基于互联网的癌痛管理闭环的构建及评价
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摘要
目的构建基于互联网的癌痛管理闭环,并评价其价值。方法第一阶段:2015年3月～2016年1月,招募80例在本院接受治疗的癌痛患者,随机分成实验组和对照组。实验组由专科医生和社区医生合作进行院外癌痛管理,对照组由专科医生主导进行院外癌痛管理。第二阶段:2016年3月～2017年6月,招募60例社区癌痛患者,随机分成实验组和对照组。实验组由受训社区医生主导进行癌痛管理,对照组由未受训社区医生主导进行癌痛管理。管理前、管理1个月后,评价两组患者的疼痛程度;管理1个月后,评价两组患者的满意程度;基础培训前、两个阶段研究完成后,评价受训社区医生的癌痛管理能力。结果第一阶段管理前、管理1个月后,两组患者的疼痛程度均无统计学差异[(6.05±1.66) vs (6.15±1.73),(3.53±1.11) vs (3.38±1.03),t=-0.263、0.627,P=0.793、0.533]。第二阶段管理前,两组患者的疼痛程度无统计学差异[(6.13±1.65) vs (6.23±1.71),t=-0.230,P=0.819];管理1个月后,实验组患者的疼痛程度较对照组患者低[(3.80±1.05) vs (4.53±1.36)],差异有统计学意义(t=-2.231,P=0.030)。第一阶段结束后,两组患者的满意程度无统计学差异(Z=-1.138,P=0.255)。第二阶段结束后,实验组患者的满意程度较对照组患者高,差异具有统计学意义(Z=-2.188,P=0.029)。第一阶段结束后,受训社区医生的癌痛管理能力得分较培训前提高[(70.13±8.41) vs (53.06±14.10)],差异具有统计学意义(t=4.496,P=0)。第二阶段结束后,受训社区医生的癌痛管理能力得分较第一阶段结束后进一步提高[(77.06±9.33) vs (70.13±8.41)],差异具有统计学意义(t=4.656,P=0)。结论基于互联网的癌痛管理闭环能更好地进行癌痛管理,能有效提高社区医生的癌痛管理能力。
Objective To construct a closed loop of cancer pain management based on Internet and evaluate its value.Methods Stage 1: From March 2015 to January 2016, 80 patients with cancer pain who were treated in our hospital were enrolled. They were randomly divided into experimental group and control group. The experimental group was given out-of-hospital cancer pain management under the cooperation of specialist doctors and community doctors. The control group was led by specialist doctors for the management of out-of-hospital cancer pain. Stage 2: From March 2016 to June 2017, 60 patients with community cancer pain were enrolled. They were randomly divided into experimental group and control group. The experimental group was led by trained community doctors for cancer pain management. The control group was led by untrained community doctors for cancer pain management. The degree of pain in the two groups of patients was evaluated before management and one month after management; after one month of management, the satisfaction degree of the two groups of patients was evaluated; before the basic training and after the completion of the two stages of the study, the cancer pain management ability of the trained community doctors was evaluated. Results Before the first stage of management and one month after management, there was no statistically significant difference in the pain degree between the two groups of patients[(6.05±1.66) vs(6.15±1.73),(3.53±1.11) vs(3.38±1.03), t=-0.263, 0.627, P=0.793, 0.533]. Before the second stage of management, there was no statistically significant difference in pain degree between the two groups[(6.13±1.65) vs(6.23±1.71), t=-0.230, P=0.819]; after one month of management, the pain degree in the experimental group was lower than that in the control group[(3.80±1.05) vs(4.53±1.36)], and the difference was statistically significant(t=-2.231, P=0.030). After the end of the first stage, there was no statistically significant difference in the satisfaction degree between the two groups(Z=-1.138, P=0.255). After the end of the second stage, the satisfaction degree in the experimental group was higher than that in the control group, and the difference was statistically significant(Z=-2.188, P=0.029). After the end of the first stage, the scores of cancer pain management ability of the trained community doctors were higher than those before training[(70.13 ±8.41) vs(53.06±14.10)], and the difference was statistically significant(t=4.496, P=0). After the end of the second stage, the scores of cancer pain management ability of the trained community doctors were further improved after the end of the first stage[(77.06±9.33) vs(70.13±8.41)], and the difference was statistically significant(t=4.656, P=0). Conclusion The Internetbased closed-loop cancer pain management can better manage cancer pain and effectively improve the cancer pain management ability of community doctors.
