Purpose To explore the impact of stigma on the patient delay for colorectal cancer from the perspectives of patients and their family members. Methods A descriptive phenomenological design was conducted. In total, 30 patients and 17 family members of patients were recruited from a Grade-A tertiary cancer center in southern China through purposive sampling. In-depth interviews were conducted using a semi-structured guide. The data were organized by NVivo 11 and qualitatively analyzed using thematic analysis. Results Four themes and twelve subthemes were generated from the interviews: (1) cancer stereotypes (a proxy for death and cultural taboos);(2) symptom attribution (rationalization and benignization, denying the possibility of cancer and evasion of suspected cancer);(3) barriers to symptom disclosure (concealment of symptoms, negative effects of symptom disclosure and weakened description of symptoms);(4) resistance to seeking medical attention (negative symbolism of the hospital, embarrassment and pain during diagnosis and treatment, fear of cancer diagnosis, and internalized ageism of the elderly). Conclusions Stigma plays a crucial role in patient delay of colorectal cancer in China. To reduce delays, interventions should address cultural stereotypes, encourage early identification of symptoms, promote symptom disclosure, and reduce psychological barriers to seeking medical attention. Culturally sensitive strategies are essential in tackling the stigma that impedes timely cancer treatment.

PURPOSE:To assess the stigma levels among colorectal cancer (CRC) survivors, identify determinants, examine correlations with CRC knowledge and self-efficacy, and quantify the relative influence of various contributing factors. METHODS:In total, 301 CRC survivors were enrolled from a tertiary oncology center in southern China. The participants completed the Social Impact Scale (SIS), Bowel Cancer Awareness Measure (Bowel CAM), General Self-Efficacy Scale (GSES), and a demographic and disease-related questionnaire. The analytical framework included multiple linear regression to identify the factors influencing stigma, LASSO regression for variable refinement, and random forest modeling to construct hierarchies of factor importance. RESULTS:Participants demonstrated moderate levels across all measures: stigma (54.63 ± 8.37), CRC knowledge (8.25 ± 4.74), and self-efficacy (26.81 ± 5.95). Multiple linear regression identified type of medical insurance, support from peers, unwillingness to accept colonoscopy, CRC knowledge, and self-efficacy as significant factors influencing stigma. Random forest analysis ranked factor importance by Gini index: self-efficacy (4366.41), support from peers (1618.03), CRC knowledge (1029.04), type of medical insurance (886.66), and unwillingness to accept colonoscopy (750.16). CONCLUSIONS:Healthcare providers should pay more attention to stigma among CRC patients. Effective stigma reduction necessitates culturally-sensitive psychosocial interventions, including enhancing patients' confidence in managing their disease, strengthening professional-driven online popularization of science campaigns, and facilitating social support networks.

OBJECTIVE:This study investigated the biomedical, psychological, and social behavior factors for supportive care needs in colorectal cancer patients with a stoma, aiming to provide a theoretical basis for the development of targeted interventions.METHODS:This cross-sectional study included 175 colorectal cancer patients with a stoma. A questionnaire was used to collect demographic and disease-related data on patients. The M.D. Anderson Symptom Inventory-Gastrointestinal Cancer (MDASI-GI), Hospital Anxiety and Depression Scale (HADS), and Perceived Social Support Scale (PSSS) were used to assess patients' symptom distress, anxiety and depression status, and social support, respectively. The Supportive Care Need Survey Short Form (SCNS-SF34) was used to evaluate supportive care needs.RESULTS:The total score of supportive care needs of patients with colorectal cancer stoma was 87.75±17.34 points. The multivariate linear regression analysis results showed that younger age and a higher total score on symptom distress, depression, and anxiety were independent risk factors for supportive care needs.CONCLUSIONS:Patients with colorectal cancer stoma with higher supportive care needs can be identified early from the bio-psycho-social perspective. Younger patients have more symptom distress, are depressed and anxious, have lower social support, and have higher supportive care needs. Closer monitoring of patients with symptom distress, early detection of depression and anxiety, and improving patients' social support can meet supportive care needs and improve patients' quality of life.

