健康教育模式在全胃切除术后患者院外生活质量改善中的意义

Health education improves quality of life outside the hospital in patients after total gastrectomy

目的:本研究旨在探究健康教育模式在全胃切除术后患者院外生活质量改善中的意义.方法:选取2013-04/2014-04于承德医学院附属医院诊断为胃癌并进行全胃切除手术的患者100例进行前瞻性临床研究,随机分为研究组和对照组,每组50例.研究组采用延续性健康教育模式进行院外护理,而对照组采取常规护理,并记录两组患者生活质量评分以及血液生化检查.两组患者在年龄、性别、肿瘤分期(TNM分期)及心血管、呼吸道疾病等方面均无统计学差异(P>0.05),具有可比性.结果:两组患者术后1 mo时躯体功能、角色功能、情绪功能、认知功能、社会功能以及不良症状和总体健康水平等方面相比无明显差异(t=0.829,0.227,0.446,0.357,0.295,1.223,1.112,1.287,0.111,0.329,1.980,0.229,0.723,0.567,均P>0.05).而在术后3 mo后,研究组的躯体功能等生活质量较对照组均明显升高,在不良症状以及总健康水平方面,研究组均优于对照组,差异具有统计学意义(t=2.345,2.172,2.118,1.978,1.885,2.547,3.779,1.569,2.509,2.160,2.980,2.511,2.151,均P<0.05).在术后3mo时,研究组患者的体质量、总蛋白及白蛋白等均有所升高,其差值变化优于对照组,差异具有统计学意义(t=2.673,3.547,3.981,均P<0.05),而血液血红蛋白值在两组患者中无明显差异(t=0.045,P>0.05).结论:延续性健康教育可有效提高患者院外生活质量和患者自身内环境,值得广泛推广.

AIM： To explore the significance of health educa-tion in the patients outside the hospital to im-prove the quality of life after total gastrectomy.METHODS： One hundred patients who were diagnosed with gastric cancer and underwent total gastrectomy at our hospital between April 2013 and April 2014 were randomly di-vided into either a study group or a control group,with 50 patients in each group.The study group was given continued health edu-cation outside the hospital,while the control group received routine care.The quality of life score and blood tests of the two groups were recorded.RESULTS： There were no significant differences in age,gender,tumor stage（TNM stage） andcardiovascular or respiratory diseases between the two groups（P〉0.05）.There were also no significant differences between the two groups in physical function,role function,emotional function,cognitive function,social function,negative symptoms and other aspects one month after surgery（t = 0.829,0.227,0.446,0.357,0.295,1.223,1.112,1.287,0.111,0.329,1.980,0.229,0.723,0.567,P〉0.05）.However,three months after surgery,the physical features,such as quality of life,were significantly improved in the study group compared with the control group.The levels of negative symptoms in terms of overall health were also significantly better in the study group than in the control group（t = 2.345,2.172,2.118,1.978,1.885,2.547,3.779,1.569,2.509,2.160,2.980,2.511,2.151,P〈0.05）.After three months,the weight,total protein and albumin were sig-nificantly better in the study group than in the control group（t = 2.673,3.547,3.981; P〈0.05）,although blood hemoglobin showed no signifi-cant difference（t = 0.045,P〉0.05） between the two groups.CONCLUSION： Continued health education can improve the quality of life outside the hos-pital in patients after total gastrectomy.