Objective To construct a closed loop of cancer pain management based on Internet and evaluate its value.Methods Stage 1: From March 2015 to January 2016, 80 patients with cancer pain who were treated in our hospital were enrolled. They were randomly divided into experimental group and control group. The experimental group was given out-of-hospital cancer pain management under the cooperation of specialist doctors and community doctors. The control group was led by specialist doctors for the management of out-of-hospital cancer pain. Stage 2: From March 2016 to June 2017, 60 patients with community cancer pain were enrolled. They were randomly divided into experimental group and control group. The experimental group was led by trained community doctors for cancer pain management. The control group was led by untrained community doctors for cancer pain management. The degree of pain in the two groups of patients was evaluated before management and one month after management; after one month of management, the satisfaction degree of the two groups of patients was evaluated; before the basic training and after the completion of the two stages of the study, the cancer pain management ability of the trained community doctors was evaluated. Results Before the first stage of management and one month after management, there was no statistically significant difference in the pain degree between the two groups of patients[(6.05±1.66) vs(6.15±1.73),(3.53±1.11) vs(3.38±1.03), t=-0.263, 0.627, P=0.793, 0.533]. Before the second stage of management, there was no statistically significant difference in pain degree between the two groups[(6.13±1.65) vs(6.23±1.71), t=-0.230, P=0.819]; after one month of management, the pain degree in the experimental group was lower than that in the control group[(3.80±1.05) vs(4.53±1.36)], and the difference was statistically significant(t=-2.231, P=0.030). After the end of the first stage, there was no statistically significant difference in the satisfaction degree between the two groups(Z=-1.138, P=0.255). After the end of the second stage, the satisfaction degree in the experimental group was higher than that in the control group, and the difference was statistically significant(Z=-2.188, P=0.029). After the end of the first stage, the scores of cancer pain management ability of the trained community doctors were higher than those before training[(70.13 ±8.41) vs(53.06±14.10)], and the difference was statistically significant(t=4.496, P=0). After the end of the second stage, the scores of cancer pain management ability of the trained community doctors were further improved after the end of the first stage[(77.06±9.33) vs(70.13±8.41)], and the difference was statistically significant(t=4.656, P=0). Conclusion The Internetbased closed-loop cancer pain management can better manage cancer pain and effectively improve the cancer pain management ability of community doctors.
引文
[1]赵丽波,张颖,郭宏伟,等.肺癌生存者在医疗机构-社区医疗服务模式下疼痛治疗的疗效及生活质量研究[J].临床肿瘤学杂志,2013,18(4):335-339.
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[4]朱慧,吴秀琴.社区癌症患者疼痛护理近况及建议[J].上海医药,2016,37(10):39-41.
[5]黄娟娟.基于JCI标准的全髋关节置换术后患者疼痛管理[J].护理学杂志,2016,31(14):37-39.
[6]徐艳,叶启乐,温萍萍,等.中西医结合快速康复技术在消化性溃疡穿孔中的应用效果[J].中华现代护理杂志,2016,22(1):89-94.
[7]周敏捷,周艳艳,许兵,等.合作型培训对提高社区医护骨质疏松症防治能力的影响[J].中国现代医生,2016,54(26):134-136,141.
[8]耿秀双,李巧香.“艾宾浩斯”遗忘曲线在高血压健康教育中的应用[J].中国实用护理杂志,2011,27(2):60-61.
[9]高圆圆,谢波,孙子林,等.医院-社区-患者-志愿者一体化慢病管理新模式的构建研究[J].中国全科医学,2013,16(22):2624-2626.
[10]谢秋燕,李玉琴,吴安琪.QQ群在体检延伸服务中的应用[J].齐鲁护理杂志,2014,20(15):108-109.
[11]顾叶春,叶启乐,许虹波,等.基于网络的综合医院-社区医院合作型胃肠道肿瘤随访的应用研究[J].中华全科医学杂志,2015,13(12):1990-1992,2000.
[12]周艳艳,李若和,陈晓萍,等.基于网络俱乐部的骨质疏松健康教育的实践和效果评价[J].中国现代医生杂志,2015,53(20):128-133,136.
[13]杨丽,陈上,何晓慧,等.基于互联网的医院社区合作型慢病随访医方价值分析[J].护理学杂志,2016,31(1):85-88.
