Health Related Quality of Life May Increase when Patients with a Stoma Attend Patient Education – A Case-Control Study

IntroductionAdaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we implemented interventions aimed at increasing health related quality of life during and after hospital admission.Materials and MethodsWe designed a case/control study aimed at adult patients admitted to the surgical ward for stoma creation, irrespective of type of stoma or reason for creation of stoma. We included 50 patients in the study. Health related quality of life was measured before hospital discharge, three months and six months after stoma creation. The program included educational interventions involving lay-teachers, alongside health professional teachers.ResultsWe found a significant rise in health related quality of life in the intervention group (Pp = 0.12 and p = 0.63, respective). Additionally, there were differences in scores in health related quality of life baseline (p = 0.045) with lower scores in the intervention group compared with the intervention group. However, there were no significant differences in the demographic variables at baselineConclusionsEducational activities aimed at increase in knowledge and focusing on patients' psychosocial needs may lead to a rise in patients' health related quality of life. When patients with a stoma attend a structured patient education program it is possible to improve their health related quality of life compared with patients with a stoma, who do not attend the program.Trial RegistrationClinicalTrials.gov NCT01154725

引言
造口（stoma）术后适应过程复杂，已有研究证实造口手术对患者的健康相关生活质量（health related quality of life, HRQoL）具有显著影响。本研究旨在探讨结构化患者教育项目对患者健康相关生活质量的作用，故于患者住院期间及出院后实施旨在提升其健康相关生活质量的干预措施。

材料与方法
本研究设计为病例对照研究（case/control study），纳入外科病房因造口手术住院的成年患者，不限造口类型及造口手术指征。本研究共纳入50例患者。分别于患者出院前、造口术后3个月及6个月评估其健康相关生活质量。该教育项目由非专业宣教教师（lay-teachers）与医护专业教师共同开展教学干预。

结果
本研究发现干预组的健康相关生活质量出现显著提升（原文标注P值分别为0.12与0.63，疑似存在笔误）。此外，两组基线健康相关生活质量评分存在差异（p=0.045），干预组基线评分低于对照组（原文此处原表述为"compared with the intervention group"，结合研究设计疑似笔误）。不过两组基线人口学变量无显著差异。

结论
旨在提升患者知识水平并关注其社会心理需求的教育活动，可改善患者的健康相关生活质量。与未参与结构化患者教育项目的造口患者相比，参与该项目的造口患者健康相关生活质量可获得提升。

临床试验注册
ClinicalTrials.gov NCT01154725