肺癌术后化疗患者多团队协同按需延续护理研究
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摘要
目的探索基于需求导向的延续性护理干预对肺癌术后化疗患者生活质量及疲乏的影响。方法运用德尔菲法编制患者院外护理需求量表评估需求内容,将符合标准的76例患者随机分为观察组和对照组各38例。对照组按照常规护理,观察组根据院外护理需求实施延续性护理干预,分别在干预后3个月、6个月末使用肺癌治疗功能评定量表,癌症疲乏量表评估两组患者生活质量和疲乏状况。结果干预后3个月末,观察组肺癌特异性、生活质量总分得分显著高于对照组(均P<0.01);干预后6个月末,观察组社会/家庭、情感、生活质量总分得分显著高于对照组(均P<0.01),情感疲乏、认知疲乏、疲乏总分得分低于对照组(均P<0.01)。结论基于肺癌术后化疗患者延续性护理需求研究,采用延续性干预可提高肺癌术后化疗患者生活质量,并一定程度减轻患者癌因性疲乏。
Objective To explore the effect of demands-directed, multidisciplinary team based transitional care on quality of life and fatigue level of lung cancer patients receiving post-operative chemotherapy.Methods A nursing service demand scale for discharged patients was compiled, and the service contents were evaluated with the Delphi method.A total of 76 patients who met the inclusion standards were randomly and evenly divided into 2 groups.The control group received routine post-discharge nursing care, while the intervention group received interventions based on the their service demands.After 3 and 6 months, patients′ quality of life and fatigue levels were measured using the Functional Assessment of Cancer Therapy-Lung(FACT-L) and Cancer Fatigue Scale.Results After 3 months′ intervention, the lung cancer specificity score and the total score of quality of life in the intervention group were significantly higher than those in the control group(P<0.01 for both).After 6 months′ intervention, the social/family well-being scores,emotional well-being scores and the total score of quality of life in the intervention group were significantly higher than the controls(P<0.01), while scores of emotional fatigue, cognitive fatigue and the total score of cancerfatigue in the intervention group were lower than those in the control group(P<0.01).Conclusion Based on the survey into service demands of lung cancer patients receiving post-operative chemotherapy, continuous nursing intervention could improve patients′ quality of life and lessen cancer-related fatigue level.
Objective To explore the effect of demands-directed, multidisciplinary team based transitional care on quality of life and fatigue level of lung cancer patients receiving post-operative chemotherapy.Methods A nursing service demand scale for discharged patients was compiled, and the service contents were evaluated with the Delphi method.A total of 76 patients who met the inclusion standards were randomly and evenly divided into 2 groups.The control group received routine post-discharge nursing care, while the intervention group received interventions based on the their service demands.After 3 and 6 months, patients′ quality of life and fatigue levels were measured using the Functional Assessment of Cancer Therapy-Lung(FACT-L) and Cancer Fatigue Scale.Results After 3 months′ intervention, the lung cancer specificity score and the total score of quality of life in the intervention group were significantly higher than those in the control group(P<0.01 for both).After 6 months′ intervention, the social/family well-being scores,emotional well-being scores and the total score of quality of life in the intervention group were significantly higher than the controls(P<0.01), while scores of emotional fatigue, cognitive fatigue and the total score of cancerfatigue in the intervention group were lower than those in the control group(P<0.01).Conclusion Based on the survey into service demands of lung cancer patients receiving post-operative chemotherapy, continuous nursing intervention could improve patients′ quality of life and lessen cancer-related fatigue level.
引文
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[11] 王红爱,曹枫林,李洁.肺癌患者积极心理品质、社会支持与生活质量的关系研究[J].护理学杂志,2015,30(17):23-25.
[12] 王丹丹,付菊芳,房宁宁.肺癌患者的症状群及其与生活质量的相关性[J].护理学杂志,2012,27(23):5-8.