目的 了解结直肠癌造口术后患者支持性照顾需求与症状困扰的现状,并探讨其相互关系,为制定针对性的干预提供理论依据.方法 采用一般资料问卷、支持性照顾需求简明问卷(supportive care need survey short form,SCNS-SF34)及安德森症状评估量表胃肠道肿瘤特异性模块(M.D.Anderson symptom inventory-gastrointestinal cancer,MDASI-GI)对175例结直肠癌造口术后患者进行调查.结直肠癌造口患者支持性照顾需求与症状严重程度及症状困扰程度相关性采用Spearman相关分析法.结果 结直肠癌造口患者术后支持性照顾需求总分为(87.75±17.34)分,得分最高的为生理与日常生活需求维度,均分为(2.83±0.79)分.患者的症状严重程度总分为20.00(12.00,32.00)分,发生率最高的症状为疲乏(89.71％).症状困扰程度总分为15.00(9.00,22.00)分,主要表现在工作(86.28％)、情绪(84.57％)的困扰.结直肠癌造口患者支持性照顾需求与症状严重程度(r=0.567,P<0.001)及症状困扰程度(r=0.651,P<0.001)呈正相关.结论 结直肠癌造口患者术后普遍存在未满足的支持性照顾需求,主要表现为生理与日常生活方面的需求;患者术后存在多种症状,造成不同程度的困扰,患者症状及困扰程度越高,其支持性照顾需求水平越高.医护人员应加强患者症状管理评估与实施针对性干预,以满足患者需求.

OBJECTIVES:To investigate public awareness of colorectal cancer (three components: total knowledge, confidence and anticipated delay) in the Chinese population, to explore factors associated with total knowledge and to elucidate relationships among three components of public awareness of colorectal cancer.METHODS:We recruited 562 adult Chinese participants with no history of colorectal cancer between March and May 2020 by convenience sampling method. Data were collected online using a self-designed demographic questionnaire and a simplified Chinese version of the Bowel Cancer Awareness Measure. Univariate analysis and multivariate linear regression were applied.RESULTS:The mean score for total knowledge was 10.56 (SD: 5.89). Over half of the participants (58.2%) lacked confidence about detecting warning signs. For 42.7% of participants, the anticipated delay was not within the acceptable range (2 weeks). Totally eight demographic variables were identified as significant predictors of total knowledge, accounting for 36.2% of the variance. Total knowledge was positively correlated with confidence (r = 0.126, p < 0.01) and negatively associated with anticipated delay (F = 8.891, p < 0.01).CONCLUSION:Public awareness of colorectal cancer was low in the Chinese population. Hence, educational interventions targeted for improving knowledge, enhancing individuals' confidence in detecting symptoms and reducing barriers to seeking medical help may be urgently required.

目的 探讨微凸底盘造口袋联合宽胶带在肠造口回缩患儿中的应用效果.方法 选取2017年1月—2020年12月收治的肠造口术后并发肠造口回缩的患儿40例,按照组间基线资料匹配的原则分成对照组与观察组,每组20例.观察组肠造口粪便收集采用50 mm微凸底盘两件式造口袋联合2.5 cm宽胶带封边增加稳固性,对照组采用一件式平面底盘儿童造口袋.跟踪评价1个月后两组患儿造口袋更换频次、肠造口周围皮肤DET评分[颜色改变(D)、浸渍/溃疡(E)、组织增生(T)]、肠造口周围皮肤刺激性皮炎发生率.结果 两组患儿肠造口周围皮肤刺激性皮炎发生率比较差异无统计学意义(P>0.05);观察组造口袋更换频次低于对照组,组间比较差异有统计学意义(P<0.05);观察组肠造口周围皮肤DET评分低于对照组,组间比较差异有统计学意义(P<0.05).结论 肠造口粪便收集采用50 mm微凸两件式造口袋联合2.5 cm宽胶带封边虽不能明显降低肠造口回缩患儿肠造口周围皮肤刺激性皮炎的发生率,但可明显减少造口袋更换频次,降低肠造口周围皮肤损害程度.

