| Objective:To establish a safe and scientific home-based physical activity program for cutaneous ureterostomy patients,verify the effects of this program on patients’aerobic endurance,body balance function,physical activity level and quality of life,and explore its influence on the incidence of ureteral stent plugging and migration.Method:Preliminary construction of physical activity program for patients with cutaneous ureterostomy patients:literature review was conducted according to evidence-based steps,and relevant information was further extracted and summarized to form a preliminary framework of physical activity program.Improve the content of physical activity program:evaluate,revise and supplement the overall framework and content of the program through Delphi expert consultation,select experts in the fields of ostomy,urology,rehabilitation and sports,carry out two rounds of expert letter consultation,and complete the final version of home-based physical activity program for cutaneous ureterostomy patients.Application of physical activity program at home for cutaneous ureterostomy patients:70 cutaneous ureterostomy patients who received treatment in the wound ostomy outpatient department of a 3A hospital in Jiangxi Province from July 2022 to September 2022 and met the inclusion criteria were selected as the study objects by randomized control method.The control group(n=35)received routine outpatient health education.The experimental group(n=35)were given home-based physical activity program and corresponding health education.General information questionnaire,6-minute walking test,timed up and go test,international physical activity questionnaire,the medical outcomes study 36-item short-form health survey were used to compare the changes of the above indexes at baseline and 3 months after intervention.The 6-minute walking test,the main outcome index,was repeated at baseline,at 1 month,2 months and 3 months.The data were processed by SPSS using the following statistical methods:independent sample t test,paired sample t test,Mann Whitney U test,chi-square test,mixed linear model and Marginal Homogeneity test.Results:1.A total of 12 literatures were screened out,including 6 guidelines,2 expert consensus,1 systematic review and 3 randomized controlled trials.The physical activity related information extracted from the included literatures was sorted out.It was summarized into six major contents,namely,significance of physical activity,assessment,contraindication,implementation,health education,and intervention strategy,with a total of 37 contents.2.Expert consultation:after two rounds of expert consultation,effective questionnaire recoveries were 94.12%and 100%,expert opinion proposal rates were75.00%and 6.25%,expert authority coefficients were 0.84 and 0.87,and coordination coefficients were 0.20 and 0.18 in the second round,with statistical significance(P<0.05).Finally,the home-based physical activity program was constructed,including 7 primary indexes and 43 contents.3.In this study,8 patients fell off during the intervention process,and 62patients completed the study(30 patients in the intervention group and 32 patients in the control group).The 6-minute walking tests of the experimental group at baseline,1 month,2 months and 3 months after intervention were 411.29±47.69m,429.28±46.42m,449.56±48.71m and 476.88±58.05m.The 6-minute walking tests of patients in the control group were 405.61±56.12m,408.91±54.80m,417.86±50.21m and 412.11±51.06m.The linear mixing model showed that the time effect(F=29.276,P<0.001)the group effect(F=34.491,P<0.001)and the interaction effect(F=21.886,P<0.001)were statistically significant.4.After intervention,the timed up and go test in the experimental group was better than that in the control group,with a statistically significant difference(t=4.941,P<0.001);The experimental group showed significant improvement before and after intervention(t=5.638,P<0.001),while the control group showed no statistically significant changes within the group before and after intervention(t=0.931,P>0.05).5.After intervention,there was a statistically significant difference in the number of patients with different levels of physical activity between the two groups(χ~2=5.995,P<0.05);The intra group differences between the experimental group and the control group before and after intervention were statistically significant(Z=4.243,P<0.001和Z=2.333,P<0.05).6.Before intervention,there was no statistical significance in 8 dimensions of SF-36 in 2 groups(P>0.05);After intervention,scores of general health,physical functioning,role-physical,vitality and social functioning of experimental group were58.87±14.24,82.50(75.00,95.00),100.00(50.00,100.00),72.50(58.75,58.75),respectively.85.00),75.00(62.50,87.50)points;The scores of the control group were 49.13±13.16,70.00(51.25,83.75),50.00(0.00,100.00),55.00(50.00,73.75),62.50(37.50,62.50),and the difference was statistically significant(P<0.05).7.During the 3-month intervention,the incidence of ureteral stent blockage was13.3%in the experimental group and 9.4%in the control group,with no statistically significant difference(χ~2=0.008,P>0.05).The incidence of ureteral stent migration was 3.3%in the experimental group and 0%in the control group,with no significant difference(P>0.05).8.The average compliance of the experimental group was 72.58%,among which the compliance of walking exercise was 77.42%,and that of modified aerobics was 67.74%,indicating that the compliance was acceptable.Conclusion:The home-based physical activity program for cutaneous ureterostomy patients established in this study is relatively safe and compliant,improves patients’aerobic endurance,enhances balance,increases the level of home-based physical activity,and improves the quality of life.Further exploration is needed in terms of the incidence of ureteral stent blockage and migration. |
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