中华护理杂志 ›› 2026, Vol. 61 ›› Issue (16): 2165-2173.DOI: 10.3761/j.issn.0254-1769.2026.16.001
• 消化系统疾病护理专题 • 下一篇
收稿日期:2025-10-20
出版日期:2026-08-20
发布日期:2026-08-14
*通讯作者:
汤玉梅,E-mail:tangyumei1976@126.com作者简介:蒋艳琳:女,本科,主管护师,E-mail:15838093537@163.com蒋艳琳:资料收集与分析、论文撰写与修改;侯梦晓:资料收集;张桂菊:论文审阅与修改;汤玉梅:研究指导、经费支持
基金资助:
JIANG Yanlin(
), HOU Mengxiao, ZHANG Guiju, TANG Yumei*(
)
Received:2025-10-20
Online:2026-08-20
Published:2026-08-14
* Corresponding author:
TANG Yumei,E-mail:tangyumei1976@126.comFunding program:摘要:
目的 探究虚拟现实(virtual reality,VR)干预对结直肠癌造口患者出院准备度与出院早期自我管理能力的影响,为促进患者从医院向家庭的平稳过渡提供借鉴。 方法 采用便利抽样法,选取2024年1—10月郑州市某三级甲等医院收治的结直肠癌造口患者作为研究对象,将2024年6—10月收治的48例患者纳入试验组,2024年1—5月收治的48例患者纳入对照组。试验组在常规围手术期健康教育基础上,于术后第3天至出院前实施虚拟现实干预,对照组接受常规围手术期健康教育。分别于出院当天评估患者出院准备度,于术后3 d、出院当天、出院后1个月和3个月评估两组的自我管理能力及造口适应能力,并计算造口并发症发生率。 结果 试验组、对照组均脱落2例,每组有46例参与完整研究。试验组出院准备度总分和各维度得分均高于对照组,差异均有统计学意义(P<0.05)。广义估计方程分析显示,两组自我管理能力及造口适应能力的组间效应、时间效应及交互效应均有统计学意义(均P<0.05)。两组造口并发症发生率比较,差异无统计学意义(P=0.099)。结论 在常规围手术期健康教育基础上,实施虚拟现实干预可有效提升结直肠癌造口患者的出院准备度及早期自我管理能力,增强造口适应能力,且安全性良好。
蒋艳琳, 侯梦晓, 张桂菊, 汤玉梅. 虚拟现实干预对结直肠癌造口患者出院准备度与自我管理能力影响的研究[J]. 中华护理杂志, 2026, 61(16): 2165-2173.
JIANG Yanlin, HOU Mengxiao, ZHANG Guiju, TANG Yumei. Impact of a virtual reality intervention program on discharge readiness and self-management ability of patients with colorectal cancer stoma[J]. Chinese Journal of Nursing, 2026, 61(16): 2165-2173.
![]() |
表4 两组自我管理能力得分和造口适应能力得分的比较[分,M(P25,P75)]
Table 4 Comparison of self-management ability and stoma adaptability scores between the 2 groups[scores,M(P25,P75)]
![]() |
| [1] | Han BF, Zheng RS, Zeng HM, et al. Cancer incidence and mortality in China,2022[J]. J Natl Cancer Cent, 2024, 4(1):47-53. |
| [2] | Yan MH, Lv L, Zheng MC, et al. Quality of life and its influencing factors among Chinese patients with permanent colostomy in the early postoperative stage:a longitudinal study[J]. Cancer Nurs, 2022, 45(1):E153-E161. |
| [3] |
Zhang X, Zhou L, Zhang FJ, et al. Network analysis of psychosocial adaptation in intestinal stoma patients:a national cross-sectional study in China[J]. J Adv Nurs, 2026, 82(2):1243-1252.
DOI URL |
| [4] | 熊丹莉, 潘路晨, 杨赛, 等. 出院准备计划方案在老年肠造口患者中的应用研究[J]. 护理学杂志, 2023, 38(19):100-104. |
| Xiong DL, Pan LC, Yang S, et al. Application of discharge planning service in elderly patients with stoma[J]. J Nurs Sci, 2023, 38(19):100-104. | |
| [5] |
van der Storm SL, Consten ECJ, Govaert MJPM, et al. Better stoma care using the stoma App:does it help? A first randomized double-blind clinical trial on the effect of mobile healthcare on quality of life in stoma patients[J]. Surg Endosc, 2024, 38(3):1442-1453.