Objectives: A large proportion of mid-low rectal cancer patients develop low anterior resection syndrome (LARS) after Sphincter-sparing surgery. This study aimed to investigate the effect of low anterior resection syndrome (LARS) on quality of life (QoL) in Chinese rectal cancer patients following sphincter-sparing surgery. Methods: This was a comparative cross-sectional study. Between Jan 2019 to Jun 2020, 146 mid-low rectal cancer patients following sphincter-sparing surgery were enrolled. The low anterior resection syndrome (LARS) score was used to assess bowel dysfunction. According to the LARS score, patients were divided into three levels, no LARS (n = 34), minor LARS (n = 60), and major LARS (n = 52). The Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was used to assess the QoL of the patients. Results: The major LARS group had a significantly shorter level of tumor from the dentate line than the no LARS group. The total FACT-C score of 146 patients was 98.45 +/- 17.83. The total FACT-C score and the score of each dimension (physical, emotional, functional dimensions, and colorectal cancer subscale) were significantly different between the minor LARS and major LARS groups, as well as between the no LARS and major LARS groups. Subgroups analyses of the FACT-C score stratified by each item in the LARS scales showed that except for flatus incontinence, patients with different frequencies of other symptoms (bowel frequency, liquid stool incontinence, liquid stool incontinence, stool clustering, urgent bowel movement) had a significantly different total score of FACT (all P < 0.01). Conclusions: The LARS had a significant impact on the QoL in Chinese mid-low rectal cancer patients following sphincter-sparing surgery, especially in patients with major LARS.

Purpose: The prognosis for colorectal cancer is closely related to the time of diagnosis. However, patient delay is common and become a major contributor to delays in cancer diagnosis. We aimed to investigate patient delay and its predictors based on the Theory of Planned Behavior among colorectal cancer patients. Methods: In total, 303 colorectal cancer patients were recruited from a Grade-A tertiary cancer center in southern China by convenience sampling. The participants' general information, stigma, self-efficacy, and knowledge about colorectal cancer were assessed by a self-designed general information questionnaire, the Social Impact Scale, the General Self-Efficacy Scale, and the section of the Bowel Cancer Awareness Measure on total knowledge of colorectal cancer. Descriptive statistics, univariate analysis, and binary logistic regression were applied for data analysis. Results: The median patient delay was four months (range: 1 day-10 years). The prevalence of prolonged patient delay (>= 3 months) was 57.8%. Identified by binary logistic regression, prolonged patient delay was associated with having no close family members/friends in medical professionals, unwillingness to accept colonoscopy, blood in stools, dyspepsia, insufficient support from family members, more measures taken to control symptoms, lower perceived severity of symptoms, knowledge shortage, negative help-seeking attitudes, lower self-efficacy, and higher stigma. Conclusions: Patient delay was considerable in individuals with colorectal cancer in China. Factors associated with patient delay are complex in Chinese culture. To shorten patient delay, culturally sensitive interventions may be required to improve knowledge, alleviate cancer stigma, enhance self-efficacy to seek medical attention, and promote positive help-seeking behaviors.

AIM:The purpose of this study was to translate the Stoma-quality of life into Chinese and evaluate its psychometric properties in Chinese patients.BACKGROUND:Quality of life is an important issue for patients with colostomy, and its appropriate and precise measurement is beneficial to promoting better care. The Stoma-quality of life questionnaire has been widely used; however, the validity and reliability of its Chinese version has not been determined.DESIGN:A cross-sectional validation study was conducted.METHODS:We translated the Stoma-quality of life into Chinese using standardized methods. Then it was psychometrically tested on a convenience sample of 513 patients with colostomy. Construct validity was evaluated via exploratory factor analysis and confirmatory factor analysis. Reliability was measured with Cronbach's alpha and the split-half Spearman-Brown coefficient.RESULTS:The content validity, the Cronbach's α coefficient and the Spearman-Brown split-half reliability coefficient indicated adequate validity and reliability. The exploratory factor analysis yielded four common factors, and the cumulative variance contribution rate was 67.5%. Moreover, the confirmatory factor analysis showed a good model fit.CONCLUSION:This study confirmed that the Chinese version of Stoma-quality of life is an effective and reliable measurement for evaluating the quality of life of patients with colostomy.

