The influence of the evidence-based program of “five fixations and four observations” on the quality of life and application effect of patients with rectal cancer stoma

doi:10.3877/cma.j.issn.1674-3946.2025.04.016.

Abstract

Abstract:

Objective

To explore the application effect of the evidence-based nursing program of “five fixations and four observations” in patients with stoma after rectal cancer surgery and its influence on complications and quality of life.

Methods

A total of 80 patients with stoma after rectal cancer surgery admitted from January 2021 to June 2024 were selected as the research subjects. They were randomly divided into the observation group and the control group according to the random number table method, with 40 patients in each group. The control group received routine nursing care, and the observation group adopted the evidence-based nursing program of “five fixations and four observations” on the basis of routine nursing care.The SPSS 22.0 statistical software was used to analyze the data. Measurement data were expressed as (),and independent sample t tests were used; Enumeration data were expressed as ［cases (%)］, and χ² tests were performed. P<0.05 was considered to indicate a statistically significant difference.

Results

The nursing satisfaction of the patients in the observation group was significantly higher than that in the control group (95.0% vs. 77.5%, P<0.05), and the total incidence of complications was significantly reduced (12.5%vs. 35.0%, P<0.05). After the intervention, the scores of self-care ability (ESCA) and quality of life (EORTC QLQ-C30) in the observation group were both higher than those in the control group (both P<0.05).

Conclusion

The evidence-based nursing program of “five fixations and four observations” can effectively improve the nursing satisfaction of patients with stoma after rectal cancer, reduce the incidence of complications, and improve their self-care ability and quality of life, which has clinical promotion value.

Key words: Rectal Neoplasms, Ostomy, Five-Determination and Four-Observation Evidence-Based Nursing, Postoperative Complications, Quality of Life

Linpu Xin, Min Yang, Junfeng Du. The influence of the evidence-based program of “five fixations and four observations” on the quality of life and application effect of patients with rectal cancer stoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 409-412.

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Figures/Tables 5

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )	造口类型（例）	造口部位（例）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )	临时性/永久性	回肠/结肠
观察组	40	22/18	58. 2±6. 5	23. 6±1. 3	32/8	34/6
对照组	40	23/17	59. 1±7. 2	24. 4±2. 1	31/9	35/5
χ ²/t 值		0. 067	-0. 232	-1. 774	0. 075	0. 105
P值		0. 795	0. 817	0. 081	0. 785	0. 745

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )	造口类型（例）	造口部位（例）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )	临时性/永久性	回肠/结肠
观察组	40	22/18	58. 2±6. 5	23. 6±1. 3	32/8	34/6
对照组	40	23/17	59. 1±7. 2	24. 4±2. 1	31/9	35/5
χ ²/t 值		0. 067	-0. 232	-1. 774	0. 075	0. 105
P值		0. 795	0. 817	0. 081	0. 785	0. 745

组别	例数	非常满意	满意	不满意	护理满意度
观察组	40	25(62. 5)	13(32. 5)	2(5. 0)	38(95. 0)
对照组	40	15(37. 5)	16(40. 0)	9(22. 5)	31(77. 5)
χ ²值		-	-	-	5. 164
P值		-	-	-	0. 023

组别	例数	造口周围皮肤感染	造口狭窄	造口脱垂	造口旁疝	总并发症
观察组	40	2(5. 0)	1(2. 5)	0(0. 0)	2(5. 0)	5(12. 5)
对照组	40	6(15. 0)	4(10. 0)	1(2. 5)	3(7. 5)	14(35. 0)
χ ²值		-	-	-	-	5. 591
P值		-	-	-	-	0. 018

组别	例数	时间	自我护理技能	自我责任感	自我概念	健康知识水平
观察组	40	干预前	30. 2±4. 5	22. 1±3. 2	25. 3±3. 8	35. 6±5. 2
		干预后	45. 6±5. 8^ab	30. 5±4. 1^ab	35. 8±4. 5^ab	48. 7±6. 3^ab
对照组	40	干预前	30. 5±4. 8	22. 3±3. 5	22. 5±3. 6	35. 8±5. 0
		干预后	38. 2±5. 1^a	26. 3±3. 8^a	30. 2±4. 2^a	42. 1±5. 8^a

组别	例数	时间	躯体功能	角色功能
观察组	40	干预前	50. 2±6. 3	45. 5±5. 8
		干预后	68. 7±7. 5^ab	60. 2±6. 5^ab
对照组	40	干预前	50. 5±6. 5	45. 8±5. 6
		干预后	60. 1±7. 0^a	52. 3±6. 0^a
组别	例数	时间	认知功能	情绪功能	社会功能
观察组	40	干预前	52. 3±6. 5	48. 6±6. 0	46. 7±5. 5
		干预后	65. 8±7. 0^ab	62. 5±7. 2^ab	60. 3±6. 2^ab
对照组	40	干预前	52. 5±6. 3	48. 8±6. 2	46. 9±5. 3
		干预后	58. 2±6. 8^a	54. 3±6. 8^a	52. 1±5. 8^a

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