Abstract:

Objective To explore the effect of a virtual reality（VR） intervention on the readiness for hospital discharge and early post-discharge self-management ability of patients with colorectal cancer stoma，and to provide references for promoting the smooth transition of patients from hospital to family. Methods A convenience sampling method was used to select patients with colorectal cancer stoma admitted to a tertiary hospital in Zhengzhou from January to October 2024 as the study subjects. 48 patients admitted from June to October 2024 were included in an experimental group， and 48 patients admitted from January to May 2024 were included in a control group. On the basis of routine perioperative health education, the experimental group received virtual reality intervention from the third day after operation to before discharge， while the control group received routine perioperative health education. The patient’s readiness for discharge was evaluated on the day of discharge. The self-management ability and stoma adaptability of the 2 groups were evaluated 3 days after operation， on the day of discharge，1 month and 3 months after discharge，and the incidence of stoma complications was counted. Results 2 cases were lost in the experimental group and the control group， and 46 cases in each group participated in the complete study. The total score of discharge readiness and the scores of each dimension in the experimental group were higher than those in the control group， and the differences were statistically significant（P<0.05）. Generalized estimating equation analysis showed that the inter-group effect， time effect and interaction effect of self-management ability and ostomy adaptability in the 2 groups were statistically significant（all P<0.05）. There was no significant difference in the incidence of ostomy complications between the 2 groups（P=0.099）. Conclusion On the basis of routine perioperative health education，the implementation of virtual reality intervention can effectively improve the discharge readiness and early self-management ability of patients with colorectal cancer stoma，enhance the adaptability of stoma, and have good safety.

Key words: Virtual Reality, Colorectal Cancer, Ostomy, Discharge Readiness, Self-Management Ability, Stoma Adaptability, Nursing Care

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。

关键词: 虚拟现实, 结直肠癌, 肠造口, 出院准备度, 自我管理能力, 造口适应能力, 护理