DOI |
| [6] |
孙慧慧, 庄金珊, 程莉洁, 等. 虚拟现实辅助下肝移植患者术后运动干预方案的构建及应用研究[J]. 中华护理杂志, 2025, 60(21):2565-2572.
DOI |
|
Sun HH, Zhuang JS, Cheng LJ, et al. Construction and application research of a virtual reality-assisted exercise intervention program for liver transplantation[J]. Chin J Nurs, 2025, 60(21):2565-2572.
DOI |
|
| [7] |
Niki K, Nakagawa S, Arai M, et al. Effect of immersive virtual reality on chemotherapy-related side effects in patients receiving paclitaxel-carboplatin with or without bevacizumab:2-arm randomized controlled trial[J]. J Med Internet Res, 2025, 27:e65924.
DOI URL |
| [8] | 赵煜华, 王俊霞, 吴田瑞, 等. 肠造口患者出院准备度干预方案的构建及应用[J]. 护理学杂志, 2023, 38(9):6-9. |
| Zhao YH, Wang JX, Wu TR, et al. Development and application of a discharge readiness intervention program in stoma patients[J]. J Nurs Sci, 2023, 38(9):6-9. | |
| [9] | 李欣颖, 郑学风, 王淑云, 等. 预防性肠造口患者出院早期自我管理现状及影响因素分析[J]. 护理学杂志, 2021, 36(1):18-21. |
| Li XY, Zheng XF, Wang SY, et al. Self-management and its influencing factors among patients receiving preventive enterostomy in early discharge[J]. J Nurs Sci, 2021, 36(1):18-21. | |
| [10] | 江律薇, 左文青, 王莹, 等. 基于《促进以患者为中心的学习》指南的肠造口患者健康教育方案的构建[J]. 中华现代护理杂志, 2023, 29(22):2963-2969. |
| Jiang LW, Zuo WQ, Wang Y, et al. Construction of a health education program for enterostomy patients based on the guideline of facilitating client centered learning[J]. Chin J Mod Nurs, 2023, 29(22):2963-2969. | |
| [11] | 司龙妹, 张泽曦, 李朝煜, 等. 世界造口治疗师协会《国际造口指南(第2版)》要点解读[J]. 中华现代护理杂志, 2023, 29(5):561-565. |
| Si LM, Zhang ZX, Li ZY, et al. Interpretation of international ostomy guideline(second edition) by World Council of Enterostomal Therapists[J]. Chin J Mod Nurs, 2023, 29(5):561-565. | |
| [12] | 中华医学会外科学分会结直肠外科学组, 中国医师协会结直肠肿瘤专业委员会, 中国医师协会肛肠医师分会, 等. 结直肠(癌)手术永久性肠造口专家共识(2025版)[J]. 中华现代护理杂志, 2025, 28(6):587-598. |
| Colorectal Surgery Group of Society of Surgery of Chinese Medical Association, Professional Committee of Colorectal Oncology of Chinese Medical Doctor Association, Anorectal Branch of Chinese Medical Doctor Association, et al. Expert consensus on permanent ostomy for colorectal cancer(version 2025)[J]. Chin J Mod Nurs, 2025, 28(6):587-598. | |
| [13] |
Ouyang RG, Long Y, Zhang JQ, et al. Interventions for improving self-efficacy in patients after stroke based on self-efficacy-related principles of Bandura’s cognition theory:a systematic review and meta-analysis[J]. Top Stroke Rehabil, 2023, 30(8):820-832.
DOI URL |
| [14] |
Weiss ME, Piacentine LB. Psychometric properties of the Readiness for Hospital Discharge Scale[J]. J Nurs Meas, 2006, 14(3):163-180.
