Nursing Care of Patients Managed With a Defunctioning Tube Ileostomy: An Exploratory Study.

IF 1.7 3区 医学 Q2 NURSING Journal of Wound Ostomy and Continence Nursing Pub Date : 2024-09-01 Epub Date: 2024-09-21 DOI:10.1097/WON.0000000000001110
Feixia Wang, Qunmin Wang, Xia Li, Qin Wang, Hanju Hua, Zifeng Zhong
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Abstract

Purpose: The purpose of this study was to describe nurses' experiences of caring for patients with colorectal cancer who underwent surgery to create a spontaneously closed defunctioning tube ileostomy after low anterior resection.

Design: Exploratory, descriptive study.

Subjects and settings: Data were collected from 6 registered nurses specialized in Wound, Ostomy and Continence Care (WOC nurses). The patient cohort comprised 247 hospitalized patients with histologically confirmed colorectal cancer who underwent low anterior resection of the rectum and creation of a closed defunctioning tube ileostomy. The study setting was the First Affiliated Hospital, Zhejiang University School of Medicine.

Methods: Semi-structured interviews and content analysis were used to collect and analyze data. The Wound, Ostomy and Continence Care nurses visited patient participants 1 week after hospital discharge and 1 to 2 times per week until the cannula was removed and the ostomy wound closed. Data were collected over a 6-month span after the surgery from January 2016 to December 2018.

Results: Content analysis identified 7 management strategies unique to caring for patients with a closed defunctioning tube ileostomy. They are: (1) cannula fixation (securement); (2) maintaining inflation of the cannular balloon to prevent fecal flow into the distal bowel, (3) cannular patency, (4) dietary advice for prevention of cannular blockage, (5) selecting an ostomy pouching system, (6) patient education, and (7) care during and following cannula removal (extubation).

Conclusions: We identified 7 areas of nursing care unique to the closed defunctioning tube ileostomy that provide a basis for creating clinical guidelines for patients undergoing this procedure.

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对功能失调性管式回肠造口术患者的护理:一项探索性研究。
目的:本研究旨在描述护士护理结直肠癌患者的经验,这些患者在前路低位切除术后接受了自发闭合功能障碍管回肠造口手术:探索性、描述性研究:数据收集自 6 名专门从事伤口、造口和失禁护理的注册护士(WOC 护士)。患者队列包括 247 名经组织学确诊的结直肠癌住院患者,他们都接受了直肠低位前切除术,并建立了闭合式功能失调回肠造口。研究地点为浙江大学医学院附属第一医院:方法:采用半结构式访谈和内容分析法收集和分析数据。伤口、造口和尿路护理护士在患者出院后 1 周探访患者,每周探访 1 至 2 次,直至拔除插管并关闭造口伤口。数据收集时间跨度为术后 6 个月,从 2016 年 1 月至 2018 年 12 月:内容分析确定了 7 种护理闭式功能失调回肠造口患者的独特管理策略。它们是(1)插管固定(固定);(2)保持插管球囊充气以防止粪便流入远端肠道;(3)插管通畅;(4)预防插管堵塞的饮食建议;(5)选择造口袋系统;(6)患者教育;(7)插管移除(拔管)期间和之后的护理:我们确定了闭合式功能失调回肠造口术特有的 7 个护理领域,为为接受该手术的患者制定临床指南提供了依据。
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来源期刊
CiteScore
3.10
自引率
34.60%
发文量
186
审稿时长
6-12 weeks
期刊介绍: ​​The Journal of Wound, Ostomy and Continence Nursing (JWOCN), the official journal of the Wound, Ostomy and Continence Nurses Society™ (WOCN®), is the premier publication for wound, ostomy and continence practice and research. The Journal’s mission is to publish current best evidence and original research to guide the delivery of expert health care. The WOCN Society is a professional nursing society which supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and continence care needs.
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