提升腸造口術後病人自我照護改善專案

Special Article Improving Self-care Among Patients' Families After Enterostomy

目的：手術後完整的自我照護能力對腸造口術後病人自我效能、社交、經濟與生活品質有著極大的相關性，專案目的期望能提升腸造口術後病人自我照護認知及技能正確率進而增加自我照護信心，減少合併症的發生並提升病人之生活品質。方法：經現況分析發現單位腸造口術後病人自我照護認知正確率為40％，技能正確率為51.8％。確立問題為：病人或主要照顧者練習次數太少、護理師教育訓練、指導工具及護理作業程序不完整。解決方案：結合醫師、營養師及造口護理師，共同製作QRcode護理指導影片及指導手冊、修訂護理作業程序、增加造口模型示教及回示教並舉辦教育訓練講座。結果：專案施行後病人自我照護認知正確率由40％提升為98.4％，技能正確率由51.8％提升為97.8％，顯示專案介入措施成效顯著。結論透過跨團隊合作、進行流程改善及標準作業書修訂，有效提升腸造口術後病人自我照護認知、技能、信心及生活品質。

Purposes Complete self-care autonomy following an enterostomy operation has been shown to have significant positive correlations with patients' self-efficacy, social interactions, financial condition, and quality of life. This study aims to improve the levels of self-care awareness and abilities in patients who have undergone an enterostomy, thereby increasing self-care confidence, reducing complications, and improving patients' quality of life. Methods After analyzing the current situation, we found that the levels of self-care awareness and abilities in patients' families were 40% and 51.8%, respectively. The primary issues were: the patients or primary caregivers had very little practice; and the education, training, guidance tools, and nursing procedures for nurse practitioners were inadequate. Hence, doctors, nutritionists, and stoma nurse practitioners jointly developed a QR code-based nursing guidance video and instruction manual, revised the nursing operating procedures, improved the methods for teaching and evaluating the stoma model, and held educational and training lectures. Results After implementing this project, the levels of self-care awareness among the patients' families increased from 40% to 98.4%, and the levels of self-care abilities increased from 51.8% to 97.8%, suggesting that the intervention measures proposed by this study achieved remarkable results. Conclusions Through cross-functional cooperation, improvement of the process framework, and revision of the standard operating procedure, the self-care awareness, abilities, and confidence of patients' families, as well as the quality of life of patients after enterostomy, were effectively improved.