[14]杨晶晶,余雪菲,何晓慧,等.温州市两家医院网络合作随访促进老年慢病患者社区卫生服务利用的研究[J].医学与社会,2016,29(8):82-84.
[15]陈晓萍,许兵,周艳艳,等.移动技术在骨质疏松延续护理中的应用[J].中国医药导报,2015,12(25):160-165.
[16]王新,唐跃中,王海迪.NCCN成人癌痛临床实践指南在社区临终关怀癌痛患者中的应用研究[J].河北医学,2015,20(7):1116-1117.
[17]洪莲.社区护理干预在癌痛治疗的影响[J].中国社区医师(医学专业),2012,14(36):269.
[18]王京娥,兰海燕,邓建华,等.社区癌痛患者规范化综合治疗应用性研究[J].南昌大学学报(医学版),2012,52(12):38-41.
[19]张慧,周广美,赵云鹏,等.连续护理对改善社区慢性癌痛患者睡眠质量的研究[J].护理管理杂志,2014,14(10):693-695.
[20]刘宇,邱峰,罗玲,等.社区癌痛患者药学服务实施及效果评价[J].中国药学杂志,2016,51(21):1890-1894.
[2]李霞,何旖旎,施萍.社区癌性疼痛患者的治疗状况分析[J].中国全科医师杂志,2011,11(3):217-218.
[3]王京娥,黎莹.社区医务人员癌痛治疗相关知识调查[J].实用临床医学,2012,13(2):120-123.
[4]朱慧,吴秀琴.社区癌症患者疼痛护理近况及建议[J].上海医药,2016,37(10):39-41.
[5]黄娟娟.基于JCI标准的全髋关节置换术后患者疼痛管理[J].护理学杂志,2016,31(14):37-39.
[6]徐艳,叶启乐,温萍萍,等.中西医结合快速康复技术在消化性溃疡穿孔中的应用效果[J].中华现代护理杂志,2016,22(1):89-94.
[7]周敏捷,周艳艳,许兵,等.合作型培训对提高社区医护骨质疏松症防治能力的影响[J].中国现代医生,2016,54(26):134-136,141.
[8]耿秀双,李巧香.“艾宾浩斯”遗忘曲线在高血压健康教育中的应用[J].中国实用护理杂志,2011,27(2):60-61.
[9]高圆圆,谢波,孙子林,等.医院-社区-患者-志愿者一体化慢病管理新模式的构建研究[J].中国全科医学,2013,16(22):2624-2626.
[10]谢秋燕,李玉琴,吴安琪.QQ群在体检延伸服务中的应用[J].齐鲁护理杂志,2014,20(15):108-109.
[11]顾叶春,叶启乐,许虹波,等.基于网络的综合医院-社区医院合作型胃肠道肿瘤随访的应用研究[J].中华全科医学杂志,2015,13(12):1990-1992,2000.
[12]周艳艳,李若和,陈晓萍,等.基于网络俱乐部的骨质疏松健康教育的实践和效果评价[J].中国现代医生杂志,2015,53(20):128-133,136.
[13]杨丽,陈上,何晓慧,等.基于互联网的医院社区合作型慢病随访医方价值分析[J].护理学杂志,2016,31(1):85-88.
[14]杨晶晶,余雪菲,何晓慧,等.温州市两家医院网络合作随访促进老年慢病患者社区卫生服务利用的研究[J].医学与社会,2016,29(8):82-84.
[15]陈晓萍,许兵,周艳艳,等.移动技术在骨质疏松延续护理中的应用[J].中国医药导报,2015,12(25):160-165.
[16]王新,唐跃中,王海迪.NCCN成人癌痛临床实践指南在社区临终关怀癌痛患者中的应用研究[J].河北医学,2015,20(7):1116-1117.
[17]洪莲.社区护理干预在癌痛治疗的影响[J].中国社区医师(医学专业),2012,14(36):269.
[18]王京娥,兰海燕,邓建华,等.社区癌痛患者规范化综合治疗应用性研究[J].南昌大学学报(医学版),2012,52(12):38-41.
[19]张慧,周广美,赵云鹏,等.连续护理对改善社区慢性癌痛患者睡眠质量的研究[J].护理管理杂志,2014,14(10):693-695.
[20]刘宇,邱峰,罗玲,等.社区癌痛患者药学服务实施及效果评价[J].中国药学杂志,2016,51(21):1890-1894.