痔疮术后患者出院准备度及影响因素分析

Analysis of Discharge Readiness and Influencing Factors of Patients with Hemorrhoids after Surgery

摘要: 目的：调查痔疮术后患者的出院准备度、出院指导质量、家庭功能现状，探讨分析痔疮术后患者出院准备度的影响因素。方法：采用随机抽样法选取2024年1月至2024年12月在吴起县人民医院普外科和安塞区中医医院外科住院实施痔疮切除术后的患者作为研究对象。采用一般资料调查表、出院准备度量表(RHDS)、出院指导质量量表(QDTS)、家庭功能评估量表(APGAR)收集资料，采用SPSS 26.0软件统计分析，一般资料中计数资料用频数与构成比(n, %)来描述，计量资料符合正态分布采用($\overline{X}\pm s$ )描述，组间比较采用c²检验或t检验；二元Logistic回归分析痔切除术后患者出院准备度的影响因素，以P < 0.05有统计学差异。结果：本研究共纳入218例痔切除术后患者，其中115例患者出院准备度量表得分 < 7分，即52.8%的患者出院准备不足，平均得分(4.74 ± 1.16)分，103例痔切除术后患者出院准备度良好，量表平均得分(7.60 ± 0.82)分。二元Logistic回归分析结果显示，肛门狭窄(OR = 3.494)、出院指导质量(指导不足OR = 0.284、指导中等OR = 0.438、指导较高OR = 0.036)，即发生肛门狭窄的患者，其出院准备度越不足，而出院指导质量越低的，其出院准备度越不足(P < 0.05)。结论：痔疮术后患者出院准备度低，出院准备度不足发生率较高，术后并发症(肛门狭窄)、出院指导质量较低是其危险因素，因此，医护人员应在临床中为患者提供适当的指导策略，加强健康宣教与护理，采取积极措施预防痔疮术后并发症的发生，提升对患者的出院指导质量，从而提高痔疮术后患者的出院准备度。

Abstract: Objective: To investigate the status quo of discharge readiness, discharge guidance quality and family function of patients with hemorrhoids after surgery and explore the influencing factors of discharge readiness of patients with hemorrhoids after surgery. Methods: Random sampling method was used to select the patients who underwent hemorrhoidectomy in the General Surgery Department of Wuqi County People’s Hospital and the Surgery Department of Ansai District Hospital of Traditional Chinese Medicine from January 2024 to December 2024 as the research objects. General data questionnaire, Readiness for Hospital Discharge Scale (RHDS), Quality of Discharge Teaching Scale (QDTS) and Family Function Assessment Scale (APGAR) were used to collect data, and SPSS 26.0 software was used for statistical analysis. In general data, counting data were described by frequency and component ratio (n, %). Measurement data consistent with normal distribution were described by ($\overline{X}\pm s$ ), and comparison between groups was performed by c² test or t-test. Binary Logistic regression analysis was performed to determine the influencing factors of discharge readiness of patients after hemorrhoidectomy, and the difference was statistically significant at P < 0.05. Results: A total of 218 patients after hemorrhoidectomy were included in this study, of which 115 patients scored < 7 points on the discharge readiness scale, that is, 52.8% of patients were not prepared for discharge, with an average score of (4.74 ± 1.16) points, and 103 patients were well prepared for discharge, with an average score of (7.60 ± 0.82) points. Binary Logistic regression analysis showed that patients with anal stenosis (OR = 3.494) and quality of discharge guidance (insufficient OR = 0.284, medium OR = 0.438, high OR = 0.036), that is, patients with anal stenosis were less prepared for discharge. The lower the quality of discharge guidance, the less readiness they were for discharge (P < 0.05). Conclusion: Patients with hemorrhoids after surgery have low discharge readiness, high incidence of insufficient discharge readiness, and postoperative complications (anal stenosis) and low quality of discharge guidance are risk factors. Therefore, medical staff should provide appropriate guidance strategies for patients in clinical practice, strengthen health education and nursing, take active measures to prevent postoperative complications of hemorrhoids, and improve the quality of discharge guidance for patients, so as to improve the discharge readiness of patients after hemorrhoids.