目的:本研究旨在研究出院准备(RHD)和造口自我效能感(SSE)在结直肠癌临时肠造口患者出院教学质量(QDT)与健康相关生活质量(HRQOL)之间的关系中的中介作用。中介效应的性别差异。
背景:尚不清楚RHD如何,QDT,SSE和HRQOL在结直肠癌临时肠造口患者中相互作用。
方法:这是一项前瞻性随访调查。从中国东南部的一家综合医院方便地招募了221例临时肠造口术的结直肠癌患者。出院质量教学量表,医院出院量表的准备情况,造口自我效能感量表,和Stoma生活质量量表用于收集数据。采用Pearson相关和结构方程模型对数据进行分析。采用SPSS26.0和Amos28.0软件对收集的数据进行分析。
结果:关于QDT和HRQOL的关系,只有QDT-T在有气孔的结直肠癌患者中有直接作用(b=0.233,P<0.001,百分位数95%CI=[0.145,0.314]).然而,QDT-T和QDT-R都可以通过三个途径间接预测HRQOL:(1)SSE的中介作用(b=0.050,P=0.009,百分位数95%CI=[0.013,0.098];b=0.077,P=0.008,百分位数95%CI=[0.021,0.164]),(2)RHD的中介作用(b=0.044,P=0.004,百分位数95%CI=[0.014,0.085];b=0.044,P=0.005,百分位数95%CI=[0.010,0.102]),(3)SSE和RHD的链介导作用(b=0.030,P=0.003,百分位数95%CI=[0.011,0.059];b=0.047,P=0.003,百分位数95%CI=[0.015,0.103])。在男性造口患者中也发现了类似的链介导效应(b=0.041,P=0.002,百分位数95%CI=[0.016,0.080];b=0.046,P=0.004,百分位数95%CI=[0.011,0.114])。
结论:造口自我效能和出院准备在结直肠癌造口患者出院教学质量与健康相关生活质量的关系中起重要中介作用。医疗保健提供者可以为患有临时肠造口术的结直肠癌患者设计SSE增强和RHD增强的出院计划。
OBJECTIVE: This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect.
BACKGROUND: It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy.
METHODS: This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson\'s correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data.
RESULTS: Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]).
CONCLUSIONS: Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.