Malignant fungating wounds are associated with heavy exudate and malodor, and can thus have a devastating impact on the physical, psychological, and functional health of patients at the end of life. Management is typically limited to the use of more absorbent dressings and frequent changing of dressings. However, this method is associated with a large amount of time needed for wound care, and does not always resolve the problem of malodor. Herein, we report the use of an inexpensive ostomy pouch to manage facial fungating wounds caused by maxillary gingival carcinoma. The pouches are adhered to the skin, and collect a large amount of malodorous exudate for days without leaking. Fewer dressing changes and the absence of malodor result in an improved quality of life for the patient and family.

目的:评价6种含银敷料对慢性伤口的愈合效果.方法:计算机检索PubMed、Web of Science、the Cochrane Library、EMbase、中国知网(CNKI)、维普数据库(VIP)及万方数据库(WanFang Database)中关于含银敷料用于慢性伤口治疗的随机对照试验(RCT),检索时间均为建库至2020年5月20日,对符合纳入标准的研究使用ADDIS软件进行网状Meta分析.结果:共纳入21篇文献.网状Meta分析结果显示:伤口治疗效果最佳的敷料是银离子藻酸盐敷料,其次为亲水性纤维含银敷料、纳米银敷料,软聚硅酮银离子泡沫敷料、磺胺嘧啶银脂质水胶体敷料和银离子泡沫敷料效果相对较差.结论:现有证据表明,在慢性伤口疗效方面银离子藻酸盐敷料和亲水性纤维含银敷料优于其他类型含银敷料.

目的:探讨中低位直肠癌保肛术后病人排便功能的现状,进一步分析其影响因素.方法:采用中文版低位前切除综合征(LARS)评分表,于2019年1月—2020年6月对广州市某三级甲等肿瘤医院146例中低位直肠癌保肛术后恢复肛门排便1个月及以上的病人进行问卷调查,并采用高分辨肛门直肠测压仪检测病人的肛门直肠生理功能,采用单因素和多因素分析研究中低位直肠癌保肛术后病人排便功能的影响因素.结果:中低位直肠癌保肛术后病人的LARS的发生率为76.71％(112/146),重度LARS发生率为35.62％(52/146).肛门直肠测压结果显示,与正常人群相比,病人的肛管静息压、肛管最大收缩压、直肠便意感觉容量、直肠最大耐受容量、直肠顺应性等指标均明显下降,差异具有统计学意义.多因素Logistic回归分析显示,术前接受放化疗、肿物位置是中低位直肠癌保肛术后病人发生LARS的独立危险因素(P<0.05).结论:中低位直肠癌保肛术后病人普遍存在排便功能失调,LARS的发生率较高,术前接受放化疗、肿物位置越低,术后排便功能越受影响.提示在临床工作中对术前接受放化疗、肿物位置低的病人尽早干预,可通过指导针对性的康复锻炼、症状自我管理尽可能降低排便功能失调对生活质量的影响.

Purpose Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and social domains. Since discharge is an important transition period, the patient experience at that time is worthy of attention. The aim of this study was to explore the immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy in China. Methods A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living with colostomy in China, who were asked open-ended questions about their postoperative experience. The thematic analysis approach was used to analyze the data. Results Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions (stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings, sexual life compromise and work restriction), (3) stoma care consideration (strong stoma self-care willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support from others (enterostomal nurses, family members and stoma friends). Conclusion Colostomy patients experience various obstacles in physiological, psychological, and societal aspect. Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients to psychological care, and promote transitional care.