[13] 周喜春,王蕊娥,奚力,等.延续性护理对肺癌根治术后癌性疲乏与生活质量的影响研究[J].现代中西医结合杂志,2016,25(9):1016-1018.
[14] 王苗,李益民,汤阿毛.多模式延续性护理对晚期肺癌化疗患者生活质量的影响[J].护理与康复,2018,17(7):47-50.
[15] 沈慧敏,鲁继斌.延续性护理对非小细胞肺癌化疗患者近期复发及生存质量的影响[J].中国医药导报,2017,14(28):166-169.
[16] Zhang L L, Wang S Z, Chen H L, et al.Tai chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy: a randomized controlled trial[J].J Pain Symptom Manage,2016,51(3):504-511.
[17] 郑爱波,赵爱青,吴沛霞.步行锻炼缓解肝癌患者癌因性疲乏的效果[J].解放军护理杂志,2013,30(8):72-74.
[18] 田利,胡雁.2017版NCCN癌因性疲乏临床实践指南要点解读[J].上海护理,2017,17(1):9-13.
[2] 谭雪敏,王卫,张莉华,等.护理干预对乳腺癌患者癌性疲乏与生活质量的影响[J].中国医药导报,2011,8(36):106-108.
[3] 刘吉福,武珊珊.非小细胞肺癌切除术后化疗的选择及价值[J].肿瘤防治研究,2011,38(5):601-603.
[4] Chow S K Y, Wang F K Y, Chan T, et al.Community nursing services for postdischarge chronically ill patients[J].J Clin Nurs,2008,17(7):260-271.
[5] 缪静波,钱珠萍.晚期肺癌患者居家健康需求及护理干预研究[J].临床肺科杂志,2011,16(6):980-981.
[6] Denise F, Polit, Bernadette P.Hungler.Nursing Research Principles and Methods[M].6th ed.New York:Lippincott Philadelphia, sixth Edition:1999:491-492.
[7] 张如娣,韩迎慧,曹琳.延伸护理对乳腺癌患者癌性疲乏和生存质量改善的作用[J].江西医药,2013,39(12):1486-1487.
[8] 万崇华,张灿珍,宋元龙.肺癌患者生命质量测定研究概况[J].中国肿瘤,2001,10(2):83-85.
[9] Okuyama T, Akechi T, Kugaya A, etal. Development and validation of the Cancer Fatigue Scale:a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients[J].J Pain Symptom Manage,2000,19(1):5-14.
[10] Heyddrnejad M S, Hassanpour D A, Solati D K.Factors affecting quality of life in cancer patients undergoing chemotherapy[J].Afr Health Sci,2011,11(1):266-270.
[11] 王红爱,曹枫林,李洁.肺癌患者积极心理品质、社会支持与生活质量的关系研究[J].护理学杂志,2015,30(17):23-25.
[12] 王丹丹,付菊芳,房宁宁.肺癌患者的症状群及其与生活质量的相关性[J].护理学杂志,2012,27(23):5-8.
[13] 周喜春,王蕊娥,奚力,等.延续性护理对肺癌根治术后癌性疲乏与生活质量的影响研究[J].现代中西医结合杂志,2016,25(9):1016-1018.
[14] 王苗,李益民,汤阿毛.多模式延续性护理对晚期肺癌化疗患者生活质量的影响[J].护理与康复,2018,17(7):47-50.
[15] 沈慧敏,鲁继斌.延续性护理对非小细胞肺癌化疗患者近期复发及生存质量的影响[J].中国医药导报,2017,14(28):166-169.
[16] Zhang L L, Wang S Z, Chen H L, et al.Tai chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy: a randomized controlled trial[J].J Pain Symptom Manage,2016,51(3):504-511.
[17] 郑爱波,赵爱青,吴沛霞.步行锻炼缓解肝癌患者癌因性疲乏的效果[J].解放军护理杂志,2013,30(8):72-74.
[18] 田利,胡雁.2017版NCCN癌因性疲乏临床实践指南要点解读[J].上海护理,2017,17(1):9-13.