive, exploratory, cross-sectional study design to collect and analyze data. Data in this article are a secondary analysis of data collected from a primary study, developed by Santos and Gomboski, on the adaptation and validation of the City of Hope-Quality of Life-Ostomy Questionnaire (COH-QOL-OQ) to the Portuguese language in Brazil.

SUBJECTS AND SETTING

A convenience sample of 215 adults living with an ostomy was evaluated. Slightly more than half (51.6%) were men, 67.5% underwent colostomy surgery, and 59.1% underwent cancer-related ostomy surgery. Subjects received care in specialized health care units in 3 cities in the Brazilian state of Rio Grande do Sul.

METHODS

After approval by the Research Ethics Committee and permission from health care units, data were collected using 2 instruments: the World Health Organization Quality of Life-Short Version (WHOQOL-Bref) (generic HRQOL instrument) and the COH-QOL-OQ (disease specific HRQOL instrument). Data were analyzed using χ test and logistic regression (via a stepwise forward method). Patients were classified into 3 groups according to the means and standard deviations of the scores: low, moderate, and high quality of life (QOL).

RESULTS

Ostomy patients had total scores of 69.6 ± 20.2 and 6.1 ± 1.4 for the WHOQOL-Bref and COH-QOL-OQ instruments, respectively. Patients with shorter times since their ostomy creation had worse scores on both the specific QOL (P = .006) and generic QOL (P = .019) instruments. Patients who did not practice religion (P = .027; odds ratio [OR] = 3.39) and those without a partner/spouse (P = .007; OR = 4.90) had increased probability of having worse scores on the WHOQOL-Bref (generic instrument).

CONCLUSION

Persons living with ostomies were found to have scores indicating moderate HRQOL on a disease-specific and generic instrument. Shorter time since ostomy creation, lack of religious practice, and lack of a partner negatively influenced the HRQOL of these patients.

摘要

目的

我们对接受门诊护理的造口术患者的健康相关生活质量(HRQOL)进行了研究。我们还分析了HRQOL、人口统计学因素和相关临床因素之间的关系。

设计

我们采用描述性、探索性横断面研究设计来收集和分析数据。本文中的数据是对Santos和Gomboski开展的一项初步研究收集的数据进行的二次分析,该初步研究是关于希望之城生活质量造口术问卷(COH-QOL-OQ)在巴西葡萄牙语环境下的改编和验证。

研究对象与研究背景

对215名成年造口术患者的便利样本进行了评估。略超过半数(51.6%)为男性,67.5%接受了结肠造口术,59.1%接受了与癌症相关造口术。研究对象在巴西南里奥格兰德州3个城市的专门医疗保健单位接受护理。

方法

经研究伦理委员会批准并获得各医疗保健单位许可后,使用两种工具收集数据:世界卫生组织生活质量简表(WHOQOL-Bref)(通用HRQOL工具)和COH-QOL-OQ(疾病特异性HRQOL工具)。使用χ检验和逻辑回归(通过逐步向前法)分析数据。根据得分的均值和标准差将患者分为3组:低生活质量、中等生活质量和高生活质量(QOL)。

结果

造口术患者的WHOQOL-Bref和COH-QOL-OQ工具的总分分别为69.6±20.2和6.1±1.4。造口术后时间较短的患者在特定QOL(P = 0.006)和通用QOL(P = 0.019)工具上的得分均较差。不参加宗教活动的患者(P = 0.027;优势比[OR]= = 3.39)和没有伴侣/配偶的患者(P = 0.007;OR = 4.90)在WHOQOL-Bref(通用工具)上得分较差的可能性增加。

结论

发现造口术患者在疾病特异性和通用工具上的得分表明其HRQOL为中等。造口术后时间较短以及缺乏宗教活动和伴侣对这些患者的HRQOL产生了负面影响。

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