基于某三甲医院肝硬化肝癌患者的生活质量评估及护理要点研究

Evaluation of quality of life and nursing care for patients with hepatic cirrhosis and carcinoma

目的分析肝硬化肝癌患者的生活质量,明确肝硬化肝癌患者的护理要点,为医院开展肝病患者的护理及健康教育工作提供参考依据。方法选择2014年4—6月北京佑安医院肝硬化患者60例,肝癌患者50例为研究对象,采用生活质量评估通用量表和癌症特异性系列量表调查110例肝硬化和肝癌患者的生活质量,并利用Epidata 3.02录入问卷数据,SPSS 20.0分析相关数据,通过非结构式访谈法了解110例患者的生活及患者获得社会和家庭的支持程度。结果 110例患者中,40.0%的患者产生中度以上疼痛或不舒服,43.3%的患者产生中度以上焦虑或抑郁,患者心理问题不容忽视;患者缺乏基本的肝病相关知识,不能进行疾病的自我管理;新型农村合作医疗肝硬化肝癌患者较城镇职工与城镇居民患者得到的社会支持程度低,25例新型农村合作医疗患者中有18例不能得到朋友支持,72例城镇职工与城镇居民患者有3例不能得到朋友支持,差异有统计学意义(P<0.05),而在获得家庭支持及其他方面的支持中,新型农村合作医疗患者与城镇职工城镇居民患者没有差异。结论关注肝硬化肝癌患者特异性病变护理,重视患者的心理护理;开展针对性的患者健康知识教育;关注肝病弱势人群,鼓励患者获取社会支持。

Objective To evaluate the quality of life （QOL） of patients with hepatic cirrhosis and carcinoma, determine the key points of nursing care, and provide a reference for the nursing and health education. Methods Quality of Life Scale and the Functional Assessment of Cancer Therapy Scale were used to survey the QOL among 110 patients（60 cases of hepatic cirrhosis and 50 cases of carcinoma） between April and June in 2014. Epidata 3.02 and SPSS were used to en- try and analyze questionnaire data. The non-structured interviews were used to understand the life condition of patients and the received support from family and social. Results Forty percent of patients were with moderate or severe pain and dis- comfort,43.3% of the patients was with moderate to severe anxiety or depression. Most of the patients were with psycho- logical problems. Lots of patients with liver disease were lack of basic knowledge, and cannot be self-management. The pa- tients in New Rural Co-operative Medical System received less social support as compared with workers and urban resi- dents. 18 of 25 patients with New Rural Co-operative Medical System were not supported by friends ,whole only 3 of 72 ea- ses urban workers and urban residents were not supported by friends, the difference was statistically significant （ P 〈 0.05 ）. However, in family and other supports, there was no significant difference between patients with the New Rural Co- operative Medical System and urban workers and urban residents. Conclusion The nursing care for specific lesions and psychological nursing care for the patients with hepatic cirrhosis and carcinoma should be paid more attentions. The medi- cal facilities should promote the targeted healthy knowledge education for patients, and concern the liver disease group, and encourage them to obtain social support actively.