肠造口患者社会疏离感干预方案的构建及初步验证

doi:10.3761/j.issn.0254-1769.2026.05.008

摘要/Abstract

摘要：

目的构建肠造口患者社会疏离感干预方案，并初步验证该方案减轻肠造口患者社会疏离感的临床可行性，以期为促进患者健康行为发展提供参考。方法 2023年12月—2024年11月，基于计划行为理论与助推策略，通过混合研究、文献研究、专家会议构建肠造口患者社会疏离感干预方案；采用便利抽样法，选取2024年8—10月在泸州市某三级甲等医院胃肠外科及造口门诊肠造口患者为研究对象，并按时间分为试验组和对照组。试验组接受基于专家会议修订的干预方案，对照组接受科室常规健康教育。分别在干预前及干预后4周，对两组社会疏离感、自尊及自我隐瞒水平进行评估。结果 16名专家参与专家会议，有效问卷回收率为100%，专家权威系数为0.86，共提出6条修改建议；最终形成了包括5项干预主题、共14条干预措施的肠造口患者社会疏离感干预方案；共纳入39例肠造口患者，分为试验组（20例）、对照组（19例）。干预前两组一般资料比较，差异无统计学意义（P>0.05）；干预后4周，试验组社会疏离感各维度得分及总分均低于对照组，试验组自尊得分高于对照组、自我隐瞒得分低于对照组，差异有统计学意义（P<0.05）。结论该研究构建的肠造口患者社会疏离感干预方案具有一定的科学性和可行性，可减轻肠造口患者的社会疏离感、提高其自尊感受、降低其自我隐瞒倾向。

关键词: 肠造口, 社会疏离感, 计划行为理论, 助推策略, 干预方案, 护理

Abstract:

Objective To construct an intervention program for social alienation in patients with enterostomy，and preliminarily verify the clinical feasibility of this program in reducing social alienation in enterostomy patients. It is expected to provide a reference for clinical nursing to promote the development of healthy behaviors in patients. Methods From December 2023 to November 2024，based on the theory of planned behavior and nudge strategies，an intervention program for social alienation in patients with enterostomy was constructed through mixed-methods research，literature research，expert meetings. Patients with enterostomy who attended the Department of Gastrointestinal Surgery and Stoma Clinic of a tertiary A hospital in Luzhou from August to October 2024 were selected as research subjects using the convenient sampling method. They were divided into an intervention group and a control group by time stratification. The control group received routine health education of the department，while the intervention group received the intervention program revised by expert meetings. The levels of social alienation，self-esteem，and self-concealment of patients in both groups were evaluated before the intervention and 4 weeks after the intervention，respectively. Results A total of 16 experts participated in the expert meeting，with a 100% valid questionnaire return rate and an expert authority coefficient of 0.86. 6 modification suggestions were proposed, leading to the development of an intervention program for social alienation in enterostomy patients，which included 5 intervention themes and 14 intervention measures. A total of 39 enterostomy patients were enrolled，and they were divided into an experimental group（20 cases） and a control group（19 cases）. No statistically significant differences were found in the general data of both groups before the intervention（P>0.05). At 4 weeks after the intervention, the experimental group scored lower than the control group on all dimensions of social alienation and total score，while the experimental group had higher self-esteem scores and lower self-concealment scores than the control group, with statistically significant differences（P<0.05). Conclusion The intervention program can alleviate social alienation，enhance self-esteem，and reduce self-concealment tendencies in patients with enterostomy.

Key words: Enterostomy, Social Alienation, Theory of Planned Behavior, Nudge Strategies, Intervention Program, Nursing Care

严满琳, 黄薇融, 张智慧, 李显蓉. 肠造口患者社会疏离感干预方案的构建及初步验证[J]. 中华护理杂志, 2026, 61(5): 630-638.

YAN Manlin, HUANG Weirong, ZHANG Zhihui, LI Xianrong. The construction and preliminary validation of an intervention program for social alienation in patients with enterostomy[J]. Chinese Journal of Nursing, 2026, 61(5): 630-638.

图/表 5

图1 理论框架

Figure 1 Theoretical framework

表1 专家意见及修改情况

Table 1 Expert opinions and modifications

表2 肠造口患者社会疏离感干预方案

Table 2 Intervention program for social alienation in patients with enterostomy

表3 两组一般资料的比较[例（百分比，%）]

Table 3 Comparison of general data between 2 groups[case（percentage，%）]

表4 两组社会疏离感总分及各维度得分和自尊量表总分的比较（分，$\bar{x} \pm s$）

Table 4 Comparison of social alienation scores and self-esteem scores between 2 groups（scores，$\bar{x} \pm s$）

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