集束化干预对口腔癌术后患者心理状态及生活质量改善效果的分析
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摘要
目的探讨集束化干预对口腔癌患者术后心理状态和生活质量的改善效果。方法回顾性分析46例接受常规护理干预的口腔癌患者的临床资料(对照组)和50例接受集束化干预的口腔癌患者的临床资料(观察组)。比较两组患者干预后临床症状(失眠、恶心呕吐、疼痛、疲劳、腹泻、便秘、吞咽障碍)的改善情况,并发症(切口感染、皮瓣部坏死、肺部感染、术后创面出血、应激性溃疡)的发生率,观察两组干预前后焦虑评分量表(SAS)评分、抑郁评分量表(SDS)评分及生活质量(躯体功能、角色功能、社会功能、情绪功能)评分的变化。结果观察组患者干预后失眠、恶心呕吐、疼痛、疲劳、腹泻、便秘、吞咽障碍的评分均明显低于对照组患者,差异均有统计学意义(P<0.01)。观察组患者切口感染、皮瓣部坏死、肺部感染、术后创面出血、应激性溃疡的总发生率为10.0%,低于对照组患者的28.3%,差异有统计学意义(P<0.05)。两组患者干预后躯体功能、角色功能、社会功能、情绪功能的评分均高于本组干预前,差异均有统计学意义(P<0.05);干预后,观察组患者的上述各项评分均明显高于对照组患者,差异均有统计学意义(P<0.01)。两组患者干预后的SAS、SDS评分均低于本组干预前,差异均有统计学意义(P<0.05);干预后,观察组患者的SAS、SDS评分均明显低于对照组患者,差异均有统计学意义(P<0.01)。结论给予口腔癌患者术后集束化干预,可以有效地改善患者的临床症状,提高生活质量,降低焦虑、抑郁情绪及并发症的发生率,有利于提高患者对护理工作的满意度,值得临床推广应用。
Objective To explore the effect of cluster intervention on psychological status and quality of life of postoperative patients. Method The clinical data of patients with oral cancer were analyzed retrospectively, including 46 patients receiving routine treatment(control group) and 50 patients receiving cluster intervention(study group). All the issues below were compared between two groups, including the improvement of symptoms(such as insomnia, nausea and vomiting, pain, fatigue, diarrhea and constipation, dysphagia) after intervention, the incidences of complications(such as incision infection, skin flap necrosis, pulmonary infection, postoperative wound bleeding and stress ulcer), and the changes of selfrating anxiety scale(SAS), selfrating depression scale(SDS), somatic function, role function, social function and emotional function score before and after intervention. Result After intervention, the scores of insomnia, nausea and vomiting, pain, fatigue, diarrhea and constipation, dysphagia in the study group were significantly lower than those in the control group(P<0.01). The total incidences of incision infection, skin flap necrosis, pulmonary infection, postoperative wound bleeding and stress ulcer in the study group was 10.0%, which was significantly lower than that in the control group of 28.3%(P<0.05). The scores of somatic function, role function, social function and emotional function after intervention in both groups were all significantly increased compared with those before intervention(P<0.05), and the scores in the study group were significantly higher than those in the control group(P<0.01). After intervention, the scores of SAS and SDS in both groups were lower than those before intervention(P<0.05), and the scores in the study group were significantly lower than those in the control group(P<0.01). Conclusion Cluster intervention for postoperative patients with oral cancer can effectively improve the clinical symptoms, improve the quality of life, reduce anxiety and depression, reduce the incidence of complications, improve the satisfaction, and is worthy of clinical application.
Objective To explore the effect of cluster intervention on psychological status and quality of life of postoperative patients. Method The clinical data of patients with oral cancer were analyzed retrospectively, including 46 patients receiving routine treatment(control group) and 50 patients receiving cluster intervention(study group). All the issues below were compared between two groups, including the improvement of symptoms(such as insomnia, nausea and vomiting, pain, fatigue, diarrhea and constipation, dysphagia) after intervention, the incidences of complications(such as incision infection, skin flap necrosis, pulmonary infection, postoperative wound bleeding and stress ulcer), and the changes of selfrating anxiety scale(SAS), selfrating depression scale(SDS), somatic function, role function, social function and emotional function score before and after intervention. Result After intervention, the scores of insomnia, nausea and vomiting, pain, fatigue, diarrhea and constipation, dysphagia in the study group were significantly lower than those in the control group(P<0.01). The total incidences of incision infection, skin flap necrosis, pulmonary infection, postoperative wound bleeding and stress ulcer in the study group was 10.0%, which was significantly lower than that in the control group of 28.3%(P<0.05). The scores of somatic function, role function, social function and emotional function after intervention in both groups were all significantly increased compared with those before intervention(P<0.05), and the scores in the study group were significantly higher than those in the control group(P<0.01). After intervention, the scores of SAS and SDS in both groups were lower than those before intervention(P<0.05), and the scores in the study group were significantly lower than those in the control group(P<0.01). Conclusion Cluster intervention for postoperative patients with oral cancer can effectively improve the clinical symptoms, improve the quality of life, reduce anxiety and depression, reduce the incidence of complications, improve the satisfaction, and is worthy of clinical application.