DOI PMID |
| [15] | 于清舒, 陆连芳, 王淑云, 等. 肠造口患者出院准备度量表的编制及信效度检验[J]. 中国实用护理杂志, 2020, 36(13):998-1002. |
| Yu QS, Lu LF, Wang SY, et al. Preparation of Discharge Readiness Scale for Patients with Enterostomy and reliability and validity test[J]. Chin J Pract Nurs, 2020, 36(13):998-1002. | |
| [16] | 韩舒. 肠造口患者自我管理现状及医院—社区—家庭护理模式构建的研究[D]. 青岛: 青岛大学, 2014. |
| Han S. Study on the self-management status of enterostomy patients and the construction of hospital-community-family nursing model[D]. Qingdao: Qingdao University, 2014. | |
| [17] |
Simmons KL, Smith JA, Maekawa A. Development and psychometric evaluation of the ostomy adjustment inventory-23[J]. J Wound Ostomy Continence Nurs, 2009, 36(1):69-76.
DOI PMID |
| [18] | 皋文君, 袁长蓉. 中文版造口患者适应量表的信效度测评[J]. 中华护理杂志, 2011, 46(8):811-813. |
| Gao WJ, Yuan CR. Reliability and validity evaluation of Chinese version of Stoma Patient Adaptation Scale[J]. Chin J Nurs, 2011, 46(8):811-813. | |
| [19] | 封蕾, 李云姝, 杨杰, 等. 基于虚拟现实技术的体感游戏融入居家透析运动管理对透析患者跌倒风险及生活质量的影响[J]. 中国血液净化, 2021, 20(5):302-305,332. |
| Feng L, Li YS, Yang J, et al. Virtual reality somatosensory games integrated into the home exercise management and its effects on fall risk and quality of life in dialysis patients[J]. Chin J Blood Purif, 2021, 20(5):302-305,332. | |
| [20] |
旷婉, 祝敏, 胡露红. 简短的正念干预在围手术期患者中应用的范围综述[J]. 中华护理杂志, 2026, 61(5):707-714.
DOI |
| Kuang W, Zhu M, Hu LH. Brief mindfulness-based interventions in perioperative surgical patients:a scoping review[J]. Chin J Nurs, 2026, 61(5):707-714. | |
| [21] |
许采颉, 潘爱红, 徐佩丽, 等. 结直肠癌造口患者围手术期主动健康行为干预方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(10):1301-1309.
DOI |
|
Xu CJ, Pan AH, Xu PL, et al. Construction and preliminary application of a proactive health behaviors intervention program in colorectal cancer patients undergoing ostomy surgery during the perioperative period[J]. Chin J Nurs, 2026, 61(10):1301-1309.
DOI |
|
| [22] | Akbari M, Taheri M, Tabaeian SP, et al. The effect of e-learning on self-efficacy and sense of coherence of cancer caregivers:application of the bandura and antonovsky social cognitive theory[J]. Curr Health Sci J, 2021, 47(4):539-546. |
| [23] |
Corvese F, Giordano V, Alvaro R, et al. Sociodemographic characteristics and self-care management knowledge of patients with an ostomy[J]. Br J Nurs, 2020, 29(22):S20-S26.
DOI PMID |
| [24] |
Lin L, Zheng J, Lin Z, et al. Understanding the challenges of readiness for hospital discharge in stoma patients:a mixed-methods study[J]. J Clin Nurs, 2025, 34(5):1704-1712.
DOI URL |
| [25] | 郑兆丽, 钟梦诗, 李文, 等. 早期适应干预方案对结直肠癌肠造口患者自我效能及社会心理适应水平的影响和安全性[J]. 现代中西医结合杂志, 2024, 33(2):283-287. |
| Zheng ZL, Zhong MS, Li W, et al. Effect and safety of early adaptation intervention program on self-efficacy and psychosocial adaptation level of colorectal cancer patients undergoing enterostomy[J]. Mod J Integr Tradit Chin West Med, 2024, 33(2):283-287. | |
| [26] |
Song QF, Yin GX, Guo XP, et al. Effects of a self-management program for patients with colorectal cancer and a colostomy:a nonrandomized clinical trial[J]. J Wound Ostomy Continence Nurs, 2021, 48(4):311-317.
