A total of 60 adult patients who underwent enterostomy surgery in the gastroenterology department of Jinzhou First People’s Hospital with negative emotions and insomnia between August 2021 and August 2022 were selected as research objects. This study was conducted in accordance with the relevant principles of Helsinki Declaration, and was submitted to the ethics committee of the First Affiliated Hospital of Yangtze University for approval (No. KY202301). Among them, there were 27 males and 33 females, with an average age of 54.10 ± 10.89 years. All cases met the following inclusion criteria: 1) all patients were diagnosed with colon cancer by pathological examination and underwent enterostomy, 2) all cases were informed consent and willing to cooperate with relevant experimental research, and 3) they had good communication and understanding skills. Samples were considered for exclusion if 1) patients had metastasis or recurrence after enterostomy, 2) patients with heart, lung, brain, liver, kidney and other organ diseases, 3) patients with mental disorders, and 4) those who did not have complete clinical data and cannot cooperate with the whole experiment. This study was reviewed and approved by the hospital ethics committee, and there was no significant difference in age, sex, physique and other general data of all selected cases (P > 0.05).

An enterostomy nursing team was set up, consisting of one enterostomy therapist, four nurses in charge, and two gastrointestinal attending surgeons, with the head nurse as the team leader. All the selected cases were divided into “3H” nursing mode group (group A, 30 cases) and conventional nursing management group (group B, 30 cases) by using random number table method. Group B received conventional nursing after enterostomy, including keeping the skin around stoma clean and dry, giving dietary guidance, observing whether there was edema, bleeding, retraction, and prolapse, and blood supply of stoma intestine, giving health education to patients, and instructing them to use stoma bags correctly and participate in stoma nursing. Group A received “3H” nursing intervention on the basis of conventional nursing: 1) Hotel-style nursing service— comfortable nursing. The concept of comfort was highlighted on the basis of keeping the ward quiet, safe and tidy. The ward lights were soft, landscape paintings were hung for mood adjustment, TV and toilet were equipped and soothing music was played regularly to relieve the anxiety and tension of patients, as if they were in a hotel. The nursing staff was dignified and elegant. They were provided with corresponding training and guidance, including etiquette and communications skills, and were required to pass the examination. They were asked to be patient-centered, give more greetings and patience to patients, be gentle, be prompt, be efficient, and serve patients wholeheartedly. 2) Home-based nursing service—family nursing. A detailed introduction was given to patients when they were admitted to hospital, leaving a warm impression on them. During hospitalization, with the service aim at satisfying patients’ needs, nursing staff should think of whatever patients need and give them help as much as possible, and create a family-like nursing atmosphere. Flowers, cards and sincere wishes were sent to patients on festivals or patients’ birthdays, which reflected humanistic care and made patients feel at home in the hospital. 3) Hospital-based nursing service—personalized nursing. Patients were given a comprehensive assessment at the time of admission, and the nursing plan was formulated in combination with patients’ personal situation, with the goal of satisfying patients’ needs. The nursing staff can understand the patients’ conditions, medication and treatment effect in detail, provide the most professional, comprehensive and warmest nursing for patients, eliminate patients’ negative emotions, and help them build self-confidence to actively cooperate with treatment.

Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) compiled by W. K. Zung et al. are used to assess the subjective feelings of patients with anxiety or depression, and can measure the severity and dynamic changes [9] [10] . SAS and SDS both contain 20 items, each of which is based on a 4-level scoring system, 1 - 4 points for each level. The standard score of SAS is equal to [the sum of 20 scores * 1.25], and the standard score of SDS is equal to [the sum of 20 scores * 1.25]. The SAS standard score < 50 is considered normal, 50 - 60 considered mild anxiety, 61 - 70 considered medium anxiety, and >70 considered severe anxiety. The SDS standard score < 53 is considered normal, 53 - 62 considered mild depression, 63 - 72 considered medium depression, and >72 considered severe depression.

Pittsburgh Sleep Quality Index (PSQI) is a widely used assessment tool that is currently developed for sleep disorder, and is often used as an auxiliary diagnostic index in clinic [11] [12] . The PSQI contains 9 items. Each item uses a 4-level scoring system, 0 - 3 points for each level. The PSQI standard score is equal to the sum of 9 scores (0 - 21 points). In China, the PSQI standard score > 7 is considered to have sleep disorder [13] [14] . The higher the PSQI score is, the worse the sleep quality is considered to be.

Barthel index (BI) measures a series of independent behaviors of patients to assess the functional status of daily living activities of patients. It can also clarify the degree of dysfunction of patients so as to guide clinical rehabilitation and nursing [15] [16] . The BI assessment includes 10 items, namely, defecation, urination, grooming, toilet use, eating, transfer, exercise, dressing, going up and down stairs, and bathing. Each item is assessed in three levels, with scores (0, 5, 10) for each level, respectively. The BI standard score is the sum of 10 scores, with 100 points being the full score, and >60 considered that patients are able to take care of themselves basically.

Nursing satisfaction was quantified by questionnaire. The total score was 100 points, 81 - 100 was excellent, 60 - 80 was qualified, and <60 was unqualified. Nursing satisfaction = (excellent + qualified) number of cases/total number of cases × 100%.

SPSS20.0 Software was utilized for data analysis. Measurement data were expressed as mean ± SD, and t test was used for comparison between groups. Count data is expressed by percentage (%), and X² test was used for comparison between groups. A value of P < 0.05 was considered statistically significant, and P < 0.01 was considered very significant.

Before the implementation of comparative nursing measures, the SAS and SDS scores of group A and group B were compared, and there was no significant difference between the two groups (P > 0.01). After the intervention of different nursing measures, compared with the conventional nursing management group, the “3H” nursing mode can significantly reduce the SAS and SDS scores of patients after enterostomy, with a significant difference (P < 0.01). See Table 1.

This comparison had a familiar result to that in section 3.1. There was no significant difference in sleep quality between the two groups before implementing the comparative nursing measures (P > 0.05). After different nursing interventions, the PSQI score of patients in group A was reduced significantly compared to group B, and the sleep quality of patients in group A improved significantly (P < 0.01). See Table 2.

Before the implementation of comparative nursing measures, we compared the BL scores of the two groups, and it was found that there was no significant difference

SAS: Self-rating Anxiety Scale; SDS: Self-rating Depression Scale; *P < 0.01 vs. B group.

between the two groups (P > 0.05). After different nursing interventions, the result showed that compared with group B, the BL score of patients in group A was increased significantly, and their daily living abilities were obviously improved (P < 0.05). See Table 2.

It was found from the quantitative analysis of the questionnaire that compared with group B, the nursing satisfaction of group A was significantly improved, with significant difference (P < 0.05). See Table 3.