การพัฒนาแนวปฏิบัติทางคลินิกสำหรับการดูแลช่องเปิดลำไส้ ทางหน้าท้องในผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนัก โรงพยาบาลนครพิงค์ จังหวัดเชียงใหม่

Abstract

Permanent ostomy surgery in colorectal cancer patients can affect them physically, mentally, socially, as well as economically. Stoma care is very important for preventing complications. This developmental study aimed to develop clinical practice guidelines (CPGs) for stoma care among colorectal cancer patients. The framework for developing clinical practice guidelines proposed by the Australian National Health and Medical Research Council (NHMRC) (1999) was applied as the framework for this study. The participants of the study comprised of 5 professional nurses working in surgical wards at Nakornping Hospital, Chiang Mai Province. The developed CGPs was validated by three experts and was piloted with five patients who had colostomies. The CPGs developed from this study included six categories: 1) protecting patient rights and ethics, 2) patient assessment, 3) management of stoma, 4) education for stoma care, 5) continuation of care, and 6) quality control for stoma care. The CPGs pilot showed their feasible, practical, and effective. The CPGs developed from this study should be used as a part of clinical service to improve quality of care for patients with colostomy. An executive summary should be done and these CPGs should be proposed to hospital administrators. Further study on CPGs implementation is recommended to test effectiveness of the guidelines.