The effect of a nurse-led health education model for patients with temporary stomas: A randomized controlled trial

Purpose: To assess the impact of a nurse-led Skinner-based health education model on stoma readiness for hospital discharge, self-management, social impact, and complication rates. Methods: In a tertiary care hospital's Gastrointestinal Surgery Unit in Fujian, China, a blinded assessor conducted a repeated-measures randomized controlled trial. A total of 124 participants were assigned to either the intervention or control group randomly. The intervention group was subjected to a structured, progressive stoma care protocol incorporating Skinner's procedural teaching principles across seven stages: preoperative education, stoma observation, care training, active participation, self-care, home management, and supportive guidance. Data collection occurred at four time points: pre-intervention (T0), hospital discharge (T1), and 1 (T2) and 3 months post-hospitalization (T3). Outcome measures included hospital discharge readiness, stoma self-management, social impact, and stoma-related complications. Medical records were reviewed for complication data. The impact of group, time, and their combined influence on the results was assessed using generalized estimating equations. Results: Patients in the intervention group demonstrated significant improvements in readiness for hospital discharge (p < 0.001), stoma self-management (p < 0.001), social impact (p < 0.05), and incidence of complications (p < 0.05) compared to the control group. Conclusion: The study indicates that the nurse-led Skinner-based health education model significantly enhances readiness for hospital discharge and self-management in stoma patients, while also mitigating social impact and complications. It is recommended that the nurse-led health education model be integrated into clinical practice to enhance successful self-management and psychosocial adaptation in stoma patients.