引文
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[9]龚梅恩,刘军,苏程,等.症状自评量表焦虑与抑郁分比值对焦虑症和抑郁症诊断价值的探讨[J].中华行为医学与脑科学, 2008, 17(11):993-995.
[10]贲智勤,张雪松,李世东,等.医学生SCL-90量表评定结果分析[J].交通医学, 2007, 21(6):761-762.
[11] Silverman MJ. Effects of a single lyric analysis intervention on withdrawal and craving with inpatients on a detoxification unit:a cluster-randomized effectiveness study[J].Subst Use Misuse, 2016, 51(2):241-249.
[12]肖燕,张沛沛,李文鹿,等.口腔癌患者健康相关生活质量及其影响因素调查[J].口腔医学研究, 2016, 32(5):478-482.
[13] Oppezzo MA, Michalek AK, Delucchi K, et al. Health-related quality of life among veterans in addictions treatment:identifying behavioral targets for future intervention[J]. Qual Life Res, 2016, 25(8):1949-1957.
[14]秦帅华,李新明,李文鹿.修复重建后口腔癌患者生存质量的影响因素分析[J].口腔医学研究, 2018, 34(2):144-147.
[15]孙慧,林红,吴荣华,等.集束化干预策略控制患者结直肠术后SSI的效果与效益分析[J].中华医院感染学杂志,2018, 20(13):541-548.
[16]李婷,孙洪巧,王萍,等.集束化护理对改善风湿性心脏病患者睡眠障碍及心理状态的临床效果研究[J].国际精神病学杂志, 2017, 18(3):556-559.
[2]潘旭.护理干预在口腔癌手术患者中的效果评价及患者家属心理健康状况调查[J].实用临床护理学电子杂志,2017, 2(15):23-29.
[3] Boogaard JA, de Vet HC, van Soest-Poortvliet MC, et al. Effects of two feedback interventions on end-of-life outcomes in nursing home residents with dementia:a cluster-randomized controlled three-armed trial[J]. Palliat Med, 2018, 32(3):693-702.
[4]梁煜程,陈纯柳,徐彬妮.改良口腔护理法联合漱口液漱口在口腔癌术后患者中的应用[J].广东医学, 2016, 37(s2):264-265.
[5] Sussman J, Bainbridge D, Whelan TJ, et al. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery:a cluster randomized trial[J]. Support Care Cancer, 2018, 26(5):1533-1541.
[6]张丽琼.全程口腔护理在口腔癌患者围手术期的应用[G]//上海市护理学会.第二届上海国际护理大会论文摘要汇编.上海:上海市护理学会, 2014:1.
[7]张国志,范妮娜,王秀莲.视觉模拟评分评价微波治疗骨转移癌痛的疗效[J].中国临床康复, 2003, 7(8):1353.
[8]刘福安,于世英.癌症患者生活质量评估量表QLQ-52的设计及质量评价[J].临床肿瘤学杂志, 2005, 10(3):235-239.
[9]龚梅恩,刘军,苏程,等.症状自评量表焦虑与抑郁分比值对焦虑症和抑郁症诊断价值的探讨[J].中华行为医学与脑科学, 2008, 17(11):993-995.
[10]贲智勤,张雪松,李世东,等.医学生SCL-90量表评定结果分析[J].交通医学, 2007, 21(6):761-762.
[11] Silverman MJ. Effects of a single lyric analysis intervention on withdrawal and craving with inpatients on a detoxification unit:a cluster-randomized effectiveness study[J].Subst Use Misuse, 2016, 51(2):241-249.
[12]肖燕,张沛沛,李文鹿,等.口腔癌患者健康相关生活质量及其影响因素调查[J].口腔医学研究, 2016, 32(5):478-482.
[13] Oppezzo MA, Michalek AK, Delucchi K, et al. Health-related quality of life among veterans in addictions treatment:identifying behavioral targets for future intervention[J]. Qual Life Res, 2016, 25(8):1949-1957.
[14]秦帅华,李新明,李文鹿.修复重建后口腔癌患者生存质量的影响因素分析[J].口腔医学研究, 2018, 34(2):144-147.
[15]孙慧,林红,吴荣华,等.集束化干预策略控制患者结直肠术后SSI的效果与效益分析[J].中华医院感染学杂志,2018, 20(13):541-548.
[16]李婷,孙洪巧,王萍,等.集束化护理对改善风湿性心脏病患者睡眠障碍及心理状态的临床效果研究[J].国际精神病学杂志, 2017, 18(3):556-559.