Applying the Chronic Care Model to Support Ostomy Self-Management: Implications for Oncology Nursing Practice.
Applying the Chronic Care Model to Support Ostomy Self-Management: Implications for Oncology Nursing Practice.
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DOI：
10.1188/16.cjon.20-03ap
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发表时间：
2016-06-01
影响因子：
1.1
通讯作者：
Krouse R
中科院分区：
文献类型：
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作者：
Ercolano E;Grant M;McCorkle R;Tallman NJ;Cobb MD;Wendel C;Krouse R
每年至少有4万人因癌症接受造口术。生活与造口需要日常网站和设备护理，生活方式的改变，情绪管理和社会角色的调整。慢性护理造口自我管理培训计划（CCOSMTP）提供造口自我管理课程;强调解决问题，自我效能，重新构建认知反应和目标设定。内容分析的定性方法进行分类的自我报告的目标，确定在护士为主导的可行性试验测试CCOSMTP的造口。三十八ostomates确定的目标在三个CCOSMTP会议。这些目标根据City of Hope健康相关生活质量模型进行分类，该模型是一个经过验证的多维框架，描述了身体，心理，社会和精神造口术相关的影响。护理专家独立编码的目标，然后合作，以达到100%的共识，对目标的分类。38名参与者确定了118个目标。87个目标（77.2%）是物理目标，与皮肤护理、袋/袋放置和泄漏管理相关。有26个社会目标（22.0%）涉及参与社会/娱乐角色和日常活动，5个（0.8%）心理目标涉及自信和控制消极思维。虽然造口术癌症幸存者的目标是可变的，但身体目标在自我管理训练中最常见。
Each year at least 40,000 individuals receive an ostomy due to cancer. Living with an ostomy requires daily site and equipment care, lifestyle changes, emotional management, and social role adjustments. The Chronic Care Ostomy Self-management Training Program (CCOSMTP) offers an ostomy self-management curriculum; emphasizing problem-solving, self-efficacy, reframing cognitive responses, and goal setting. The qualitative method of content analysis was employed to categorize self-reported goals of ostomates identified during a nurse-led feasibility trial testing the CCOSMTP. Thirty-eight ostomates identified goals at three CCOSMTP sessions. The goals were classified according to the City of Hope Health-Related Qualify of Life Model, a validated multi-dimensional framework, describing physical, psychological, social and spiritual ostomy-related effects. Nurse experts coded the goals independently and then collaborated to reach 100% consensus on the goals’ classification. One-hundred and eighteen goals were identified by 38 participants. Eighty-seven goals (77.2%) were physical goals, related to the care of the skin, placement of the pouch/bag and management of leaks. There were 26 social goals (22.0%) addressing engagement in social/recreation roles and daily activities and five (0.8%) psychological goals on confidence and controlling negative thinking. While ostomy cancer survivors’ goals are variable, physical goals are most common in self-management training.