老年肠造口患者护理依赖困境与延续性护理模式研究进展

Research Progress on Nursing Dependency Dilemmas and Continuity of Care Models for Elderly Patients with Colostomy

摘要: 随着当今社会人口老龄化的进程不断加快，老年肠造口患者的比例在逐年上升。因此，患者出院后面临的长期且复杂的护理需求与有限的护理资源的矛盾日益加重。延续性护理作为可以保障患者从医院到家庭的平稳过渡、降低护理依赖的关键护理措施，其护理模式的创新与完善已成为学术研究与临床实践关注的焦点。文章剖析了老年肠造口患者在社会、生理、心理等层面面对的困境，阐明了实施延续性护理的必要性；梳理了护理依赖量表等主流的评估工具；重点论述了“以医院为主导、以社区为主导、以互联网 + 家庭为主导”的护理模式；列举了降低肠造口病人护理依赖的干预策略；指出了当前延续性护理体系在服务整合度、人才队伍建设、支付机制方面存在的瓶颈；并对未来发展方向做出展望，提出应着力构建新型延续性护理服务体系、加强跨学科人才培养，以期为提升老年肠造口患者的生活质量、促进其尽快回归社会提供理论参考和实践路径。

Abstract: With the accelerating pace of population aging in today’s society, the proportion of elderly patients with colostomy is increasing year by year. Consequently, the contradiction between patients’ long-term and complex nursing needs after discharge and limited nursing resources has become increasingly severe. As a key nursing intervention that ensures a smooth transition from hospital to home and reduces nursing dependency, continuity care has emerged as a focal point in both academic research and clinical practice, particularly regarding innovation and improvement of its models. This article analyzes the challenges faced by elderly colostomy patients at social, physiological, and psychological levels, clarifies the necessity of implementing continuity care, reviews mainstream assessment tools such as the nursing dependency scale, and focuses on three primary care models: hospital-led, community-led, and internet-based home-centered care. It outlines intervention strategies aimed at reducing nursing dependency among colostomy patients, identifies current bottlenecks in the continuity care system—including service integration, workforce development, and payment mechanisms—and offers future directions. The study advocates building a new continuity care service system and strengthening interdisciplinary talent development to provide theoretical guidance and practical pathways for improving the quality of life of elderly colostomy patients and facilitating their reintegration into society.