背景 创伤后洗浴是保持皮肤清洁的重要手段,但如何洗浴一直存有争议,有研究报道术后温水淋浴不增加伤口感染率,居家洗浴是否可行尚缺乏证据支持.目的 多中心调查创伤伤口患者居家洗浴及伤口感染的现况,分析居家洗浴与伤口感染的相关性以及伤口感染的影响因素,为选择适宜的洗浴方法提供依据.方法 2020年9月纳入13所医院伤口护理门诊创伤伤口患者为研究对象,设计创伤伤口患者居家洗浴与伤口感染现况的调查问卷,包括人口学资料、创伤伤口资料、创伤后洗浴及伤口感染资料等.通过问卷星链接或二维码自愿完成在线问卷的匿名填写及提交.分别采用描述性分析和多因素Logistic回归分析居家洗浴和伤口感染的现况及其影响因素.结果 共收到949份问卷,剔除2份无效问卷,有效问卷947份,有效率为99.8％.(1)基本资料:男460例,女487例;年龄18～100岁,平均年龄(50.2±17.9)岁.创伤持续时间(42.7±66.7)d,全皮层损伤和部分皮层损伤分别占55.8％(528/947)和44.2％(419/947);致伤原因中以利器切割伤和跌倒外伤为主,分别占43.4％(411/947)和27.8％(263/947).(2)伤后居家洗浴现况:伤后从未洗浴者占28.0％(265/947),带伤居家洗浴者占72.0％(682/947);洗浴方式以温水擦浴为主,占76.7％(523/682),包裹和敞开伤口温水淋浴分别占18.3％(125/682)和5.0％(34/682);洗浴以1次/周最多,占38.4％(262/682),其次为2次/周37.4％(255/682)和3次/周24.2％(165/682).(3)伤口感染现况:伤口总感染率为36.0％(341/947),带伤居家洗浴者伤口感染率为24.6％(168/682),伤后从未洗浴者伤口感染率为65.3％(173/265),差异有统计学意义(χ2=136.900,P<0.001);其中温水擦浴、包裹和开放伤口温水淋浴者伤口感染率分别为25.8％(135/523)、20.0％(25/125)和23.5％(8/34),差异无统计学意义(χ2=1.860,P=0.395);居家洗浴频次1次/周者、2次/周者和3次/周者伤口感染率分别为32.8％(86/262)、22.4％(57/255)和15.2％(25/165),差异有统计学意义(χ2=18.173,P<0.001).(4)伤口感染影响因素分析:以伤口是否感染分组进行单因素分析,结果显示,伤口感染组居家洗浴情况、洗浴频次、抗生素治疗情况、创伤持续时间、致伤原因、创伤深度、创伤部位比例与无伤口感染组比较,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示,居家洗浴情况〔OR=0.30,95％CI(0.20,0.44),P<0.001〕、洗浴频次〔OR=0.60,95％CI(0.39,0.93),P=0.023〕、抗生素治疗情况〔OR=1.67,95％CI(1.20,2.33),P=0.002〕、创伤持续时间〔OR=1.64,95％CI(1.19,2.76),P=0.003〕和创伤部位〔OR=5.69,95％CI(2.72,11.90),P<0.001〕是伤口感染的影响因素.结论 居家洗浴和增加洗浴频次不增加伤口感染率,是可行的皮肤清洗方法.抗生素治疗、创伤持续时间超过30 d和腰臀部及四肢伤口可能增加伤口感染风险,患者可根据自理能力和伤口疼痛、伤口异味等因素选择适宜的洗浴方式和频次.

Purpose: Patients with mid-to low-rectal cancer can have various dysfunctions of defecation after sphincter-saving resection. Defecation dysfunction can manifest as incontinence, urgency, or frequent bowel movements, and is called low anterior resection syndrome (LARS). This study aimed to examine LARS score and objective anorectal function indices in Chinese patients receiving sphincter-saving surgery for mid-to low-rectal cancer. Method: This was a single-center cross-sectional study of patients undergoing sphincter-saving resection for lowor mid-rectal cancer and had restoration of trans-anal defecation for at least 1 month seen between January 2019 and June 2020. Patients completed a questionnaire regarding clinical characteristics, and Low Anterior Resection Syndrome (LARS) score and high-resolution anorectal manometry (HR-ARM) were used to assess defecation function. Multivariable analysis was used to identify variables significantly associated with defecation dysfunction. Results: 146 patients completed and returned the questionnaires. 25 healthy adults also participated as control group for the anorectal manometry. Approximately 76% of patients developed LARS after surgery, of which 35.6% had major LARS. In these patients, anorectal manometry indices including initial rectal sensory capacity and rectal fecal sensory capacity, were significantly lower than normal. Logistic regression analysis showed that preoperative chemo-radiotherapy and the tumor inferior margins being close to the dentate line, especially 2-5 cm, were independent risk factors for defecation dysfunction after surgery. Conclusions: Defecation dysfunction is a frequent occurrence after sphincter-saving resection for mid- and lowrectal cancer. Preoperative chemo-radiotherapy and a shorter tumor inferior margins distance to the dentate line are independent factors for defecation dysfunction.