DOI PMID |
| [27] |
Denti FC, Guerra E, Caroppo F, et al. Exploring the impact of a structured educational approach on peristomal skin complications:an interim analysis[J]. Healthcare, 2024, 12(18):1805.
DOI URL |
| [1] | 中华护理学会静脉输液治疗专业委员会, 北京护理学会, (执笔:李佳, 李旭英, 覃惠英, 陈利芬, 吴珍明, 胡泽吟, 罗梦娜, 范育英, 吴嘉慧, 林宇萍, 王蕾, 孙文彦, 冯毕龙, 高伟, 李亚南, 侯罗娅, 李春燕. 中心静脉通路装置拔除护理专家共识[J]. 中华护理杂志, 2026, 61(9): 1157-1162. |
| [2] | 周霞, 马艳艳, 师正坤, 于海霞, 周艳, 胡红玲, 李莜, 陈思思, 张京慧. 隧道式经股静脉PICC置入术在困难静脉通路婴幼儿中的应用研究[J]. 中华护理杂志, 2026, 61(9): 1163-1170. |
| [3] | 黄萍, 李黎, 郭骊莉, 徐莹, 叶赟, 江淑芳. 与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用[J]. 中华护理杂志, 2026, 61(9): 1171-1179. |
| [4] | 李佳, 张玉玲, 邢乐, 张利峰, 牛秀峰, 许莉. 早产儿经上肢置入PICC尖端继发性异位风险预测模型的建立与验证[J]. 中华护理杂志, 2026, 61(9): 1180-1186. |
| [5] | 何娟, 赵蕾蕾, 叶冠军, 余艳芬, 傅晓君, 周琴. 1例双侧无名静脉及上腔静脉人工血管置换术后患者经上肢置入PICC的护理[J]. 中华护理杂志, 2026, 61(9): 1187-1191. |
| [6] | 梁江淑渊, 曾妃, 何鹏, 谢梦珊, 江悦, 蒋宗恒, 王建茗. 静脉-静脉体外膜肺氧合患者早期活动风险等级评估系统的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1192-1199. |
| [7] | 陈晨, 顾肖, 郭凡, 王敏, 倪兴梅, 黄琴, 程念开. 3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值[J]. 中华护理杂志, 2026, 61(9): 1200-1207. |
| [8] | 郑煜琳, 刘晋宁, 张静, 郭会敏, 谷艳梅, 张莉莉. 酒精性肝病患者肝移植术后再饮酒现状及其影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1208-1214. |
| [9] | 叶俊霜, 沈丽佳, 孟霞靓, 张玉姣, 蔡根莲, 邵碧云, 周亚辉, 张柳倩, 应金萍. 维持性血液透析患者对口腔衰弱认知和体验的质性研究[J]. 中华护理杂志, 2026, 61(9): 1215-1220. |
| [10] | 王芸姣, 杨玉金, 郑春艳, 彭菲津, 王淑贞, 蒋喜露, 周为民, 王薇, 张娜. 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1221-1229. |
| [11] | 杨明霞, 安冉, 臧金凤, 李春梅. 老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析[J]. 中华护理杂志, 2026, 61(9): 1230-1236. |
| [12] | 梁和静, 许鹊, 史云霞, 祖金美, 黄文静, 杨春旭, 郭明华, 王磊. 颈动脉内膜剥脱术围手术期护理质量评价指标的构建[J]. 中华护理杂志, 2026, 61(9): 1237-1244. |
| [13] | 韩媛媛, 石玉竹, 尚文涵, 么莉. 870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1245-1252. |
| [14] | 夏云芳, 王洪, 崔岱, 付真真, 朱敏. 1例弥漫性毒性甲状腺肿合并超敏反应综合征青少年患者的护理[J]. 中华护理杂志, 2026, 61(9): 1253-1256. |
| [15] | 周益飞, 王海苹, 胡益环, 应莉, 罗松娜. 1例氢氟酸中毒并发呼吸心搏骤停患者的急救护理[J]. 中华护理杂志, 2026, 61(9): 1257-1260. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||