以家庭为中心的预立医疗照护计划在肿瘤终末期患者中的应用研究

Application of family-centered Advance Care Planning in patients with terminal cancer

目的:分析以家庭为中的预立医疗照护计划对肿瘤终末期患者尊严、生命质量及死亡质量的影响。方法:将入住肿瘤科的88例肿瘤终末期患者随机分为实验组(n=43)和对照组(n=45),对照组实施肿瘤常规照护,实验组在对照组的基础上实施以家庭为中心的预立医疗照护计划,采用重复测量方差分析比较干预前、干预1个月、干预2个月时两组患者的生命质量及尊严水平;采用t检验对干预后两组患者优逝的10个核心因子及总分进行比较。结果:两组的生命质量和尊严得分的组间效应、时间效应和交互效应均具有统计学意义(P<0.05);干预后两组优逝的10个核心因子得分及总分比较差异具有统计学意义(P<0.05)。结论:以家庭为中心的预立医疗照护计划有效提升了肿瘤终末期患者的尊严水平,改善其生命质量和死亡质量。

Objective:To investigate the effect of family-based Advance Care Planning on dignity,quality of life and quality of death of patients with terminal cancer.Methods:Totally 88 end-stage tumor patients were randomly divided into the experimental group(n=43)and the control group(n=45).Routine care was offered to patients of the control group while patients in the experimental group received family-centered Advance Care Planning on the basis of routine care.Repeated measurement analysis of variance was used to compare the quality of life and dignity of the two groups before intervention,one month after intervention and two months after intervention.Besides,T-test was used to compare the 10 core factors and total scores of optimal death in the two groups of patients after intervention.Results:The between-group effect,time effect and interaction effect of the difference of life quality and dignity scores between the two groups were statistically significant(P<0.05).After intervention,statistically significant differences were observed when comparing the 10 core factors and total scores between the two groups(P<0.05).Conclusion:The family-centered Advance Care Planning can effectively enhance the dignity level of patients with terminal cancer and improve their quality of life as well as the quality of death.