Background This study aimed to examine the effects of applying the negative pressure wound therapy (NPWT) combined with intermittent instillation (NPWTi) in patients with cervical anastomotic leakage (AL) after esophageal cancer surgery. Methods From July 2019 to June 2021, 64 patients undergoing AL after esophageal cancer surgery were selected from our Hospital's Thoracic Department, and randomly allocated to the conventional nursing group (20 patients), the hospital central NPWTi group (23 patients), and the portable NPWTi group (21 patients). The hospital central NPWTi group was treated with central negative pressure combined with intermittent instillation, and the portable NPWTi group was treated with portable negative pressure combined with intermittent instillation. Indicators of fistula healing, healing days, treatment costs, comfort, and nursing satisfaction were examined in each group. Results The fistula healing rate, healing days, nursing satisfaction, and comfort level of the hospital central NPWTi group and the portable NPWTi group were better than those of the conventional nursing group (P<0.05). There was no difference in the fistula healing rates and healing days between the hospital central NPWTi group, and the portable NPWTi group (P>0.05). The treatment costs of the hospital central NPWTi group were lower than those of the portable NPWTi group (P<0.05). Conclusions Negative pressure treatment technology combined with the intermittent instillation of the neck anastomotic fistula improved the fistula microenvironment, strengthened the sterilization effect, drained the leachate effectively, shortened the fistula healing time, improved the fistula cure rate, and increased patients' satisfaction with nursing. In relation to the negative pressure source, there was no difference in the therapeutic effects of hospital central NPWTi compared to the portable negative pressure meter, but the hospital central NPWTi treatment costs were lower and patients' acceptance of NPWT instillation was higher. Thus, central NPWT instillation treatment is worthy of promotion. Trial Registration Chinese Clinical Trial Registry ChiCTR2100052240.

Objective: To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients. Methods: A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients. Results: A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups (χ2=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions: Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.

目的 了解中低位直肠癌保肛术后患者的排便功能与生活质量现状,并探讨两者的相关性.方法 采用便利抽样法,对2019年1月-2020年6月于我院排便障碍专科门诊随访的146例中低位直肠癌保肛术后患者应用一般资料调查表、中文版低位前切除综合征评分表(LARS)及癌症治疗功能评价量表(FACT-C)进行调查.结果 中低位直肠癌保肛术后患者LARS评分表得分为(25.67±9.24)分,FACT-C评价量表得分为(98.45±17.83)分.LARS评分表总分及各排便问题与FACT-C评价量表总分呈负相关(r=0.324～0.680,P＜0.01).结论 中低位直肠癌保肛术后患者排便功能与生活质量呈负相关.提示医护人员应密切关注患者术后的排便问题,并指导患者采取措施正确应对,从而改善其生活质量.

目的 了解利用微信开展延续性干预对永久性回肠造口患者自我护理能力的影响.方法 120例永久性回肠造口患者随机分为对照组和观察组,每组60例.对照组在出院后仅进行常规随访,观察组则利用微信开展延续性随访,采用自制的自我护理能力测量表对两组患者出院前1d和出院后3、6个月的自我护理能力进行评价.结果 两组患者出院前1d的各项自我护理能力比较差异无统计学意义(P＞0.05).出院后3、6个月时观察组患者的各项自我护理能力均较出院前1d明显提高,且高于同期对照组(P＜0.05或0.01);出院6个月的各项自我护理能力得分亦高于出院后3个月(P＜0.05或0.01).而对照组患者出院后3、6个月时的各项自我护理能力得分与出院前1d比较差异无统计学意义(P＞0.05).结论 利用微信开展延续性干预能够显著提高并维持永久性回肠造口患者的自我护理水平.