Construction And Applicability Evaluation Of Remote Bowel Symptoms Intervention Protocol In Patients With Rectal Cancer Based On WeChat Applet

Objective To construct a remote bowel symptoms intervention protocol in patients with rectal cancer based on mobile health and to explore its feasibility,acceptability and effectiveness.By constructing scientific and reasonable intervention programs,we can improve the health level of patients and provide reference and opinions for the subsequent intervention for rectal cancer patients Methods This study includes two stages: intervention protocol construction and pre-trial study Stage Ⅰ1.Literature study: a comprehensive search of Chinese and foreign databases and guidelines,including CNKI,Wanfang,VIP,China biomedical abstract database,Pubmed,Embase,CINAHL database,Australian evidence-based health care center(JBI),BMJ best clinical practice(BMJ),etc.The search time is that the database was built until October 2021.Use subject words combined with free words in the database,and use free words in the guide network.The literature was screened according to the exclusion criteria,the information in the literature was summarized and sorted,and the first draft of the intervention plan was formed by the research group.2.Intervention plan collaborative participation meeting: group according to the research content using the purpose sampling,invited the first affiliated hospital of Anhui medical university gastrointestinal surgery 1 doctor,two head nurse and 2 graduate degree nurses discuss program content,and combined with the suggestion of clinical patients revised,form enquiry for intervention plan.3.Delphi expert inquiry: 26 experts in the field of rectal cancer were invited to conduct two rounds of letter inquiries on the specific content of the intervention plan,and WPS Excel and IBM SPSS27.0 were used to input and analyze the data.Members of the research group summarized and analyzed the results of the experts to further modify the intervention plan to form the final version of the intervention plan.stage ⅡIn a non-concurrent control test,the patients admitted to the gastrointestinal surgery department of the First Affiliated Hospital of Anhui Medical University were selected for meeting the inclusion criteria.The rectal cancer patients admitted from June 2021 to July 2021 as the control group adopted the usual hospital care;the rectal cancer patients admitted from August 2021 to September 2021 as the intervention group on the basis of the usual care measures.The intervention duration was from admission to 3 months after surgery.After the intervention,the feasibility,acceptability and effectiveness of the program were evaluated,and the effectiveness evaluation indicators were quality of life,severity of intestinal symptoms,and self-management.The analysis of data was performed by IBM SPSS27.0 statistical analysis software.Results Stage Ⅰ1.Literature research: 11 articles were finally included,including 8 randomized controlled trials,1 guideline,and 2 experimental studies.Organizing the literature content,the first draft of the intervention program containing 3 first level items,11 second level items and 51 third level items.2.Intervention program Collaborative participation in the meeting: According to the suggestions of medical staff and clinical patients,refine the intervention plan,determine the intervention time and clarify the intervention form,then a letter inquiry version of the intervention plan was formed.3.Delphi expert inquiry: The effective recovery rate of the two rounds of expert inquiry questionnaire was 100%,the coefficient of expert authority was 0.896,the Kendall coordination coefficient(W)was 0.335 and 0.302,and the coefficient of variation of each item was 0 ～ 0.18,finally forming three topics of intervention: information,motivation,and behavior skills,preparation,preoperative,7 days,before discharge,home rehabilitation and intervention programs of 37 items.Stage Ⅱ16 and 18 patients completed the intervention and control groups,respectively.The general data,clinical data and quality of life were comparable.After the intervention,the completion rate was 100%,14 patients agreed with the intervention form and content;the incidence or severity of anterior resection syndrome was less than the intervention group,higher self-management score than the control group,and the difference was statistically significant(P <0.05).Conclusions(1)This study takes IMB model as the theoretical guidance,constructed three topics,namely information,motivation,and behavioral skills intervention:preparation before intervention,preoperative,7 days after surgery,discharge,and home rehabilitation,and 37 items.(2)The remote intervention program for intestinal symptoms in patients with rectal cancer after anal preservation surgery based on mobile medical treatment is highly scientific and practical.The next step will be a randomized controlled trial with a large sample to provide reference for the management of intestinal symptoms in patients with rectal cancer.